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Fatigue in patients on oral targeted or chemotherapy for cancer and associations with anxiety, depression, and quality of life

Published online by Cambridge University Press:  19 September 2019

Hanneke Poort Open the ORCID record for Hanneke Poort [Opens in a new window] ,
Jamie M. Jacobs ,
William F. Pirl ,
Jennifer S. Temel  and
Joseph A. Greer
Hanneke Poort
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Jamie M. Jacobs
Affiliation:
Massachusetts General Hospital Cancer Center, Boston, MA
William F. Pirl
Affiliation:
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
Jennifer S. Temel
Affiliation:
Massachusetts General Hospital Cancer Center, Boston, MA
Joseph A. Greer*
Affiliation:
Massachusetts General Hospital Cancer Center, Boston, MA
*
Author for correspondence: Dr. Joseph Greer, Massachusetts General Hospital Cancer Center & Harvard Medical School, Yawkey Center, Suite 10B, 55 Fruit Street, Boston, MA02114. E-mail: jgreer2@mgh.harvard.edu
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Abstract

Objectives

Oral treatment (targeted or chemotherapy) for cancer is being increasingly used. While fatigue is a known side effect of intravenous chemotherapy, the rate of fatigue and the impact of fatigue on other patient-reported outcomes are not well described.

Method

At Massachusetts General Hospital Cancer Center, 180 adult patients prescribed oral targeted or chemotherapy for various malignancies enrolled in a randomized controlled trial of adherence and symptom management. Patients completed baseline self-reported measures of fatigue (Brief Fatigue Inventory; BFI), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale; HADS), and quality of life, including subscales for physical, social, emotional, and functional well-being ([QOL] Functional Assessment of Cancer Therapy — General; FACT-G). We examined clinically relevant fatigue using a validated cut-off score for moderate-severe fatigue (BFI global fatigue ≥4) and tested the associations with anxiety symptoms, depressive symptoms, and QOL with independent samples t-tests.

Results

At baseline, 45 of 180 participants (25.0%) reported moderate-severe fatigue. Fatigued patients experienced more anxiety symptoms (mean diff. 3.73, P < 0.001), more depressive symptoms (mean diff. 4.14, P < 0.001), and worse QOL on the total FACT-G score (mean diff. −19.58, P < 0.001) and all subscales of the FACT-G compared to patients without moderate-severe fatigue.

Significance of results

One in four patients on oral treatment for cancer experienced clinically relevant fatigue that is associated with greater anxiety and depressive symptoms and worse QOL.

Keywords

CancerFatigueOral chemotherapyQuality of lifeTargeted therapy
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 2 , April 2020 , pp. 141 - 147
Copyright
Copyright © Cambridge University Press 2019

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