Fatigue is one of the most common and distressing symptoms for people receiving cancer treatment, yet it is often underestimated among middle-aged patients. A new study published in Healthcare and Rehabilitation reveals that even among women aged 45–59 undergoing chemotherapy for breast cancer, fatigue is a notable concern and is strongly influenced by psychological, financial, and treatment-related factors.

Researchers evaluated 651 patients from Shanghai and Guangxi in China using validated Patient-Reported Outcomes Measurement Information System (PROMIS) tools. Although the average fatigue level remained within normal limits, 21.2% reported clinically significant fatigue. Many participants were still employed or responsible for family caregiving, indicating that fatigue can substantially impact this group’s functional and social roles.

“About one in five women had fatigue that affected daily functioning, yet this symptom is still frequently overlooked in clinical care,” said Yiwen Duan, one of the study’s co-first authors. “Its impact is magnified when patients are expected to continue caregiving or return to work during treatment.”

Multivariate analysis identified depression and pain interference as the strongest predictors of fatigue, accounting for nearly half of its variability. Lack of medical insurance, being 3–12 months after diagnosis, and undergoing later chemotherapy cycles were also significant risk factors.

“Fatigue is not just physical tiredness,” noted Professor Changrong Yuan, senior author of the study. “Routine screening for depression and comprehensive pain management should begin early, especially for patients under financial stress. Addressing these symptoms proactively can prevent long-term suffering and improve quality of life.”

The authors call for integrating psychological support, multidisciplinary pain management, and financial counseling into routine chemotherapy care. Early identification and intervention may help prevent fatigue from becoming a chronic burden for middle-aged breast cancer patients.

The work titled “Fatigue and associated factors among middle-aged patients with breast cancer undergoing chemotherapy in China: A cross-sectional study”, was published on Healthcare and Rehabilitation (published on October 4, 2025).

DOI:10.1016/j.hcr.2025.100050