Skip to main content
Log in

Cancer-related fatigue: results from patient experience surveys undertaken in a UK regional cancer centre

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript



Cancer-related fatigue (CRF) is a common but under reported symptom significantly impacting on cancer patients’ quality of life. The purpose of these surveys was to drive improvements in the provision of support of patients with CRF.


Two surveys were conducted to determine the incidence and impact of cancer-related fatigue (CRF) amongst patients attending a Cancer Centre (CC) for radiotherapy and/or systemic anti-cancer therapy.


Survey 1: retrospective examination of 68 patients’ clinical notes. Survey 2: a questionnaire distributed prospectively to 148 patients whilst attending for treatment. Survey 1 identified 29 patients’ notes recording the patient experiencing fatigue, but only two were given any advice to manage symptoms. In survey 2, the majority of patients (86 %) were advised about the risk of CRF before treatment, but only 67 % were assessed and advised about CRF during treatment. Physical fatigue (57 %) was more common than emotional (37 %) or cognitive fatigue (29 %).


Many patients are not being given advice to manage their CRF symptoms. Reasons for this include a lack of awareness regarding the occurrence of CRF and its impact and a misunderstanding by Health Care Professionals (HCPs) about the advice patients should be given. Recommendations include the continued need to improve education of HCPs to ensure patients receive the appropriate advice they need to manage their CRF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others


  1. Scott J, Lasch K, Barsevick A, Piault-Louis E (2011) Patients’ experiences with cancer-related fatigue: a review and synthesis of qualitative research. Oncol Nurs Forum 38(3):E191–E203. doi:10.1188/11.onf. e191-e203

    Article  PubMed  Google Scholar 

  2. Curt GA, Breitbart W, Cella D, Groopman JE, Horning SJ, Itri LM, Johnson DH, Miaskowski C, Scherr SL, Portenoy RK, Vogelzang NJ (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the fatigue coalition. Oncologist 5(5):353–360. doi:10.1634/theoncologist.5-5-353

    Article  CAS  PubMed  Google Scholar 

  3. Wagner LI, Cella D (2004) Fatigue and cancer: causes, prevalence and treatment approaches. Br J Cancer 91(5):822–828

    PubMed Central  CAS  PubMed  Google Scholar 

  4. Henry D, Viswanathan H, Elkin E, Traina S, Wade S, Cella D (2008) Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer 16(7):791–801. doi:10.1007/s00520-007-0380-2

    Article  PubMed  Google Scholar 

  5. Stone P, Richards M, Hardy J (1998) Fatigue in patients with cancer. Eur J Cancer 34(11):1670–1676. doi:10.1016/s0959-8049(98)00167-1

    Article  CAS  PubMed  Google Scholar 

  6. 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):4–10. doi:10.1634/theoncologist.12-S1-4

    Article  PubMed  Google Scholar 

  7. Irvine D, Vincent L, Graydon JE, Bubela N, Thompson L (1994) The prevalence and correlates of fatigue in patients receiving treatment with chemotherapy and radiotherapy; a comparison with the fatigue experienced by healthy individuals. Cancer Nurs 17(5):367–378

    Article  CAS  PubMed  Google Scholar 

  8. Morrow G, Andrews P, Hickok J, Roscoe J, Matteson S (2002) Fatigue associated with cancer and its treatment. Support Care Cancer 10(5):389–398. doi:10.1007/s005200100293

    Article  PubMed  Google Scholar 

  9. Servaes P, Verhagen C, Bleijenberg G (2002) Fatigue in cancer patients during and after treatment. Eur J Cancer 38(1):27–43. doi:10.1016/s0959-8049(01)00332-x

    Article  CAS  PubMed  Google Scholar 

  10. Wanchai A, Armer J, Stewart B (2011) Nonpharmacologic supportive strategies to promote quality of life in patients experiencing cancer-related fatigue. Clin J Oncol Nurs 15(2):203–214. doi:10.1188/11.cjon. 203-214

    Article  PubMed  Google Scholar 

  11. Minton O, Berger A, Barsevick A, Cramp F, Goedendorp M, Mitchell SA, Stone PC (2013) Cancer-related fatigue and its impact on functioning. Cancer 119:2124–2130. doi:10.1002/cncr.28058

