Skip to main content
Top
Published in: Supportive Care in Cancer 1/2013

01-01-2013 | Original Article

Appropriateness of the treatment of fatigued patients with stage IV cancer

Authors: Andrea L. Cheville, Tiffany Shen, Megan Chang, Jeffrey R. Basford

Published in: Supportive Care in Cancer | Issue 1/2013

Login to get access

Abstract

Background

Fatigue among patients with cancer is prevalent, disabling, and treatable. While fatigue management guidelines have been in place for a decade, their use remains unclear.

Methods

We surveyed 160 patients with stage IV lung (40), breast (40), colon (40), and prostate (40) cancer who reported moderate to severe fatigue (i.e., >5 of 10 on an 11-point numerical rating scale). Participants were queried about receipt of treatments in fatigue management domains emphasized in the National Comprehensive Cancer Network guidelines: general management strategies, activity enhancement, psychosocial strategies, and pharmaceuticals.

Results

The cohort was half male, had a mean age of 67, and reported an average fatigue rating of 6.4. Participants reported treatment or receipt of specific guidance in the fatigue management domains as follows: general management strategies 16.8 %, activity enhancement 11.9 %, psychosocial strategies 9.9 %, and pharmaceuticals 37.3 %. Fatigue >7 of 10 increased the likelihood of instruction in activity enhancement but no other domain.

