Assessment of Fatigue
Key Points for This Section
An assessment is done to find out the level of fatigue and how it affects the patient's daily life.
There is no test to diagnose fatigue, so it is important for the patient to tell family members and the health care team if fatigue is a problem. To assess fatigue, the patient is asked to describe how bad the fatigue is, how it affects daily activities, and what makes the fatigue better or worse. The doctor will look for causes of fatigue that can be treated.
An assessment of fatigue includes a physical exam and blood tests.
The assessment process may include the following:
- Physical exam:
This is an exam of the body to check general signs of health or anything that seems unusual. The doctor will check for problems such as trouble breathing or loss of muscle strength. The patient's walking, posture, and joint movements will be checked.
- Rating the level of fatigue:
The patient is asked to rate the level of fatigue (how bad the fatigue is). There is no standard way to rate fatigue. The doctor may ask the patient to rate the fatigue on a scale from 0 to 10. Other ways to rate fatigue check for how much the fatigue affects the patient's quality of life.
- A series of questions about the following:
- When the fatigue started, how long it lasts, and what makes it better or worse.
- Symptoms or side effects, such as pain, the patient is having from the cancer or the treatments.
- Medicines being taken.
- Sleeping and resting habits.
- Eating habits and changes in appetite or weight.
- How the fatigue affects daily activities and lifestyle.
- How the fatigue affects being able to work.
- Whether the patient has depression, anxiety, or pain.
- Health habits and past illnesses and treatments.
- Blood tests to check for anemia:
The most common blood tests to check if the number of red blood cells is normal are:
- Complete blood count (CBC) with differential: A procedure in which a sample of blood is taken and checked for the following:
- Peripheral blood smear: A procedure in which a sample of blood is checked for the number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells.
- Other blood tests may be done to check for other conditions that affect red blood cells. These include a bone marrow aspiration and biopsy or a Coombs' test. Blood tests to check the levels of vitamin B12, iron, and erythropoietin may also be done.
- Checking for other causes of fatigue that can be treated. See the Causes of Fatigue in Cancer Patients section.
A fatigue assessment is repeated at different times to see if there are patterns of fatigue.
A fatigue assessment is repeated to see if there is a pattern for when fatigue starts or becomes worse. Fatigue may be worse right after a chemotherapy treatment, for example. The same method of measuring fatigue is used at each assessment. This helps show changes in fatigue over time.