Patients on RT May Need Help to Maintain Usual Activities

BOSTON—Patients receiving radiation therapy (RT) typically have fatigue and other side effects that interfere with their ability to maintain their usual daily activities. Speaking at the Oncology Nursing Society 31st Annual Congress, Patricia Poirier, RN, PhD, AOCN, examined the factors associated with ability to maintain usual activities in 77 cancer patients who received RT (abstract 251). "Nurses can identify patients at high risk for inability to maintain usual activities, such as those who live alone or have coexisting medical conditions, and intervene early on in treatment," she said.

Dr. Poirier conducted a prospective, longitudinal study in 77 patients receiving radiation therapy recruited from one community hospital. Participants in the study rated the extent to which they were continuing to perform their usual activities on a scale of 0 (not at all) to 10 (all the time). The Karnofsky Performance Scale (KPS) was used to measure performance status. Patients were assessed prior to starting radiation, weekly during treatment, and at 1 month post-treatment.

The study showed that radiation therapy patients maintained relatively high performance status throughout the course of treatment, although their ability to perform usual activities decreased significantly from baseline to the end of treatment (P < . 0001.)

Ability to perform usual activities was reduced by fatigue and by site-specific side effects. "Work, availability of sick leave benefits, living situation, fatigue, KPS, and presence of comorbidities were predictive of ability to perform usual activities throughout the trajectory of radiation therapy," Dr. Poirier said.

Patients who worked tolerated radiation therapy better, but most had to cut back to part-time (see Table).

"We need to financially support patients' ability to work or not work during treatment. Only half of our patients had any paid sick time during radiation therapy," Dr. Poirier said. "Management of side effects of treatment, including fatigue, and supporting patients' need to work or not work during treatment may help patients continue to perform those activities important to them during radiation therapy."