Conclusion

The low rates of guideline-congruent treatment reported here are concerning, particularly as better validated behavioral treatments were the least prescribed.
Literature
1.
go back to reference Luciani A, Jacobsen PB, Extermann M, Foa P, Marussi D, Overcash JA, Balducci L (2008) Fatigue and functional dependence in older cancer patients. Am J Clin Oncol 31(5):424–430PubMedCrossRef Luciani A, Jacobsen PB, Extermann M, Foa P, Marussi D, Overcash JA, Balducci L (2008) Fatigue and functional dependence in older cancer patients. Am J Clin Oncol 31(5):424–430PubMedCrossRef
2.
go back to reference Curt GA (2000) Impact of fatigue on quality of life in oncology patients. Semin Hematol 37(4 Suppl 6):14–17PubMedCrossRef Curt GA (2000) Impact of fatigue on quality of life in oncology patients. Semin Hematol 37(4 Suppl 6):14–17PubMedCrossRef
3.
go back to reference Cheville AL, Novotny P, Sloan JA, Basford JR, Wampfler J, Garces YI, Jatoi A, Yang P (2010) The value of concurrent symptoms in predicting clinical outcomes in lung cancer survivors. J Clin Oncol 28(No 15_suppl):6110 Cheville AL, Novotny P, Sloan JA, Basford JR, Wampfler J, Garces YI, Jatoi A, Yang P (2010) The value of concurrent symptoms in predicting clinical outcomes in lung cancer survivors. J Clin Oncol 28(No 15_suppl):6110
4.
go back to reference Kurtz ME, Kurtz JC, Given CW, Given B (2006) Predictors of use of health care services among elderly lung cancer patients: the first year after diagnosis. Support Care Cancer 14(3):243–250PubMedCrossRef Kurtz ME, Kurtz JC, Given CW, Given B (2006) Predictors of use of health care services among elderly lung cancer patients: the first year after diagnosis. Support Care Cancer 14(3):243–250PubMedCrossRef
5.
go back to reference Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van der Lelie J, de Reijke TM, Kammeijer M, de Haes JC, Sprangers MA (2003) Cancer, fatigue and the return of patients to work—a prospective cohort study. Eur J Cancer 39(11):1562–1567PubMedCrossRef Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van der Lelie J, de Reijke TM, Kammeijer M, de Haes JC, Sprangers MA (2003) Cancer, fatigue and the return of patients to work—a prospective cohort study. Eur J Cancer 39(11):1562–1567PubMedCrossRef
6.
go back to reference Barsevick AM, Dudley W, Beck S, Sweeney C, Whitmer K, Nail L (2004) A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer 100(6):1302–1310PubMedCrossRef Barsevick AM, Dudley W, Beck S, Sweeney C, Whitmer K, Nail L (2004) A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer 100(6):1302–1310PubMedCrossRef
7.
go back to reference Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME (2009) Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 27(3):344–351PubMedCrossRef Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME (2009) Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 27(3):344–351PubMedCrossRef
8.
go back to reference Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH (2005) Home-based physical activity intervention for breast cancer patients. J Clin Oncol 23(15):3577–3587PubMedCrossRef Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH (2005) Home-based physical activity intervention for breast cancer patients. J Clin Oncol 23(15):3577–3587PubMedCrossRef
9.
go back to reference Mock V, Frangakis C, Davidson NE, Ropka ME, Pickett M, Poniatowski B, Stewart KJ, Cameron L, Zawacki K, Podewils LJ et al (2005) Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology 14(6):464–477PubMedCrossRef Mock V, Frangakis C, Davidson NE, Ropka ME, Pickett M, Poniatowski B, Stewart KJ, Cameron L, Zawacki K, Podewils LJ et al (2005) Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology 14(6):464–477PubMedCrossRef
10.
go back to reference Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC (2002) Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol 20(12):2851–2862PubMedCrossRef Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC (2002) Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol 20(12):2851–2862PubMedCrossRef
12.
go back to reference Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 34(3 Suppl 2):4–12PubMed Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 34(3 Suppl 2):4–12PubMed
13.
go back to reference Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, Pandya KJ (1994) Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 330(9):592–596PubMedCrossRef Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, Pandya KJ (1994) Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 330(9):592–596PubMedCrossRef
14.
go back to reference Cheville AL, Beck LA, Petersen TL, Marks RS, Gamble GL (2009) The detection and treatment of cancer-related functional problems in an outpatient setting. Support Care Cancer 17(1):61–67PubMedCrossRef Cheville AL, Beck LA, Petersen TL, Marks RS, Gamble GL (2009) The detection and treatment of cancer-related functional problems in an outpatient setting. Support Care Cancer 17(1):61–67PubMedCrossRef
15.
go back to reference Chang YJ, Lee JS, Lee CG, Lee WS, Lee KS, Bang SM, Wang XS, Mendoza TR, Cleeland CS, Yun YH (2007) Assessment of clinical relevant fatigue level in cancer. Support Care Cancer 15(7):891–896PubMedCrossRef Chang YJ, Lee JS, Lee CG, Lee WS, Lee KS, Bang SM, Wang XS, Mendoza TR, Cleeland CS, Yun YH (2007) Assessment of clinical relevant fatigue level in cancer. Support Care Cancer 15(7):891–896PubMedCrossRef
16.
go back to reference Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10PubMedCrossRef Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10PubMedCrossRef
17.
go back to reference Kwon YC, Yun YH, Lee KH, Son KY, Park SM, Chang YJ, Wang XS, Mendoza TR, Cleeland CS (2006) Symptoms in the lives of terminal cancer patients: which is the most important? Oncology 71(1–2):69–76PubMedCrossRef Kwon YC, Yun YH, Lee KH, Son KY, Park SM, Chang YJ, Wang XS, Mendoza TR, Cleeland CS (2006) Symptoms in the lives of terminal cancer patients: which is the most important? Oncology 71(1–2):69–76PubMedCrossRef
19.
go back to reference Cramp F, Daniel J (2008) Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev (2):CD006145 Cramp F, Daniel J (2008) Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev (2):CD006145
20.
go back to reference Goedendorp MM, Gielissen MF, Verhagen CA, Bleijenberg G (2009) Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev (1):CD006953 Goedendorp MM, Gielissen MF, Verhagen CA, Bleijenberg G (2009) Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev (1):CD006953
21.
go back to reference Cheville AL, Troxel AB, Basford JR, Kornblith AB (2008) Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. J Clin Oncol 26(16):2621–2629PubMedCrossRef Cheville AL, Troxel AB, Basford JR, Kornblith AB (2008) Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. J Clin Oncol 26(16):2621–2629PubMedCrossRef
22.
go back to reference Guadagnoli E, Mor V (1991) Daily living needs of cancer outpatients. J Commun Health 16(1):37–47CrossRef Guadagnoli E, Mor V (1991) Daily living needs of cancer outpatients. J Commun Health 16(1):37–47CrossRef
23.
go back to reference Lehmann JF, DeLisa JA, Warren CG, deLateur BJ, Bryant PL, Nicholson CG (1978) Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. Arch Phys Med Rehabil 59(9):410–419PubMed Lehmann JF, DeLisa JA, Warren CG, deLateur BJ, Bryant PL, Nicholson CG (1978) Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. Arch Phys Med Rehabil 59(9):410–419PubMed
24.
go back to reference Rosenbloom SK, Victorson DE, Hahn EA, Peterman AH, Cella D (2007) Assessment is not enough: a randomized controlled trial of the effects of HRQL assessment on quality of life and satisfaction in oncology clinical practice. Psychooncology 16(12):1069–1079PubMedCrossRef Rosenbloom SK, Victorson DE, Hahn EA, Peterman AH, Cella D (2007) Assessment is not enough: a randomized controlled trial of the effects of HRQL assessment on quality of life and satisfaction in oncology clinical practice. Psychooncology 16(12):1069–1079PubMedCrossRef
25.
go back to reference Mills ME, Murray LJ, Johnston BT, Cardwell C, Donnelly M (2009) Does a patient-held quality-of-life diary benefit patients with inoperable lung cancer? J Clin Oncol 27(1):70–77PubMedCrossRef Mills ME, Murray LJ, Johnston BT, Cardwell C, Donnelly M (2009) Does a patient-held quality-of-life diary benefit patients with inoperable lung cancer? J Clin Oncol 27(1):70–77PubMedCrossRef
27.
go back to reference Valgus J, Jarr S, Schwartz R, Rice M, Bernard SA (2010) Pharmacist-led, interdisciplinary model for delivery of supportive care in the ambulatory cancer clinic setting. J Oncol Pract 6(6):e1–e4PubMedCrossRef Valgus J, Jarr S, Schwartz R, Rice M, Bernard SA (2010) Pharmacist-led, interdisciplinary model for delivery of supportive care in the ambulatory cancer clinic setting. J Oncol Pract 6(6):e1–e4PubMedCrossRef
28.
go back to reference Abernethy AP, Ahmad A, Zafar SY, Wheeler JL, Reese JB, Lyerly HK (2010) Electronic patient-reported data capture as a foundation of rapid learning cancer care. Med Care 48(6 Suppl):S32–S38PubMedCrossRef Abernethy AP, Ahmad A, Zafar SY, Wheeler JL, Reese JB, Lyerly HK (2010) Electronic patient-reported data capture as a foundation of rapid learning cancer care. Med Care 48(6 Suppl):S32–S38PubMedCrossRef
29.
go back to reference DuBenske LL, Gustafson DH, Shaw BR, Cleary JF (2010) Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes. Med Decis Making 30(6):732–744PubMedCrossRef DuBenske LL, Gustafson DH, Shaw BR, Cleary JF (2010) Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes. Med Decis Making 30(6):732–744PubMedCrossRef
Metadata
Title
Appropriateness of the treatment of fatigued patients with stage IV cancer
Authors
Andrea L. Cheville
Tiffany Shen
Megan Chang
Jeffrey R. Basford
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 1/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1515-7

Other articles of this Issue 1/2013

Supportive Care in Cancer 1/2013 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine