Fatigue, Physical Symptoms, Psychological Distress, and Use of Integrative Medicine in Patients With Advanced Cancer

Abstract

Fatigue is a significant challenge for cancer patients, substantially affecting their quality of life, physical symptoms, and psychological distress. This study examined the relationship between fatigue in patients with advanced cancer and sociodemographic, clinical, and psychological factors. Conducted across 15 oncology departments in Spain, the study included patients with locally advanced, unresectable, or metastatic cancer eligible for systemic treatment. Participants completed the Fatigue Assessment Scale (FAS), European Organisation for Research and Treatment (EORTC QLQ-C30), Locus of Control (UWBHS), and Brief Symptom Inventory (BSI). A total of 512 patients are participated, classified into low-fatigue (55%) and high-fatigue (45%) groups. High fatigue was associated with lower educational attainment (53% vs. 44%), locally advanced disease (26% vs. 17%), poorer functional status according to ECOG (70% vs. 30%), and shorter expected survival (< 18 months: 51% vs. 37%). Additionally, patients with high fatigue reported greater use of integrative medicine (24% vs. 14%, p = 0.003) and higher prevalence of symptoms such as pain, nausea, and memory problems (p < 0.05). They also exhibited poorer quality of life and higher psychological distress. These findings highlight the need to develop multidimensional strategies that address both physical symptoms and quality of life to enhance the well-being of cancer patients. Clinically, systematic screening for fatigue and psychological distress, alongside tailored supportive interventions, should be embedded in routine care to optimize outcomes in advanced cancer patients.