Patient Education on Cancer Fatigue Lacking

A study presented at the recent European Cancer Conference (ECCO 11) in Lisbon, Portugal bemoaned the inadequacy of patient education about cancer-related fatigue. Agnes Glaus, RN of The Center for Tumor Diagnosis and Prevention in St. Gallen, Switzerland, said that this aspect of patient care is all-too-often not a priority for many healthcare professionals.

Glaus and her colleagues based their conclusion on a series of focus group sessions with cancer patients who were experiencing fatigue from their disease and its treatment. A questionnaire was also distributed to oncology nurses to elicit their views.

Glaus' team found that both the patients and nurses felt that current educational efforts about cancer-related fatigue were inadequate. However, the nurses believed that more technological resources were needed to educate patients about fatigue.

"The real challenge for nurses is to grasp all the technological advances in specific fields, bring them to the patients, guide them through the process of information taking and decision making-and yet still keep the human face of nursing," she told attendees.

While Glaus' research focused on the relationship between nurses and their cancer patients, she noted that the same burden of patient education rests on all medical professionals.

Studies have shown that general fatigue, including fatigue caused by anemia, affects more than three-quarters of patients undergoing cancer treatment. It can include feeling tired, weak, exhausted, slow, or simply lethargic.

A recent telephone survey published in the Proceedings of the American Society of Clinical Oncology examined how fatigue impacts the quality of life of cancer patients. The survey included 406 cancer patients, slightly more than half (53 percent) of them had chemotherapy alone, with the balance undergoing both chemotherapy and radiation.

When asked what side effects they experienced during treatment, 76 percent of the patients indicated fatigue as the most common symptom-more than nausea (54 percent), depression (23 percent), or pain (20 percent).

More than half of the patients (54 percent) also ranked fatigue as the longest-lasting side effect, ahead of nausea (27 percent), depression (12 percent), and pain (6 percent). In terms of side effects that affected their everyday activities, 60 percent of the patients again ranked fatigue as the most common symptom, well ahead of the next most debilitating symptom, nausea (22 percent).

In fact, 90% of the patients reported that fatigue had either a "significant impact" or "somewhat of an impact" on nearly every aspect of daily living, resulting in lower energy levels, insomnia, and even impaired thinking.

Fatigue also had economic consequences. Patients reported many work-related difficulties that were directly attributable to fatigue, including change of employment status (71 percent), missing one or more days of work (71 percent), being forced to reduce work-related responsibilities (35 percent), and even discontinuing work altogether (28 percent).

SOURCES:
The 11th Annual European Cancer Conference (ECCO 11), October 2001, Lisbon, Portugal
Proceedings of the American Society of Clinical Oncology, 1999; 18:573A

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