Cancer-related fatigue and its determinants in a cohort of women with breast cancer: the DAMA Cohort

Abstract

Cancer-related fatigue (CRF) is one of the most prolonged discomforts suffered by people who have had cancer. Seventy-eight to ninety-six percent of cancer patients experience fatigue, especially while undergoing treatment. CRF is related to insomnia, anxiety, depression, and also varies depending on age. However, little is known about the factors contributing to CRF and better understanding of determinants of CRF makes it easier to identify early patients at risk and in designing intervention planning. The aim of this study was to assess the influence of precipitating factors (diagnosis of breast cancer and other clinical aspects) and perpetuating factors (social network, quality of life, mental disorders) on the presence of chronic fatigue in women from our cultural context, by social class each other determinants. Methods It was carried out a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were data from the Brief Fatigue Inventory questionnaire and hospital medical records. The dependent variable was fatigue and the independent variables were age, social class, time since diagnoses, cohabitation, comorbidity, relapse, body mass index, mental health (anxiety and depression), social network, social support, and quality of life. Results Seventy-two percent of the women in the DAMA cohort reported moderate to severe fatigue. Risk of suffering from severe fatigue was greatest among individuals with low social class, those aged under 50 years, those with chronic disorders who

Subgroups of patients undergoing chemotherapy with distinct cognitive fatigue and evening physical fatigue profiles

“…Less is known about the relationship between anxiety and fatigue severity. Our findings are consistent with previous reports that found that higher rates of trait anxiety were associated with higher levels of fatigue in patients with breast cancer undergoing chemotherapy [68] and in cancer survivors [32,52,65]. One explanation for this association is that higher levels of anxiety cause dysregulation of the hypothalamic-pituitary-adrenal axis, which may increase cytokine production and associated increases in both cognitive and physical fatigue [8].…”

“…Within the context of undergoing chemotherapy, it is readily apparent why patients with the additional burden of child care would be classified in the High class. A plausible explanation for the associations between the other two characteristics and membership in the High class is the recent findings that perceptions of lack of social support and loneliness are associated with higher levels of cancer-related fatigue [52,59]. While it is difficult to disentangle the causal relationships between lack of social support and cancer-related fatigue, future studies should incorporate measures of loneliness, social isolation, and social support to evaluate these associations.…”

Cancer-related fatigue and depression: a monocentric, prospective, cross-sectional study in advanced solid tumors

“…Previously, numerous studies have been conducted aiming to explore this association, and different hypotheses have been formulated. 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 According to Reuter and Härter, 46 CRF could be interpreted as part of a depressive disorder where somatic symptoms play a central role. Conversely, Jacobsen et al.…”

“… 31 , 32 , 33 Previous studies documented that CRF and depression could coexist in cancer patients, however their possible association and interconnection remain not well established. 15 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 Results of these studies have, in fact, demonstrated that when CRF was considered as a one-dimensional construct, it could be a simple symptom of depression; on the contrary, considering CRF in a multidimensional way, it resulted in a syndrome with complex relationships with depressive disorders. In particular, emotional aspects and the inner tension of patients with fatigue present similarities with anhedonia and psychomotor agitation, typical of depressive syndromes.…”

Do posttraumatic stress symptoms predict trajectories of sleep disturbance and fatigue in patients with breast cancer? A parallel‐process latent growth model

“…Last, the conditional parallel-process LGM with baseline PTSS (i.e., avoidance, intrusion, and hyperarousal) as predictors was examined. Anxiety, depressive symptoms, and chronotype were entered as covariates in the research model given the association of anxiety with sleep 23 and fatigue 24 and that of depression 23 with SD and fatigue 1 and that of chronotype with sleep 25 and fatigue. 26 To examine the statistical significance of indirect effects in the conditional parallel-process LGM, bias-corrected 95% confidence intervals (CIs) were estimated using 5000 bootstrapping.…”