An investigation into fatigue in cancer patients during radiotherapy

M.Tech.In spite of the improvement in the delivery of anti-cancer treatments over the past decade, side effects from these treatments remain inevitable. A common, distressing side effect that all cancer patients experience is fatigue. However, cancer related fatigue (CRF) remains one that is under-reported and under-treated. CRF is a topic that has received very limited attention in the South African context. Regardless of the amount of literature available on CRF, many questions continue to go unanswered. CRF has been identified as a side effect that is associated with physical, mental and psychological elements. Consequently, it has the ability to cause a delay in treatment schedules, impinge on daily functioning and impact negatively on the quality of life (QoL) in the cancer patient. Effective management strategies for patients during and after radiation treatment are thus essential to improve QoL. The aim of the study was to investigate the general pattern of fatigue experienced by patients diagnosed with various types of cancers during a radical course of radiotherapy. For the purpose of this study fatigue was defined according to the National Comprehensive Cancer Network (NCCN) Practice Guidelines in Oncology (www.nccn.org): “a distressing persistent subjective sense of tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning” A cross-sectional, theory-generating study was conducted to explore and describe the prevalence of fatigue, factors that could influence fatigue scores, strategies being used to alleviate this side effect and the impact of fatigue on QoL. One hundred and eighty patients were asked to complete a self-developed questionnaire in three oncology centres in Gauteng, South Africa. The NCCN Clinical Practice Guidelines in Oncology were used as a framework to direct the study. The results of the study illustrate that fatigue scores increased as radiotherapy progressed. However, not all the variables explored in the study significantly impacted on fatigue scores. The study revealed, though, that all cancer patients do experience CRF irrespective of the diagnosis. Management of the causes of CRF is thus essential to improve QoL for cancer patients