Cancer and Cancer-Related Fatigue and the Interrelationships With Depression, Stress, and Inflammation

Weber, Daniel; O’Brien, Kylie

doi:10.1177/2156587216676122

Cited by 79 publications

(53 citation statements)

References 65 publications

(89 reference statements)

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“…This finding suggests that some psychological symptoms may form a fairly stable symptom cluster with CRF. It also supports the possibility that anxiety and depression add to the stress response and weaken the immune system, triggering inflammatory mediators involved in CRF and leading to pro‐inflammatory changes in the body . These findings are aligned with reviews reporting depression and anxiety as prominent correlates of CRF, and lend strength to the argument that psychological distress needs to be accounted for when investigating the usefulness of leptin as a biomarker for CRF.…”

Section: Discussionsupporting

confidence: 73%

Association of plasma leptin, pro‐inflammatory adipokines and cancer‐related fatigue in early‐stage breast cancer patients: A prospective cohort study

Toh

Tan

Yeo

et al. 2019

J Cellular Molecular Medi

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Cancer‐related fatigue (CRF) is subjective and has wide inter‐individual variability. Given that leptin is commonly associated with fatigue syndrome, its use as a potential biomarker for CRF is being investigated. The primary objective of this study was to evaluate the association between leptin and CRF in early‐stage breast cancer patients receiving chemotherapy. In a prospective cohort study, patients completed assessments at baseline (T1), during chemotherapy (T2) and after chemotherapy (T3). Levels of plasma leptin and adipokines were measured using a Luminex bead‐immunoassay and CRF was measured using the Multi‐Dimensional Fatigue Symptom Inventory‐Short Form (MFSI‐SF). Data were analysed longitudinally using a generalised estimating equation incorporating clinically relevant parameters and pro‐inflammatory adipokines. The analysis included 136 patients (mean age ± SD = 51.5 ± 8.8 years; 69.1% receiving anthracycline‐based chemotherapy). More patients experienced CRF at T3 (23.8%) than at T2 (13.8%) compared to baseline. An increase was observed in the median plasma leptin level at T2, followed by a decrease at T3 (T1: 4.07 ng/mL, T2: 4.95 ng/mL and T3: 3.96 ng/mL). In the multivariate model, the change in leptin levels over time was significantly associated with the total MFSI‐SF score ( β = −0.15, P = 0.003) after adjusting for the tumour necrosis factor‐α (TNF‐α) level, anxiety, depression, insomnia, age, menopausal status and type of chemotherapy. This is the first study to report leptin as a biomarker that predicts the onset of CRF over time. Future studies are required to validate the findings.

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Section: Discussionsupporting

confidence: 73%

Association of plasma leptin, pro‐inflammatory adipokines and cancer‐related fatigue in early‐stage breast cancer patients: A prospective cohort study

Toh

Tan

Yeo

et al. 2019

J Cellular Molecular Medi

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“…A cancer diagnosis and its treatments are stressful experiences for most patients. 1,2 The coronavirus disease 2019 (COVID-19) pandemic and associated mitigation procedures have imposed additional stress. Emerging evidence suggests that fear of infection, concerns regarding the efficacy of COVID-19 treatments, the negative impact of various mitigation procedures (e.g., social isolation), and economic uncertainty are associated with higher levels of perceived stress in the general population.…”

Section: Introductionmentioning

confidence: 99%

Stress and Symptom Burden in Oncology Patients During the COVID-19 Pandemic

Miaskowski

Paul

Snowberg

et al. 2020

Journal of Pain and Symptom Management

107

123

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Context. No information is available on oncology patients' level of stress and symptom burden during the coronavirus disease 2019 (COVID-19) pandemic. Objectives. To evaluate for differences in demographic and clinical characteristics, levels of social isolation and loneliness, and the occurrence and severity of common symptoms between oncology patients with low vs. high levels of COVID-19 and cancer-related stress. In addition, to determine which of these characteristics were associated with membership in the highstressed group. Methods. Patients were 18 years and older; had a diagnosis of cancer; and were able to complete an online survey. Results. Of the 187 patients in this study, 31.6% were categorized in the stressed group (Impact of Event ScaledRevised [score of $24]). Stressed group's Impact of Event ScaledRevised score exceeds previous benchmarks in oncology patients and equates with probable post-traumatic stress disorder. In this stressed group, patients reported occurrence rates for depression (71.2%), anxiety (78.0%), sleep disturbance (78.0%), evening fatigue (55.9%), cognitive impairment (91.5%), and pain (75.9%). Symptom severity scores equate with clinically meaningful levels for each symptom. Conclusion. We identified alarmingly high rates of stress and an extraordinarily high symptom burden among patients with cancer, exceeding those previously benchmarked in this population and on par with noncancer patients with post-traumatic stress disorder. Given that the COVID-19 pandemic will likely impact cancer care for an indefinite period, clinicians must exhibit increased vigilance in their assessments of patients' level of stress and symptom burden. Moreover, an increase in referrals to appropriate supportive care resources must be prioritized for high-risk patients. J Pain Symptom Manage 2020;60:e25ee34.

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“…Chronic arm lymphedema after breast surgery impairs physical performance and studies have shown that early mobilization and rehabilitation have improved outcomes [23]. It is imperative that the patient's physical symptoms be addressed early and adequately as physical disability often leads to depression [24].…”

Section: Discussionmentioning

confidence: 99%

The Perspective of a Breast Cancer Patient: A Survey Study Assessing Needs and Expectations

Prakash

Sardar

Shaikh

et al. 2020

Cureus

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Background Patient satisfaction is one of the key indicators of health care quality. We aim to identify patient's needs and expectations in a breast cancer clinic to provide patient-centered care and better overall satisfaction. Methods A 17-item survey was administered to 110 patients at a breast cancer clinic. The survey was designed after a thorough literature review and approved by an oncologist and a palliative care physician. Results Self-reported knowledge about the disease was reported adequate by 90.9% of our patients yet only 55.45% of our patients could identify the stage of their cancer. More education was desired by 32.7% of patients including various treatment options (29%), common complications (24.5%), prognosis (26.3%) and risk factors (11.8%). The majority of our patients were having some form of cancer-related emotional stress and physical symptoms. The majority of our patients (57.27%) wanted their oncologist to address social/emotional issues and 25.45% felt the need for more focus on physical symptoms in their subsequent visits. End-of-life (EoL) care discussions were considered an integral component of overall care by 29% of our patients. Components of EoL care discussions that patients stated they could benefit from included prognosis (27.27%), life expectancy (29%), the treatment effect on the quality of life (22.7%), palliative care (9%), hospice (10.9%), advance directives (11.8%), and family involvement in medical decision-making (13.6%). There was a difference noted regarding their EoL care discussion based on the stage of cancer. Patients with early-stage disease wanted their oncologists to decide on the frequency of this discussion (72.7%). Patients with advanced disease wanted EoL care discussion to be done more frequently as initiated by them or their oncologist or if there's a change in the treatment plan.

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Cancer and Cancer-Related Fatigue and the Interrelationships With Depression, Stress, and Inflammation

Cited by 79 publications

References 65 publications

Association of plasma leptin, pro‐inflammatory adipokines and cancer‐related fatigue in early‐stage breast cancer patients: A prospective cohort study

Association of plasma leptin, pro‐inflammatory adipokines and cancer‐related fatigue in early‐stage breast cancer patients: A prospective cohort study

Stress and Symptom Burden in Oncology Patients During the COVID-19 Pandemic

The Perspective of a Breast Cancer Patient: A Survey Study Assessing Needs and Expectations

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