Fatigue of Cancer is Distinctly Different than the Fatigue of Chronic Kidney Disease, 2025, Fernandez

Dolphin

Dolphin

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Fatigue of Cancer is Distinctly Different than the Fatigue of Chronic Kidney Disease - Supportive Care in Cancer

Introduction It remains unclear whether the mechanisms of fatigue in cancer and chronic kidney disease (CKD) are different. The assessment of self-reported fatigue by standard scales, muscle fatigue by the objective reduction in finger tapping speed, and the cost to the brain of the exercise by...
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Fatigue of Cancer is Distinctly Different than the Fatigue of Chronic Kidney Disease​

  • Research
  • Published: 23 September 2025


Abstract​

Introduction​

It remains unclear whether the mechanisms of fatigue in cancer and chronic kidney disease (CKD) are different. The assessment of self-reported fatigue by standard scales, muscle fatigue by the objective reduction in finger tapping speed, and the cost to the brain of the exercise by the rating of perceived effort (RPE) help to compare the phenotypes of fatigue between the two conditions and explore the mechanisms of fatigue.

Methods​

We initially assessed the correlations between fatigue, measured by the Brief Fatigue Inventory (BFI); muscle fatigue (measured by the finger tapping speed) and RPE in 30 patients with cancer and subsequently 30 patients with stage 3B-5 CKD. Exclusion criteria for both groups included movement disorders, history of stroke, and depression. Other exclusions for patients with CKD were ejection fraction < 40%, history of cancer, hemoglobin < 10 g/dL, and recent hospitalization. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale was also assessed for CKD patients.

Results​

In cancer patients, fatigue showed no correlation with muscle fatigue but had a strong correlation with RPE (r = 0.75, p < 0.01). Conversely, in CKD patients, fatigue did not correlate with RPE but was significantly correlated with muscle fatigue at the 30-s tapping interval (r = 0.68, p < 0.01). Additionally, BFI scores were highly correlated with FACIT-F scores in CKD patients (r = 0.89, p < 0.001).

Conclusions​

Cancer-related fatigue differs from CKD-related fatigue, based on a protocol that includes the assessment of subjective fatigue, muscle fatigue by the finger tapping speed, and RPE. Whereas cancer-related fatigue correlates with higher perceived effort, CKD-related fatigue correlates with reduced motor performance. These findings support the use of condition-specific fatigue assessments and highlight the value of integrating both subjective and objective measures in the understanding of fatigue.
 
Frankly, the fact that this is even a point of dispute is a clear sign of a profession in distress. This is too basic to have ever gotten this bad. The idea that fatigue from overt-raining may have anything to do with cancer fatigue, acute infectious illness, anemia or thyroid problems is obviously false. They are obviously entirely different causes leading to a similar outcome. Plus whatever the hell any of this may have to do with some imagined cycle of 'catastrophizing' and other blatant nonsense quacks made up in their attempt to describe individual symptoms as being the same thing regardless of its cause.

The whole psychosomatic project is a repudiation of science, the idea that we can know things, and that to do that we have to tell different things apart from other things, even if they look superficially similar, and that for that we need to know their causes. The entire ideology rejects the idea that cause is important, it literally retroactively attributes its consequences as a cause. The biopsychosocial model is regressive in all aspects, it ignores centuries of painfully learned lessons about how knowledge is built, rejects science, in a profession where science is the key element no less, even discourages thought.

And no matter how many time this horrible ideology is proven wrong, nothing ever changes, another giant red flag of a profession in serious distress.
 
They make a good point but I'm more frustrated that I can't access much information because I can only see the abstract and as usual what is in it is somewhat selective.

For example it seems to be saying that for cancer the subjective is higher than the objective and the opposite is true for kidney patients. But I don't know whether the finger tapping speed is significantly different between the two groups.

And it says "No datasets were generated or analysed during the current study." under a title of data availability.

And it was just 30 patients from each, with specifics it seems about the level of illness for kidney/renal patients although I don't know how precise a cohort that means in relation to fatigue, but not so specific regarding cancer - not that I know what I'd be looking for although I guess whether they are cured and how much they have been through seems a start as well as age. I'm assuming none had cancer that particularly affects their arm for example re the finger tapping.

I also have questions in my head regarding whether kidney patients have likely gone through any specific 'culture' in the way that we hear a lot of cancer patients get told to 'fight the cancer' etc or given CBT etc whether they consented to actual courses or it got 'embedded' at them by motivational communication styles etc.

and to look at these subjective scales and see how that might influence over the space of years people's habits in having to maybe fill such things out or getting told to 'be positive' with their answers or not be positive (if realistic idea of exhaustion is important to eg a consultant in seeing how things are going treatment-wise) is likely to have shifted answers in certain directions.
 
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