Sudden onset fatigue (SOF) in patients with breast cancer: Characteristics and symptomatology

Abstract

e20637 Background: Cancer-related fatigue is underrecognized and poorly managed. Unpredictability and rapid onset in fatigue is stressed by cancer patients but seldom addressed by health care professionals. Although sudden onset of cancer-related fatigue is anecdotally documented across qualitative studies, the symptom has never been systematically investigated. Our purpose is to describe the symptom and clinical characteristics of SOF in breast cancer patients receiving chemotherapy. Methods: This is a cross-sectional descriptive study enrolling female breast cancer outpatients undergoing chemotherapy in an urban cancer center. A brief questionnaire assessing the symptom characteristics of SOF was completed by subjects. Comprehensive metabolic panel and complete blood counts, were obtained. Descriptive statistics described the symptom characteristics of SOF. Mann-Whitney tests examined the differences between those who did and did not experience SOF. Results: Thirty patients have been enrolled. Median age 53 years (31 to 65; SD=7.7), 60% were Black. 80% (n=24) experienced SOF in the past 7 days with a median of 4 days a week and 2.5 episodes per day. SOF was most likely (75%) to occur in the afternoon while patients were engaging in activities. Levels of fatigue before, during, and after a specific episode of SOF were 5, 9, and 5, respectively, on 0–10 (highest) rating scale. Weakness, sweating, or pain sometimes accompanied SOF. When SOF occurred, individuals immediately needed to stop activities to rest until it went away. Those who experienced SOF had significantly lower levels of calcium (Median=8.9 vs. 9.4), albumin (Median=3.7 vs. 7.1), and hematocrit (Median=32.1 vs. 36) (p<0.05). Those who experienced SOF also had higher levels of GPT (Median=25.5 vs. 17), lower levels of total protein (Median=6.7 vs. 7.1), WBC (Median=4.9 vs. 8.9), RBC (Median=3.4 vs. 3.9), and hemoglobin (Median=10.7 vs. 11.4). Conclusions: Our ongoing study is one of the first to identify the characteristics of patients at high risk of SOF. SOF needs to be recognized and managed when patients undergo chemotherapy. Associated conditions should be identified and addressed. The ultimate goal is to minimize the distress and improve the quality of life of patients receiving chemotherapy. No significant financial relationships to disclose.