Prevalence and Causes of Fatigue After Cancer Treatment: The Next Generation of Research

Abstract

The presence of fatigue in cancer patients is now well documented. Fatigue is recognized as the most common and distressing side effect of cancer treatment, occurring among patients undergoing radiation, chemotherapy, and treatment with biologic response modifiers. Furthermore, there is evidence that fatigue may persist for months or years after completion of successful treatment in a substantial minority of patients. Qualitative reports indicate that cancer-related fatigue differs from normal fatigue related to lack of rest or overexertion as it involves more severe and enduring mental, physical, and emotional domains. As such, cancer-related fatigue has a particularly detrimental effect on quality of life. Although research on cancer-related fatigue has become increasingly sophisticated, few longitudinal studies have been conducted that assess patients before and after treatment completion. Clearly, knowledge of a patient’s status before treatment onset (and ideally, during treatment) is critical for an accurate understanding of posttreatment fatigue. The study by Nieboer et al in this issue of the Journal of Clinical Oncology represents an important advance in this literature in its evaluation of breast cancer patients before and at yearly intervals after randomization to treatment with standardor high-dose chemotherapy. The study is also notable for the size of the sample (N 430) and the number of post-treatment assessments. The key findings from the study are as follows.…