Cancer-related fatigue in cancer survivors (CS) with no active treatment.

238 Background: Fatigue is a subjective experience that should be systematically assessed at the initial visit, at regular intervals and as clinically indicated. Quality of fatigue management should be included in institutional continuous quality improvement projects. The PERFORM questionnaire (PQ) was developed among Spanish speaking patients for the assessment of fatigue. Methods: Outpatients recruited for projects in which physical condition and physical activity (PA) were evaluated, rated their fatigue severity on the PQ (12-60, being 60 no fatigue). PHUEM-01 evaluated early colon CS after finishing adjuvant treatment (AT). PHUEM-02 early breast CS at the end of AT. PH-UEM-03 evaluated colorectal CS (localized and metastatic) at the time of diagnosis. MS-04 evaluated fatigue at the time of diagnosis of different tumors (localized and metastatic). Physical condition was evaluated through the one-mile walk test (VO 2MAX ) and handgrip dynamometer. Heart rate was measured as a sign of autonomic dysfunction. PA was objectively evaluated through accelerometers generating weekly MVPA information. Results: 262 CS (63% women) were recruited, (110 breast, 119 colorectal, 14 other), mean age 60. 30% of survivors reported no fatigue. Mean PERFORM score 48,34; VO 2max 25.5 ml/kg/min; handgrip 29,14 kg; HR 75 bpm. Women, younger CS, CS with worse physical condition, higher BMI, higher HR and less active CS reported more fatigue (only sex, handgrip strength and weekly PA were statistically significant for the overall population). Breast CS reported higher scores of fatigue than colorectal CS (p < 0.000). For breast CS there was an association between fatigue and HR which was not seen in the overall population. Metastatic colorectal did not report worse scores of fatigue than CS with localized tumors. Conclusions: As a subjective symptom, fatigue is unpredictable and its severity and interference with daily activities can be bothersome in an unexpected population (young CS, early stages) with no active treatment. More physically active and fitter CS are less fatigued. Mechanisms underlying cancer-related fatigue could be different for different tumors. More research in prevalence, evaluation, mechanisms and management of fatigue is needed.