UICC World Cancer Congress 2006

Methods: Eight one adequately treated cancer patients, disease free or with residual disease, were studied with a focus on those complaining of unexplained and persistent fatigue, using a controlled, prospective follow-up design. Consenting subjects were interviewed regarding details of fatigue and assessed on Scale for Assessment of Somatic Symptoms (SASS), Hospital Anxiety and Depression Scale (HADS), Psychiatric Assessment Schedule (PAS) and DSM-III-R. Follow up was done 4 to 6 months later

Results: Fatigue was reported by 52 (64%), mild to moderate in 27 (34%) and severe in 25 (30%). On comparing subjects with persistent fatigue (n=52), with those without fatigue (n=29) no demographic differences were noted. Psychological and mixed somatic symptoms were more often (P<0.001) observed among persistent fatigue subjects. Fatigue patients had significantly (P<0.001) greater frequency of depressive, anxiety, and atypical somatoform disorders. Fatigue patients also had significantly greater number of depressive symptoms, depressed mood, number of anxiety symptoms, free floating anxiety, nervous tension, muscular tension, autonomic over activity, apprehension, and vigilance/ scanning symptoms. Somatic concern and somatic preoccupation was slightly but not significantly more frequent in fatigue patients. Past history of somatization and alexithymia were comparable in both groups. Follow-up revealed a significant (P < 0.001) reduction in the number of somatic symptoms, anxiety and depression scores. This study demonstrates that fatigue may persist in cancer patients which is related to anxiety, depression or abnormal illness behaviour and requires psychiatric intervention.