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Fatigue is highly prevalent amongst cancer patients. It is probably the most common unrelieved symptom of cancer, and can reduce physical, psychological and social functioning and cause distress in patients. A longitudinal study is currently in progress at RPH investigating patients' quality of life (QOL) including fatigue and psychosocial morbidity. Standardised measures were administered to a consecutive series of 198 chemotherapy patients at: (a) pretreatment, (b) on-treatment (8 weeks), (c) post-treatment and (d) 6 months follow-up. The demographic profile of the cohort included 47% male, 53% female and mean age 56 years (SD = 13). Initial results showed that 20% of patients described fatigue as the single most important recent problem. Fatigue was elevated at on- and post-treatment compared to other times (p < .05), and more so in women than men (p < .01). Consistent correlates of fatigue across time were physically-orientated included physical functioning, muscle bulk and weight loss and patients' perceived physical health (all p < .01; r = 0.4-0.6). Psychological correlates of fatigue were generally weak (r < 0.4) except for depression. Results suggest that physical variables are more important in explaining fatigue. Firmer conclusions about the relative contributions of physical and psychological variables will be made once more mature data becomes available for analyses. Some clinical options geared towards alleviating dysfunctional levels of fatigue amongst cancer patients will be discussed. [ABSTRACT FROM AUTHOR]

Purpose: Despite significant advances in antiemetic management, almost 50% of cancer patients still experience nausea and vomiting during treatment. The goal of antiemetic therapy is complete prevention of treatment-induced nausea and/or vomiting (TINV); however, realisation of this goal remains elusive, thus supplementary strategies identifying patients at high risk must be employed in the interim. Consequently, we examined TINV incidence and its risk factors, including patient, clinical and pretreatment quality of life (QOL)/psychological factors., Methods: Two hundred newly diagnosed cancer patients beginning combined treatment participated in this prospective, longitudinal, observational study. QOL (including TINV), psychological adjustment, and patient/clinical characteristics were examined at pretreatment, on-treatment (8 weeks ± 1 week) and post-treatment., Results: Overall, 62% of patients experienced TINV, with TIN incidence (60%) doubling that of TIV (27%). Eight independent risk factors predicted 73% of TIN incidence: high premorbid/anticipatory NV, moderately/highly emetogenic chemotherapy (M/HEC), longer treatment (>3 months), female gender, surgery prior to adjuvant chemotherapy ± radiotherapy, private health insurance and low emotional functioning (pretreatment). Six independent risk factors predicted 77% of TIV incidence: premorbid/anticipatory vomiting, M/HEC, female gender, cancer resection and low role functioning (pretreatment)., Conclusions: TINV still represents a very major concern for patients. Several pretreatment risk factors for the development of TIN and TIV, respectively, were identified. Patients about to undergo cancer treatment, particularly combined treatment involving emetogenic chemotherapy and surgery, should be screened for these factors with a view to modifying standard pretreatment/maintenance antiemetic therapy. Furthermore, and consistent with recent research, it is recommended that more comprehensive interventions combining antiemetics with other effective pharmacological (e.g. anxiolytics) and non-pharmacological approaches (e.g. acupuncture, relaxation techniques) be considered by clinicians in attempts to improve control of TIN and TIV (and overall QOL) for their patients. In this way, optimal holistic care will be ensured for cancer patients by clinicians providing conventional oncology treatment.