Cancer-related fatigue in colorectal cancer patients at the time of diagnosis

Cancer-related fatigue (CRF) is one of most prevalent and distressing symptoms among cancer survivors. It is a subjective experience that should be systematically evaluated in patients with colorectal cancer (CRC). The PERFORM questionnaire (PQ) was developed among Spanish speaking patients for the assessment of fatigue. It ranges from 12-60, with higher scores indicating less fatigue. PQ scores lower than 46 are associated with poor quality of life. Controversy exists regarding the influence of gender, primary tumour and also the effect of oncological treatments in CRF. Information about CRF at the time of diagnosis is lacking and could be essential to anticipate recommendations and to manage CRF during oncological treatment and after it. Cross-sectional study. Patients with recent diagnosis of CRC, ECOG 0-2, able to walk a mile and willing to wear an accelerometer could be included. Cardiorespiratory fitness was estimated through the one-mile walk test. Muscular strength was evaluated through dynamometry (handgrip) and through the sit to stand test. Patients who completed PQ are analyzed. 188 (125 male/63 female) patients were included. 111 stage II-III/ 77 stage IV. Average score for the total population was 51. There were significant differences (p < 0.00) between men (PQ 52.9) and women (PQ 46.5). However, there were no differences between patients with metastatic (50.5) and localized (51.4) CRC. Some variables related with physical condition, namely BMI, waist perimeter, handgrip and sit to stand test were associated with PQ scores of fatigue. However weekly physical activity, basal heart rate and cardiorespiratory condition were not associated with fatigue. Fatigue is a prevalent symptom among women with a recent diagnosis of CRC before initiating chemotherapy. In the total population, gender (male), BMI (higher) and muscular strength were associated with less fatigue. However cardiorespiratory fitness and weekly PA were not associated with fatigue at the time of CRC diagnosis. Surprisingly, metastatic patients do not report more fatigue than patients with localized disease. Screening of fatigue is specially recommended in women at the time of diagnosis of CRC.