Feeling tired before starting cancer treatment might mean more than just being worn out.
A new study led by researchers at Fred Hutchinson Cancer Center found that people who reported higher levels of fatigue before treatment were more likely to experience severe, life-threatening, or even fatal side effects during cancer therapy.
Fatigue related to cancer is a type of extreme tiredness that doesn’t improve with rest. It affects both physical and mental functioning and can greatly lower a patient’s quality of life. Many people with cancer say it’s one of the most difficult parts of their illness or treatment. However, doctors often don’t fully capture or report how tired patients feel.
Previous studies have shown that fatigue is common among people with cancer, with estimates ranging from 25% to 50% of patients affected. Around 25% experience moderate fatigue, while 15% to 20% suffer from severe fatigue. These levels often signal a lower ability to carry out daily tasks.
In this recent study, published in JAMA Oncology, researchers examined data from 7,086 cancer patients enrolled in 17 clinical trials. These trials included both early-stage and advanced-stage cancer patients, with most having advanced disease.
The cancers studied included prostate, lung, colon, breast, melanoma, lymphoma, ovarian, and pancreatic cancers. The average patient was around 62 years old, and the group was made up of nearly 30% women and 70% men.
Before treatment started, patients were asked to rate their fatigue using a scale with five levels, from “none” to “very much.” The research team used this information to study whether fatigue levels predicted how patients responded to treatment in terms of side effects.
The results were clear. People who reported even “some” fatigue before treatment had twice the risk of developing severe side effects compared to those who said they had no fatigue. Those with the highest fatigue levels were about five times more likely to experience fatal side effects.
Out of all patients, 34.2% of those with no fatigue had serious side effects during treatment. That number jumped to 39.4% for those with a little fatigue, 52.8% for those with some fatigue, and 58.3% for those with quite a lot or very much fatigue.
Importantly, the increased risk linked to fatigue was not affected by age, sex, race, ethnicity, or obesity. However, cancer stage did make a difference. The connection between fatigue and side effects was stronger in patients with advanced cancer than in those with early-stage cancer.
This study stands out because it shows how important it is to pay attention to how tired patients feel before starting cancer treatment. Fatigue might be an early warning sign of how well someone’s body can handle therapy. It may reflect underlying health issues that aren’t easily seen in blood tests or scans.
The findings suggest that asking patients about their fatigue before treatment could help doctors plan better care. If someone reports high fatigue, doctors might decide to monitor them more closely or adjust the treatment plan to avoid dangerous side effects.
In short, patient-reported fatigue could become a valuable tool in cancer care, helping to make treatments safer and more personalized.
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