Fatigue is the most prevalent and distressing symptom related to cancer and its treatment affecting functioning and quality of life. The National Cancer Institute´s Clinical Trials Planning Meeting adopted the PROMIS Fatigue Measure as the standard to use clinical trials. Bryce B. Reeve et al. evaluated the psychometric properties of PROMIS and reported the results in "Psychological Test and Assessment Modeling":
"Twelve of 14 PROMIS fatigue items performed well across the ethnically/racially diverse samples with minimal findings of different item functioning (DIF) that would have any effect on comparing or combining scores across cancer populations. Supporting evidence of the validity and reliability of the PROMIS measures will enhance the adoption of the measures in oncology clinical research."
Approximately 60% of cancer patients experience moderate to severe fatigue during active treatment. Cancer patients commonly describe their fatigue experience as very different from normal fatigue that most people experience. They were "drained" and felt "like a zombie". The qualitative study also found fatigue to have deleterious effects on their lives including cognitive impact ("my brain´s gone"), emotional impact ("depression", "frustration"), physical impact ("trouble keeping up with work", "too tired to get out of bed"), and social impact ("affects relationship with my kids, ... with my spouse, and ... my friends".
Observational studies with cancer patients have found fatigue to also co-occur with poor sleep quality, depressed mood and pain; forming a symptom cluster that severely impacts quality of life.
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