Definition, prevalence and characteristics of sudden exhaustion: a possible syndrome of fatigue in cancer?
OBJECTIVE
Although sudden fatigue/exhaustion is a symptom expression that oncology clinicians frequently hear from their patients, empirical information about this phenomenon is limited. This study investigated the occurrence and characteristics of sudden fatigue in patients treated for breast cancer.


METHODS
This cross-sectional descriptive study enrolled 114 breast cancer chemotherapy outpatients from a cancer clinic and an urban teaching hospital in the Midwestern United States. Subjects were screened for sudden fatigue and completed an investigator-developed Sudden Onset of Fatigue Questionnaire on the day of their chemotherapy treatment. Descriptive statistics were used to examine prevalence and clinical characteristics.


RESULTS
Approximately half (46 %) of the patients (age 31-67, 62 % Black, and 70 % unemployed) experienced sudden fatigue. The majority (81 %) reported more than one (median = 3) episode per day; 67 % of episodes lasted 60 min or less. The sudden fatigue was most likely (77 %) to occur between 10 a.m. and 5 p.m., while individuals were active (94 %). When it occurred, individuals stopped activities and sought immediate rest. It was described as abrupt exhaustion/weakness often (66 %) accompanied by other symptoms. Fatigue intensity before, during, and after a specific episode were 5, 9, and 5, respectively, on 0-10 (highest) scale.


CONCLUSIONS
To better characterize sudden fatigue, a new descriptor, sudden exhaustion syndrome, which encompasses observed abrupt onset, transitory exhaustion/paralysis, and multiple symptoms, is proposed. Individuals may experience multiple occurrences of sudden exhaustion across a day, especially during activities. The syndrome needs to be recognized by oncology professionals. Patients should be educated about the syndrome to enhance sense of control and prevent harm.
Wayne State University College of Nursing, 5557 Cass Avenue, Detroit, MI 48202, USA. wuh@wayne.edu
Horng-Shiuann
HS
Wu
Jean E
JE
Davis
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D015995:Prevalence; D012720:Severity of Illness Index; D013577:Syndrome
D000970:Antineoplastic Agents