Fatigue and functional impairment in early-stage non-small cell lung cancer survivors

Robert Hung, Paul Krebs, Elliot J. Coups, Marc B. Feinstein, Bernard J. Park, Jack Burkhalter, Jamie S. Ostroff

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Context: Fatigue is the most common sequela among non-small cell lung cancer (NSCLC) survivors one to six years post-treatment and is associated with functional limitations. Objectives: This study examined the prevalence, severity, and correlates of fatigue among early stage NSCLC survivors. Methods: Three-hundred fifty individuals diagnosed and surgically treated for Stage IA or IB NSCLC completed a survey that included the Brief Fatigue Inventory (BFI) to assess the prevalence and severity of fatigue. The Karnofsky Self-Reported Performance Rating scale (SR-KPS) was used as a measure of functional status and was compared with the severity of fatigue through Chi-squared analyses. Demographic, psychological, and medical correlates of fatigue were examined using logistic regression. Results: The prevalence of fatigue was 57%. Forty-one percent (n = 142) of participants had mild fatigue and 16.8% (n = 59) had moderate or severe fatigue (BFI ≥ 4). Among the individuals reporting moderate or severe fatigue, 23.7% (n = 14) had significant functional impairment (SR-KPS ≤ 70%) compared with 2.8% (n = 8) with mild or no fatigue (χ2 = 58.1, P < 0.001). In the multivariate analysis, NSCLC survivors with pulmonary disease (odds ratio [OR] = 2.28), depressive symptoms (OR = 6.99), and anxiety symptoms (OR = 2.31) were more likely to report experiencing clinically significant fatigue, whereas those who met physical activity guidelines (OR = 0.29) reported less fatigue. Conclusion: Fatigue is highly prevalent among NSCLC survivors and associated with more functional impairment. A comprehensive approach to the treatment of fatigue includes the screening and management of anxious and depressive symptoms, and pulmonary disorders such as chronic obstructive pulmonary disease.

Original languageEnglish (US)
Pages (from-to)426-435
Number of pages10
JournalJournal of Pain and Symptom Management
Issue number2
StatePublished - Feb 2011

All Science Journal Classification (ASJC) codes

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


  • Lung cancer survivor
  • fatigue
  • functional impairment
  • non-small cell lung cancer survivor
  • symptom cluster


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