Researchers define "sudden exhaustion syndrome" in cancer

An investigative team is urging oncology professionals as well as patients to recognize sudden exhaustion syndrome, a new descriptor the researchers have proposed to better characterize sudden fatigue and exhaustion in persons with cancer.

The syndrome, described in Supportive Care in Cancer (2013;21[2]: 609-617), encompasses observed abrupt onset of fatigue, transitory exhaustion/paralysis, and multiple symptoms, based on findings by Horng-Shiuann Wu, PhD, an assistant professor of nursing at Wayne State University in Detroit, Michigan, and colleagues.

Cancer-related fatigue (CRF) has been well documented, but a subset of patients have reported an abrupt onset of extreme tiredness that leaves them barely able to move and often forces them to lie down immediately until the episode passes, explained Wu in a statement issued by Wayne State. Because the sudden onset of such episodes distinguishes them from cancer-related fatigue, which is itself more intense and longer-lasting than typical fatigue, the study authors contend that “sudden exhaustion syndrome” is a better description.

To learn more about the occurrence and characteristics of sudden fatigue in persons undergoing breast cancer treatment, Wu and team screened 114 outpatients (aged 31 to 67 years) receiving chemotherapy at a cancer clinic or a hospital. The participants completed the investigator-developed Sudden Onset of Fatigue Questionnaire on the day of their treatment.

Nearly half (46%) of the patients reported having experienced sudden fatigue, and 81% reported more than one episode per day (median three episodes per day). Two-thirds of the episodes (67%) lasted no more than 1 hour, but some lasted up to 8 hours. The majority of participants (77%) were most likely to be stricken with sudden fatigue between 10:00 a.m. and 5:00 p.m., and almost always while they were active. The person would typically stop the activity and seek immediate rest.

The episodes were described as abrupt exhaustion and/or weakness, accompanied in 66% of cases by such other symptoms as dizziness, pain, sweating, nausea, and shortness of breath. On a scale of 1 to 10, with 10 indicating greatest fatigue, fatigue intensity before, during, and after an episode were rated as 5, 9, and 5, respectively.

When one patient experienced the onset of sudden fatigue while being surveyed by the researchers, her eyelids drooped and she was unable to form words, according to Wu. “We learned that [sudden fatigue] is something that's really happening and most patients' lives are affected by it.”

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