Abnormal weight gain with fatigue and stress in early survivorship after childhood brain tumor diagnosis

Abstract

BackgroundDiagnosis and treatment for individuals with brain tumors during childhood involves sequelae, including abnormal weight gain. This symptom is commonly clustered with fatigue and increased risk for cardiovascular disease. Children's Oncology Group recommendations include annual surveillance of body mass index (BMI) and cardiometabolic comorbidities; however, there has been little emphasis on individualized screening early in survivorship.PurposeThe primary purpose of this paper is to describe the findings of abnormal weight gain and its correlates in a sample of young childhood brain tumor survivors during early survivorship.Design and MethodsThis cross‐sectional multi‐site study included brain tumor survivors of ages 8–12 years who were less than 6 years posttreatment. Convenience sampling from two pediatric cancer centers in the southern United States was utilized. Data collected included BMI, parent report of sleep, and child report of fatigue and stress.ResultsThe sample (N = 21) consisted of children who had received chemotherapy, radiation treatment, and surgery for childhood brain tumor. BMI in overweight and obese categories exceeded normative samples with 38% at or above the 85th percentile. There were clinically significant relationships with fatigue, stress about weight, tumor location, cranial radiation, chemotherapy, and recurrencePractice ImplicationsScreening for abnormal weight gain and related factors, such as fatigue should begin early in survivorship after childhood brain tumor treatment completion with the aim of health promotion and disease prevention. Adiposity measurement techniques should be utilized in future clinical and research settings to improve assessment of cardiometabolic risk.

Cancer-Related Fatigue On Daily Living Activities in Pediatric Cancer Survivors

“…Time after completion of treatment was 28.35 ± 11.27 months in our study. Our study time point was relatively an earlier time after completion of treatment than that of the literature, but our ndings are in concordant with Johnson et al [19], Karimi et al [4], and Nagai et al [17]. in which those studies are also the studies performed just recent years after treatment.…”

“…According to our study, in terms of CNS vs ALL group, probably because ALL group was older in age and a longer period of time had passed since the end of the treatment, a lower level of fatigue was detected in that ALL group. The average time since diagnosis was under 10 years in our study and those aformentioned studies [4,17,19]. This is a shorter time than that of Langeveld et al [15], Meeske et al [7] and Mulroney et al [14] in which fatigue levels declined over time during the long follow up of survivors.…”

“…Higher BMI was associated with higher levels of fatigue in our study. Although Karimi et al [4], having a sample of recent survivors like that of us did not report such association, Johnson et al [19] reported clinically signi cant relationship with fatigue and weight. This study included brain tumor survivors of ages 8-12 years who were less than 6 years posttreatment, that is like our brain tumor study group.…”

“…Tumor type, in our study, which indicates high number of patients with CNS tumor (40% of total) was found to be associated with higher fatigue scores. Johnson et al [19], pointed the signi cance of fatigue in their brain study group of 21 patients. However, no signi cant effect was found between fatigue and primary cancer diagnosis in the literature.…”

“…This might be probably due to large sample size of patients with CNS tumors in our study in whom all of them were treated with both CT and cranial RT. Johnson et al [19] established a clinically signi cant relationship between fatigue and CT and cranial RT. Forty-two of 142 (30%) CNS tumor survivors were identi ed as having clinically signi cant fatigue in the study of Brand's et al [20].…”