Clinically relevant fatigue in men with hormone-sensitive prostate cancer on long-term androgen deprivation therapy

Storey, Dawn J; McLaren, Duncan B.; Atkinson, M A; Butcher, Isabella; Frew, Lesley C; Smyth, John F.; Sharpe, Michael

doi:10.1093/annonc/mdr447

Cited by 66 publications

(35 citation statements)

References 36 publications

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“…There is some prior evidence that clinically relevant fatigue may be more common among ADT recipients with greater concurrent co-morbidities [8]. The present study also identified an association between a higher baseline Gleason score and greater increases in the number of days fatigued raising the possibility that worsening fatigue may be due in part to advanced disease rather than ADT per se.…”

Section: Discussionsupporting

confidence: 61%

“…Consistent with these changes, a significantly higher percentage of ADT−treated patients than controls reported clinically meaningful fatigue at 6 months (33% vs 21%) and 12 months (32% vs. 19%). These figures are less than the 43% rate of clinically meaningful fatigue cases observed in a cross-sectional study of ADT−treated patients conducted by Storey and colleagues [8]. Discrepant findings may be partially explained by differences in methodology.…”

Section: Discussionmentioning

confidence: 68%

“…Along these lines, studies consistently indicate that fatigue worsens over time following ADT initiation [5–7]. Moreover, as many as 43% of patients treated with ADT have been reported to experience clinically significant fatigue [8]. Although these studies provide useful information, they are characterized by a number of methodologic limitations that include small sample sizes, limited follow-up periods, lack of a non-cancer comparison group, and/or lack of a comparison group of prostate cancer patients not receiving ADT.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and predictors of fatigue among men receiving androgen deprivation therapy for prostate cancer: a controlled comparison

Nelson

Gonzalez

Jim

et al. 2016

Support Care Cancer

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Purpose Although fatigue is a common problem for men with prostate cancer undergoing androgen deprivation therapy (ADT), there has been little systematic research on this issue. The present study examined changes in fatigue among prostate cancer patients receiving ADT compared to controls and predictors of heightened fatigue in ADT patients. Methods Prostate cancer patients treated with ADT (ADT+ group, n=60) completed assessments of fatigue prior to or just after ADT initiation (baseline) and 6 and 12 months later. Prostate cancer patients treated with prostatectomy only (ADT− group, n=85), and men without cancer (CA− group, n=86) matched on age and education completed assessments at similar intervals. Results Group-by-time interactions for fatigue severity, interference, and duration were observed when comparing the ADT+ group to controls. Groups did not differ at baseline; however, the ADT+ group reported worse fatigue at 6 and 12 months. The same pattern was observed for changes in the prevalence of clinically meaningful fatigue and the extent of clinically meaningful change in fatigue. Within the ADT+ group, higher baseline comorbidity scores were associated with greater increases in fatigue interference and higher baseline Gleason scores were associated with greater increases in fatigue duration. Conclusions Prostate cancer patients receiving ADT demonstrate a trajectory of worsened fatigue during the first 12 months following treatment initiation relative to controls. Greater comorbidities and higher Gleason scores at baseline appear to be risk factors for heightened fatigue during the first year following ADT initiation. Results highlight important time points for implementation of interventions aimed at fatigue reduction.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

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Characteristics and predictors of fatigue among men receiving androgen deprivation therapy for prostate cancer: a controlled comparison

Nelson

Gonzalez

Jim

et al. 2016

Support Care Cancer

View full text Add to dashboard Cite

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“…In contrast, Storey et al [92] found no relationship between age and fatigue, but the age range in the sample was restricted to older adults (mean age=78, range=54-95). None of these studies systematically evaluated the reasons for the association between lower age and higher fatigue.…”

Section: Discussionmentioning

confidence: 85%

The biology of cancer-related fatigue: a review of the literature

Saligan

Olson

Filler

et al. 2015

Support Care Cancer

237

211

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Purpose Understanding the etiology of cancer-related fatigue (CRF) is critical to identify targets to develop therapies to reduce CRF burden. The goal of this systematic review was to expand on the initial work by the National Cancer Institute CRF Working Group to understand the state of the science of the biology of CRF. Specifically, to evaluate studies that examined the relationships between biomarkers and CRF, and to develop an etiologic model of CRF to guide researchers on pathways to explore or therapeutic targets to investigate. Methods This review was completed by the Multinational Association of Supportive Care in Cancer Fatigue Study Group – Biomarker Working Group. The initial search used three terms (biomarkers, fatigue, cancer), which yielded 11,129 articles. After removing duplicates, 7,175 articles remained. Titles were assessed for the keywords, “cancer” and “fatigue” resulting in 3,811 articles. Articles published before 2010 and those with samples <50 were excluded, leaving 75 articles for full-text review. Of the 75 articles, 25 were further excluded for not investigating the associations of biomarkers and CRF. Results Of the 47 articles reviewed, 25 were cross-sectional and 22 were longitudinal studies. Less than half (44%) were published recently (2010-2013). Almost half (46%) enrolled breast cancer participants. A majority of studies assessed fatigue using self-report questionnaires, and only two studies used clinical parameters to measure fatigue. Conclusions The findings from this review suggest that CRF is linked to immune/inflammatory, metabolic, neuroendocrine, and genetic biomarkers. We also identified gaps in knowledge and made recommendations for future research.

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“…10 ADT is used to lower male androgens in order to treat prostate cancer and is a mainstay of treatment for both metastatic and localized disease. 86,87 ADT can produce effects, such as depression and fatigue, 88,89 that may indirectly affect cognitive functioning, and may also directly affect cognitive functioning as studies suggest that lower testosterone levels are associated with worse cognitive functioning in healthy older men 90 . In addition, both low testosterone levels and ADT increase the risk of cardiovascular disease, 91,92 which is a known risk factor for dementia.…”

Section: Risk Factors For Crcimentioning

confidence: 99%

Cognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults

Vega

Dumas

Newhouse

2017

The American Journal of Geriatric Psychiatry

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Advances in cancer treatment are producing a growing number of cancer survivors; therefore, issues surrounding quality of life during and following cancer treatment have become increasingly important. Chemotherapy-related cognitive impairment (CRCI) is a problem that is commonly reported following the administration of chemotherapy treatment in patients with cancer. Research suggests that CRCI can persist for months to years after completing treatment, which has implications for the trajectory of normal and pathologic cognitive aging for the growing number of long-term cancer survivors. These problems are particularly relevant for older individuals given that cancer is largely a disease of older age, and the number of patients with cancer who are age 65 years or older will increase dramatically over the coming decades. This review will briefly summarize empirical findings related to CRCI, discuss CRCI in older patients with cancer, potential causative hypotheses, and provide a canonical patient case to illustrate how CRCI presents clinically. Finally, potential intervention strategies for CRCI will be highlighted and issues to consider when evaluating older patients with a history of cancer will be discussed.

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Clinically relevant fatigue in men with hormone-sensitive prostate cancer on long-term androgen deprivation therapy

Abstract: Two-fifths of men with biochemically controlled prostate cancer on long-term ADT report CRF that interferes with function. Management aimed at improving CRF should address depression and pain.

Cited by 66 publications

References 36 publications

Characteristics and predictors of fatigue among men receiving androgen deprivation therapy for prostate cancer: a controlled comparison

Characteristics and predictors of fatigue among men receiving androgen deprivation therapy for prostate cancer: a controlled comparison

The biology of cancer-related fatigue: a review of the literature

Cognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults

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