    Article  PubMed  Google Scholar 

  12. Ahlberg K, Ekman T, Gaston-Johansson F, Mock V (2003) Assessment and management of cancer-related fatigue in adults. Lancet 362(9384):640–650

    Article  PubMed  Google Scholar 

  13. Weis J, Arraras JI, Conroy T, Efficace F, Fleissner C, Görög A, Hammerlid E, Holzner B, Jones L, Lanceley A, Singer S, Wirtz M, Flechtner H, Bottomley A (2013) Development of an EORTC quality of life phase III module measuring cancer-related fatigue (EORTC QLQ-FA13). Psycho-Oncology 22(5):1002–1007. doi:10.1002/pon.3092

    Article  PubMed  Google Scholar 

  14. Stone P, Ream E, Richardson A, Thomas H, Andrews P, Campbell P, Dawson T, Edwards J, Goldie T, HammIck M, Kearney N, Lean M, Rapley D, Smith AG, Teague C, Young A (2003) Cancer-related fatigue—a difference of opinion? Results of a multicentre survey of healthcare professionals, patients and caregivers. Euro J Cancer Care 12(1):20–27. doi:10.1046/j.1365-2354.2003.00329.x

    Article  CAS  Google Scholar 

  15. National Cancer Survivorship Initiative (2013) Accessed 05/01/2014 2014

  16. Corner J, Wagland R (2013) Quality of life of cancer survivors in England: Analysis of Patients’ free text comments: final report

  17. Quality Health (2013) Radiotherapy patient experience survey 2013 national report.

  18. Information Prescription Service.

  19. Goedendorp MM, Knoop H, Gielissen MFM, Verhagen CAHHVM, Bleijenberg G (2014) The effects of cognitive behavioral therapy for postcancer fatigue on perceived cognitive disabilities and neuropsychological test performance. J Pain Symptom Manag 47(1):35–44. doi:10.1016/j.jpainsymman.2013.02.014

    Article  Google Scholar 

  20. van der Lee ML, Garssen B (2012) Mindfulness-based cognitive therapy reduces chronic cancer-related fatigue: a treatment study. Psycho-Oncology 21(3):264–272. doi:10.1002/pon.1890

    Article  PubMed  Google Scholar 

  21. Dy SM, Lorenz KA, Naeim A, Sanati H, Walling A, Asch SM (2008) Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea. J Clin Oncol 26(23):3886–3895. doi:10.1200/jco.2007.15.9525

    Article  PubMed  Google Scholar 

  22. Smith C, Carmady B, Thornton C, Perz J, Ussher JM (2013) The effect of acupuncture on post-cancer fatigue and well-being for women recovering from breast cancer: a pilot randomised controlled trial. Acupunct Med 31(1):9–15. doi:10.1136/acupmed-2012-010228

    Article  PubMed  Google Scholar 

  23. Cramp F, Byron-Daniel J (2012) Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews (11). doi:10.1002/14651858.CD006145.pub3

  24. Armes J, Chalder T, Addington-Hall J, Richardson A, Hotopf M (2007) A randomized controlled trial to evaluate the effectiveness of a brief, behaviorally oriented intervention for cancer-related fatigue. Cancer 110(6):1385–1395. doi:10.1002/cncr.22923

    Article  PubMed  Google Scholar 

  25. Macmillan Cancer Support (2013) The importance of physical activity for people living with and beyond cancer - A concise evidence review

  26. National Voices (2014) Supporting self-management: Summarising evidence from systematic reviews. Accessed 07/11/2014 2014

  27. Patient Information Forum (2013) Making the case for information - the evidence for investing in high quality health information for patients and the public. Accessed 7/11/2014

  28. Macmillan Cancer Support (2013) Coping with fatigue. 6th edn

Download references


The authors would like to thank Cathy Wilson for establishing the Fatigue Interest Group and her help in initiating the service evaluation. Margaret Camps and Judith Hirst also assisted in collecting patient data.

Conflict of interest

No conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Sarah James.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

James, S., Wright, P., Scarlett, C. et al. Cancer-related fatigue: results from patient experience surveys undertaken in a UK regional cancer centre. Support Care Cancer 23, 2089–2095 (2015).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: