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The association between fatigue and pain symptoms and decreased physical activity after cancer

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Abstract

Purpose

Patients with cancer frequently experience symptoms such as fatigue and pain that can influence their ability to maintain their usual physical activity (PA). This study aimed to evaluate whether symptoms of fatigue and pain are associated with decreased PA among patients with cancer.

Methods

We recruited patients with a cancer diagnosis from one academic medical center and 11 affiliated community hospitals to participate in a cross-sectional survey. Multivariate logistic regression models were used to examine the association between symptoms, demographics, and clinical characteristics and decreased PA since cancer diagnosis.

Results

Among 629 participants, 499 (79%) reported a decreased level of PA since their cancer diagnosis. In the past 7 days from the time of the survey, 78% of participants reported moderate to very severe fatigue, and 68% reported a pain level 4 or greater on a scale of 0 to 10. Adjusted for covariates, patients with fatigue (Adjusted Odds Ratio, AOR 4.01, 95% CI 2.41–6.65) and pain (AOR 1.89, 95% CI 1.14–3.12) had higher odds of reporting decreased PA since diagnosis. Receipt of chemotherapy or currently receiving active cancer treatment was also associated with decreased PA (p < 0.05).

Conclusions

Fatigue and pain are associated with decreased PA among patients with cancer, even after adjusting for cancer treatment. Interventions focused on managing these symptoms may help promote maintenance of PA throughout cancer treatment and beyond.

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Acknowledgements

The authors would like to thank the patients, oncologists, nurses, and clinical staff at all study sites for their contributions to this study.

Funding

Research related to the development of this paper was supported in part by the National Cancer Institute grants to the University of Pennsylvania Abramson Cancer Center (2P30CA016520-40) and the Memorial Sloan Kettering Cancer Center (3P30CA008748-50; 5T32CA9461-32), the Byrne Fund, and the Translational Research and Integrative Medicine Fund at Memorial Sloan Kettering Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sally A. D. Romero, Lee Jones, Q. Susan Li & Jun J. Mao

  2. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Joshua M. Bauml & Roger B. Cohen

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  1. Sally A. D. Romero
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  2. Lee Jones
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Correspondence to Jun J. Mao.

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Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Dr. Mao has full control of all primary data and agrees to allow the journal to review the data if requested. Research related to the development of this paper was supported in part by the National Cancer Institute grants to the University of Pennsylvania Abramson Cancer Center (2P30CA016520-40) and the Memorial Sloan Kettering Cancer Center (3P30CA008748-50; 5T32CA9461-32), the Byrne Fund, and the Translational Research and Integrative Medicine Fund at Memorial Sloan Kettering Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent official views of the National Institutes of Health.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Romero, S.A.D., Jones, L., Bauml, J.M. et al. The association between fatigue and pain symptoms and decreased physical activity after cancer. Support Care Cancer 26, 3423–3430 (2018). https://doi.org/10.1007/s00520-018-4203-4

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  • DOI: https://doi.org/10.1007/s00520-018-4203-4

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