Evolving routines: preventing fatigue associated with lung and colorectal cancer

Some individuals with cancer develop fatigue whereas others do not. To begin the development of a biobehavioral model that could explain this phenomenon, the authors interviewed 29 individuals with lung and colorectal cancer before, during, and after treatment and obtained evaluable data for 18. Blood samples and body weight were obtained at the time of each interview. A three-stage process, evolving routines, and an adaptive behavioral mode labeled gliding characterized those who reported little or no fatigue, even when hemoglobin levels were low. Three other nonadaptive behavioral modes (inertia, disorganization, and overexertion) characterized those who reported fatigue. Individuals with similar disease and treatment profiles seldom demonstrated the same behavioral or biological response patterns.