FATIGUE IN CANCER-PATIENTS

In this paper an overview is presented on what is currently known of f atigue in cancer. Fatigue is considered to be a multi-dimensional conc ept. that should be measured as such. However, fatigue has been assess ed mostly by single items in general symptom checklists. The few speci fic instruments that have been used in cancer patient populations are discussed. The majority of cancer patients, about 70%, report feelings of fatigue during radio- or chemotherapy. Follow-up results show that , at least for some diagnoses, patients remain fatigued long after tre atment has ended. Somatic and psychological mechanisms that have been proposed to explain fatigue are discussed. It is argued that the signi ficance of the results obtained on fatigue as a sympton in cancer depe nds on comparison with other patient and non-patient populations. Also the occurrence of a response-shift has to be considered, leading to u nder reporting of fatigue. Finally, possible interventions to decrease feelings of fatigue are presented.