A study on the prevalence and predictors of Cancer-Related Fatigue in cancer patients receiving treatment

Background Cancer-related fatigue (CRF) is a distressing, multifactorial symptom that impairs treatment adherence and quality of life (QoL) in a majority of cancer patients. Although a major clinical problem, Indian data on CRF remain scant, and routine screening is uncommon. This study quantified CRF prevalence during active treatment and explored clinical predictors and its impact on QoL in a representative Indian cohort. Methods Between March and June 2025, a descriptive cross-sectional study was conducted in the Department of Radiation Oncology, of a tertiary cancer center in Eastern India. Adults undergoing anticancer therapy for histologically confirmed malignancies were enrolled. Strict biochemical and clinical exclusions minimized non-cancer-related fatigue confounders. Fatigue was measured with validated regional-language adaptations of EORTC FA12 questionnaire. Global Health-related QoL was assessed concurrently with the EORTC QLQ-C30. Fatigue scores were sorted as Mild, Moderate and Severe and QoL scores as Excellent, Good and Poor. Univariate and multivariate logistic regression identified predictors of moderate-to-severe CRF, and Pearson correlation tested the relationship between total FA12 and global QoL scores. p < 0.05 (2 tailed) was considered significant. Results Among 323 evaluable patients, the median age was 60 years and 55% were females. Majority were undergoing radical treatment. CRF prevalence was 100% while 26% experienced severe fatigue. Median total FA12 score was 47.2 (IQR 26–67). Older age, female sex, chemotherapy, advanced stage and poor ECOG status were consistently associated with higher fatigue scores. Multivariate analysis confirmed advanced stage, older age and chemotherapy as independent predictors of severe CRF. Global QoL was excellent in 39.4%, good in 40.9%, and poor in 28.8%; radiotherapy-only patients reported the best QoL. A strong inverse correlation existed between total fatigue and QoL. Conclusions To the best of our knowledge, this is the first Indian study using the EORTC FA12 in a large patient cohort receiving treatment. Excluding known confounders makes our results robust. All patients reported CRF and a quarter had severe fatigue. Clear predictors and a consistent negative correlation with QoL were noted. Multidimensional assessment of fatigue and early, focused interventions are imperative to improve patient outcomes.