Cancer-related fatigue: Inevitable, unimportant and untreatable? Results of a multi-centre patient survey

Objectives: To investigate cancer patients' experience of fatigue and their perceptions about the causes, management and impact of this symptom. Design: Cross-sectional, questionnaire-based survey. Settings: Three regional cancer centres; Glasgow, Birmingham and Southampto n. Participants: One thousand three hundred seven outpatients with cancer atte nding the three units over a 30-day period. Main outcome measures: Investigator designed questionnaire and the fatigue sub-scale of the Functional Assessment of Cancer Therapy - Fatigue (FACT-F) questionnaire. Results: The response rate was 576 of 1307 (44%). Fatigue was reported to a ffect 58% of patients 'somewhat or very much'. The comparable figures for p ain and nausea/vomiting were 22% and 18%, respectively. Fatigue had never b een reported to the hospital doctor by 52% (281 of 538) of patients with th is symptom. Only 75 patients (14%) had received treatment or advice about t he management of their fatigue. Fatigue was reported to be not well-managed by 33% (180 of 538) of patients with this symptom. The comparable figures for pain and nausea/vomiting were 9% (46 of 538) and 7% (37 of 538), respec tively. The median FACT-F score was 18 (range 0-52). On multivariate analys is 54% of the variation in FACT-F scores could be explained by the combinat ion of quality of life, depression, dyspnoea, weight loss/anorexia and use of analgesics in the previous month. Conclusions: Fatigue has been identified as an important problem by patient s with cancer. It affects more patients for more of the time than any other symptom and is regarded by patients as being more important than either pa in or nausea/vomiting. Research into the aetiology and management of this s ymptom should be regarded as a priority.