Symptoms experienced by fatigued patients receiving chemotherapy for cancer: A URCC CCOP study

Abstract

8092 Background: Fatigue is reported by 80–100% of patients undergoing cancer chemotherapy. Patients were queried about specific fatigue symptoms. Methods: 389 cancer patients who reported fatigue on a 10 cm. Visual Analogue Scale (VAS) (1 = ‘Not at all’ and 10 = ‘A great deal.’) during chemotherapy completed the Fatigue Symptom Checklist (FSCL) 5–7 days following their first 4 cycles. The FSCL measures the severity of 30 symptoms on a 5 point scale headed “At the moment I feel:” (1 = ‘absence of [the symptom]’ and 5 = ‘a great deal.’) Three subscales of 10 items each, (drowsiness, concentration, physical symptoms) and a total score were calculated. Results: The most common cancers were breast (56%), hematologic (13%), lung (12%), gynecologic (8%) and alimentary (6%). 76% were female and 73% of women had breast cancer. The average age was 54 for females and 61 for males. 90% were Caucasian and 6% African American. Division of patients into two groups based on the VAS fatigue score at each cycle, (2–5 = ‘less fatigued,’ and 6–10 = ‘more fatigued’) showed significant differences between total and subscale scores by degree of fatigue (all Ps < 0.001). “Feeling tired over my whole body”, “Tired in my legs”, and “Want to lie down” from the drowsiness subscale were the most severe symptoms in both groups. More fatigued patients felt these symptoms “a moderate amount” (e.g. cycle means for “tired over my whole body” were 3.1, 3.4, 3.2, and 3.1), while those who were less fatigued felt them “a little” (cycle means = 1.8, 2.3, 1.9, and 1.9). Drowsiness was the next most severe symptom. Cognitive impairment and physical symptoms were less severe. There were no significant differences in scores by gender or age group, divided at the median age of 55. Patients with lung cancer reported the most severe symptoms at all four cycles, and those with cancers of the alimentary tract reported the least severe symptoms. Conclusions: Weakness and drowsiness most often characterize the fatigue experienced by patients receiving chemotherapy, suggesting that interventions to increase stamina and improve sleep quality may be beneficial. Supported, in part, by NCI PHS grant U10 CA37420 and by ACS grant RSG-01-071-PBP No significant financial relationships to disclose.