This study investigated the characteristics, course, and correlates of fatigue in women receiving adjuvant chemotherapy for breast cancer. Fifty-four patients were assessed before the start of chemotherapy and during the first three treatment cycles. An age-matched sample of women with no cancer history was assessed at similar time intervals for comparison purposes. Results indicated that breast cancer patients experienced worse fatigue than women with no cancer history. These differences were evident before and after patients started chemotherapy. In addition, fatigue worsened among patients after treatment started. More severe fatigue before treatment was associated with poorer performance status and the presence of fatigue-related symptoms (e.g., sleep problems and muscle weakness). Increases in fatigue after chemotherapy started were associated with continued fatigue-related symptoms and the development of chemotherapy side effects (e.g., nausea and mouth sores). These findings demonstrate the clinical significance of fatigue in breast cancer patients before and during adjuvant chemotherapy treatment. Results also suggest that aggressive management of common side effects, such as nausea and pain, may be useful in relieving chemotherapy-related fatigue.

Although fatigue is one of the most common and debilitating symptoms experienced by cancer patients, it has received little systematic attention. This situation is due in large part to the lack of adequate instruments to measure fatigue. The primary aim of this study was to validate a newly developed measure of fatigue for use with cancer patients: the Fatigue Symptom Inventory (FSI). This 13 item self-report measure was designed to measure the intensity and duration of fatigue and its impact on quality of life. The psychometric properties of the FSI were assessed in women undergoing treatment for breast cancer, women who had completed treatment for breast cancer and women with no history of cancer. A seven-item interference subscale was found to have good internal consistency, with alpha coefficients above 0.90 in all three groups. The complete FSI was found to have rather weak to moderate test-retest reliability among patients in active treatment and healthy comparison subjects assessed on three separate occasions. Convergent validity was demonstrated using comparisons with existing measures of fatigue. Construct validity was demonstrated using comparisons between and within groups as well as comparisons with measures of anxiety and depression. Overall, the FSI was established as a valid and reliable measure of fatigue in cancer patients and healthy individuals. Suggestions are made for the potential application of the measure in clinical research.

Routine sun protection is recommended to prevent skin cancer. Skin cancer prevention may be particularly important for individuals at greater risk, such as those with a family history of melanoma. Our aims were to examine the prevalence of sun-protective behavior (SPB) in unaffected first-degree relatives (FDR) of individuals diagnosed with melanoma and to examine the relationship between protection motivation theory (PMT) variables (i.e., perceived risk, perceived severity, self-efficacy, response efficacy) and SPB. FDRs (n = 100), who were nominated by melanoma patients, completed a standardized, self-report questionnaire measuring demographic characteristics, melanoma risk factors, PMT variables, and SPB. The results indicated that less than one-third of FDRs used sunscreen routinely when in the sun and fewer stayed in the shade or used protective clothing on a frequent basis. FDRs with a college education and with more melanoma risk factors reported higher levels of SPB. Of the four PMT variables, greater perceived risk and greater self-efficacy were significantly correlated with higher levels of SPB. Furthermore, results of multiple regression analyses suggest that perceived risk mediated the relationship between education and SPB and between melanoma risk factors and SPB. These findings suggest that interventions to increase the frequency of SPB in at-risk individuals should highlight risk information as well as methods to improve individuals' confidence in their abilities to engage in SPB. (Cancer Epidemiol Biomarkers Prev 2006;15(1):142 -5)

Summary:outcome. 7 QOL is a multidimensional phenomenon consisting of physical, psychological, and social dimensions, 7 following BMT, an individual's QOL may be affected by As more women are treated with bone marrow transplantation (BMT) for breast cancer, there is growing difficulties in any or all of these areas. QOL following BMT has been examined in several surinterest in quality of life (QOL) following treatment. Although there have been some clinical studies of QOL vey studies. 7,8 However, in some of these studies, QOL was assessed using methods of questionable reliability and valfollowing BMT, this area has received little systematic attention. In particular, it is unclear how QOL for idity, such as open-ended questionnaires, 9 patient interviews, 10 or non-validated QOL instruments developed by women treated with BMT for breast cancer differs from that which might be expected for 'healthy' women of the study authors. 11 In this introduction, only studies which employed standard, validated questionnaires to assess QOL about the same age. To address this issue, we compared QOL reported by women treated with autologous BMT following BMT are briefly reviewed. In a study conducted by Andrykowski and colleagues, 1 for breast cancer with that of a group of women of similar age with no history of cancer. In addition, we exam-QOL was assessed in individuals who were an average of 26 months post-BMT using the Functional Living Indexined the relationship of demographic factors, medical factors, and self-reported symptom prevalence, severity, Cancer (FLIC). 12 Based on mean FLIC scores, the QOL of the BMT survivors was similar to that of a normative samand distress to QOL in post-BMT patients. All participants completed the SF-36 Health Survey developed ple of cancer patients in active chemotherapy treatment. Poorer QOL in BMT survivors was associated with being from the Medical Outcomes Study (SF-36). Post-BMT patients also completed the ECOG Performance Status older (ie above age 30) at the time of BMT. The QOL of 135 individuals who were an average of 47 Rating Scale (PSR) and the Memorial Symptom Assessment Scale (MSAS). Results indicated that, compared months post-BMT was assessed by Baker and colleagues 3 using a measure of life satisfaction (Satisfaction with Life to the women with no cancer history, post-BMT patients reported significantly impaired physical functioning, Domains Scale; SLDS) 13 and a measure of emotional wellbeing (Profile of Mood States; POMS). 14 Based on physical role functioning, general health, vitality, social functioning, and emotional role functioning. Impaired responses to the SLDS, the authors indicated that the BMT survivors reported an 'above average level of satisfaction' QOL following BMT was significantly associated with lower income, a longer time to engraftment, longer hoswith most areas of life but reported some dissatisfaction with physical strength and sexual relations. In addition, the pital stay, poor performance status, and greater symptom prevalence, severity, and d...