Cancer-Related Fatigue: A Holistic View

Assessing fatigue and self-care strategies in patients receiving radiotherapy for non-small cell lung cancer

Lung cancer represents a major public health problem worldwide (ISD 2000) with approximately 80% of patients presenting with locally advanced or metastatic disease. Treatment is essentially palliative; therefore, symptom management is important. This paper describes the findings from a prospective study of fatigue in newly diagnosed patients with non-small cell lung cancer. Fifty-three patients undergoing radical or high-dose palliative radiotherapy for Stage I, II and III disease were recruited to the study. Patients completed a structured health diary throughout radiotherapy and for up to 1 month post-treatment. Tape-recorded interviews were conducted with a sub-sample (n=11) to explore the nature of fatigue. Complete data sets were available on 46 patients. Consistent with current literature, the study findings demonstrated the progressive nature of this symptom throughout treatment; however, the levels of distress reported and interference with daily living were not found to be as overwhelming in this group of patients as the literature thus far suggests.

Assessment and management of fatigue in patients with advanced cancer: developing guidelines

Cancer-related fatigue is one of the most important untreated symptoms of cancer, with a prevalence between 60 and 100%, but there has been a reluctance to prioritize fatigue and develop effective management strategies. The development of standards and guidelines will encourage a more systematic approach and help to stimulate further research. The Mersey Palliative Care Audit Group has developed guidelines for the assessment and management of fatigue. These guidelines were produced following a regional survey, which looked at both the educational needs of nurses, and the impact of fatigue on patients with advanced cancer.

Dimensions of fatigue during radiotherapy--an application of the Swedish Occupational Fatigue Inventory (SOFI) on cancer patients

The aims of this study were primarily to evaluate the applicability of the Swedish Occupational Fatigue Inventory (SOFI) on cancer patients, secondly to describe the development of fatigue in patients, receiving full dose radiotherapy with a curative intent. A questionnaire was completed by 81 cancer patients at four occasions; before treatment. during the last week of treatment. 1 and 3 months, respectively, after treatment. The fatigue increased significantly at the end of treatment, as compared to pretreatment, and decreased after treatment. The highest fatigue ratings concerned lack of energy, lack of motivation and sleepiness. The five SOFI-dimensions explained more than half of the variance in the overall rating of fatigue, and the internal consistency of the dimensions were good. However, the ratings were on the lower part of the scale and the dimensions correlated more than expected. Thus, the relevance of the SOFI for use also among patients is only partially supported, and studies with larger samples are needed for further testing of the inventory.