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Anemia in Patients With Cancer Causes Significant Fatigue, Impacting Quality of Life
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Key Takeaways
- Anemia in cancer patients leads to fatigue, impacting HRQOL, with complex interrelations among symptoms, fatigue, and quality of life.
- Strong negative correlation exists between fatigue and performance status, and moderate negative correlation between anemia and performance status in cancer patients.
Pharmacists should be aware of the impacts that anemia in patients being treated for cancer has on daily activities and overall quality of life.
Cancer patients with anemia often experience significant fatigue and experience low-performance when completing daily tasks, which can negatively impact health-related quality of life (HRQOL), especially in physical and psychological aspects, according to new study results published in Clinical Epidemiology and Global Health.1
Anemia in patients with cancer, especially those actively undergoing treatment, can cause fatigue and performance status issues. | Image Credit: © Natalia | stock.adobe.com
Anemia in patients with cancer often results from inflammation, which suppresses the production of red blood cells. The initiation of treatment agents used to destroy cancerous cells simultaneously can also cause a decrease in the production of new blood cells in bone marrow.2
QOL, as defined by the World Health Organization, is an individual’s perception of their position in life in the context of the culture and value systems in which they live and their goals, standards, and concerns. A clear correlation has been established between a rise in hemoglobin levels and increases in QOL in patients with cancer, but the interplay among symptoms of anemia, fatigue, and QOL remain complex and poorly understood.3,4
The investigators sought to assess rates of fatigue and performance status in anemic patients with cancer receiving chemotherapy and to determine a correlation, if any, between the 2 factors and HRQOL. A total of 231 patients with cancer experiencing anemia were enrolled in the trial. Patient’s conditions were evaluated using questionnaires that assess QOL over multiple domains.1
Patient responses to the FACIT-FATIGUE questionnaire indicate that most were able to do their usual daily activities to some extent, but 32% indicated that they needed help with these activities. Almost half of the patient pool expressed feeling frustrated by being too tired to do activities they wanted to do. Additionally, 46.8% of respondents reported being forced to limit their social activity because of their fatigue.1
The investigators determined multiple relationships using Spearman’s rank correlation, with the mechanism indicating a statistically significant, very strong negative relationship between fatigue and performance status (r = -0.796, p = .01), indicating that patient performance status is dependent on fatigue level, the study authors discussed. They also found a significant, moderately negative relationship between anemia and performance status (r = -0.297, p = .01), in addition to a significant, positive relationship between QOL domains and performance status (r = 0.685, p = .01) in these patients with cancer.1
Some challenges were encountered during the data collection process, according to the investigators. Most notably, some newly diagnosed patients were unaware of their diagnosis due to the delicate nature of their cancer. Continuing, some patients had difficulties completing the lengthy questionnaire required of them to assess their fatigue and performance status, leading to some incomplete responses.1
“The study suggests implementing a self-management education program across various healthcare facilities to effectively measure and manage fatigue, which contributes to anemia, poor performance status, and a decline in quality of life among cancer patients,” the study authors concluded.1
