Supportive Care in Cancer

, Volume 17, Issue 5, pp 519–526

Patterns of fatigue related to advanced disease and radiotherapy in patients with cancer—a comparative cross-sectional study of fatigue intensity and characteristics

  • Carina Lundh Hagelin
  • Yvonne Wengström
  • Carl Johan Fürst
Original Article

DOI: 10.1007/s00520-008-0502-5

Cite this article as:
Lundh Hagelin, C., Wengström, Y. & Fürst, C.J. Support Care Cancer (2009) 17: 519. doi:10.1007/s00520-008-0502-5


Goals of work

This cross-sectional comparative study was designed to explore and describe the prevalence and patterns of cancer-related fatigue in patients with advanced cancer as well as patients undergoing curative radiotherapy. Another aim was to explore the association of anxiety and depression with fatigue.

Materials and methods

Patients with an advanced stage of disease (n = 228) and patients receiving radiotherapy (n = 81) completed the Borg Category Ratio Scale, the Multidimensional Fatigue Inventory and the Hospital Anxiety and Depression Scale.

Main results

Patients with advanced disease had an increased probability of experiencing all aspects of fatigue except for mental fatigue as compared to patients undergoing radiation, e.g., odds ratio 11.5 (CI 5.8–22.7) for physical fatigue. Higher scores for depression than for anxiety were reported when patients had high levels of fatigue, with 23% of the patients classified as anxious and 39% depressed.


The present study was carried out in order to address a gap in research by comparing the multidimensional aspects of fatigue in different groups of cancer patients. It is the intensity of fatigue that seems to be related to the underlying exposure to radiation or to the level of disease burden rather than the different fatigue profiles, such as the relation between physical and mental aspects.


Fatigue Cancer Radiotherapy Palliative care Anxiety Depression 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Carina Lundh Hagelin
    • 1
    • 2
  • Yvonne Wengström
    • 3
    • 4
  • Carl Johan Fürst
    • 1
    • 2
  1. 1.Research & Development UnitStockholms Sjukhem FoundationStockholmSweden
  2. 2.Department of Oncology–PathologyKarolinska InstitutetStockholmSweden
  3. 3.Institution of Neurobiology, Caring Sciences & Society, Section of NursingKarolinska InstitutetStockholmSweden
  4. 4.Cancer Care Research Centre, Dept. of Nursing and MidwiferyUniversity of StirlingStirlingScotland

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