Evidence Report on the Occurrence, Assessment, and Treatment of Fatigue in Cancer Patients

Lawrence, Donald P.; Kupelnick, Bruce; Miller, Kimberly D.; DeVine, Deirdre; Lau, Joseph

doi:10.1093/jncimonographs/lgh027

Cited by 322 publications

(266 citation statements)

References 94 publications

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“…When fatigue prevalence (26.8%) and intensity (mean=5.8; SD=1.3; median=5.4) in this research were compared to studies involving other cancer patients, it was noted that fatigue was less frequent than in studies on patients in palliative care and receiving adjuvant chemotherapy or radiotherapy (1)(2) , and higher than some cancer survivors' experience, who reported 26% (8) . A slightly higher prevalence of fatigue (33%), using the same cut-off score as this study, was observed among colorrectal cancer patients in the United Kingdom (22) .…”

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confidence: 60%

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Fatigue in colorectal cancer patients: prevalence and associated factors

Mota

Pimenta

Caponero

2012

Rev. Latino-Am. Enfermagem

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This study identified the prevalence and predictors of fatigue in colorectal cancer (CRC) patients.Cross-sectional study with 157 adult CRC outpatients (age 60±11.7 years; 54% male; cancer stage IV 44.8%). The Piper Fatigue Scale-revised was used to assess fatigue scores. Socio-demographic, clinical, depression, performance status, pain and sleep disturbance data were assessed. Associations between fatigue and these data were analyzed through logistic regression models. Fatigue was reported by 26.8% patients. Logistic regression identified three predictors: depression (OR: 4.2; 95%CI 1.68-10.39), performance status (OR: 3.2; 95%CI 1.37-7.51) and sleep disturbance (OR: 3.2; 95%CI 1.30-8.09). When all predictors were present, the probability of fatigue occurrence was 80%; when none were present, the probability was 8%. The model's specificity and sensitivity were 81.9% and 58.6%, respectively. Through the assessment of depression, performance status and sleep disturbance, the probability of fatigue occurrence can be estimated, and preventive and treatment strategies can be rapidly implemented in clinical practice. Fatiga en pacientes con cáncer cuello rectal: superioridad y factores asociadosLos objetivos de este estudio fueron la identificación de la superioridad y los predictores de fatiga en pacientes con Cáncer Cuello rectal (CCR). Se trata de estudio seccional con 157 pacientes de ambulatorio con CCR (edad 60±11,7 años; 54% hombres; estadio cáncer IV 44,8%). La Escala de Fatiga de Piper -Revisada fue utilizada para evaluar fatiga. Datos sociodemográficos, clínicos, depresión, funcionalidad, dolor y sueño fueron evaluados. La asociación entre variables fue realizada por regresión logística. Fatiga fue reportada por 26,8% pacientes. Por la regresión logística se identificaron tres predictores: depresión (OR: 4,2; 95%IC 1,68-10,39), funcionalidad (OR: 3,2; 95%IC 1,37-7,51) y perjuicio del sueño (OR: 3,2; 95%IC 1,30-8,09). Cuando todos predictores estaban presentes, la probabilidad de ocurrencia de fatiga fue del 80%; cuando ninguno estaba presente, la probabilidad fue del 8%. La especificidad y sensibilidad del modelo fueron, respectivamente, 81,9 y 58,6%. Conociéndose la probabilidad de fatiga, por medio de la evaluación de depresión, funcionalidad y perjuicio del sueño, se vuelve posible la implementación de estrategias de prevención y tratamiento en la clínica.

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“…In a systematic review that included 27 studies, the prevalence ranged from 4% to 91%, depending on the cancer population and assessment instruments (1) .…”

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confidence: 99%

Fatigue in colorectal cancer patients: prevalence and associated factors

Mota

Pimenta

Caponero

2012

Rev. Latino-Am. Enfermagem

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“…Of 30 patients who took at least one dose of PG, 24 (80%) were evaluable. The patients who were not evaluable had disease progression (3), did not comply with the study protocol (2), or were lost to follow-up (1).…”

Section: Resultsmentioning

confidence: 99%

High-Dose Asian Ginseng (Panax Ginseng) for Cancer-Related Fatigue

et al. 2015

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Introduction and Objective. Cancer-related fatigue (CRF) is the most common and severe symptom in patients with cancer. The number and efficacy of available treatments for CRF are limited. The objective of this preliminary study was to assess the safety of high-dose Panax ginseng (PG) for CRF. Methods. In this prospective, open-label study, 30 patients with CRF (≥4/10) received high-dose PG at 800 mg orally daily for 29 days. Frequency and type of side effects were determined by the National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 4.0. Scores on the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) scale, Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, day 15, and day 29. Global Symptom Evaluation (GSE) was assessed at day 29. Results. Of the 30 patients enrolled, 24 (80%) were evaluable. The median age was 58 years; 50% were females, and 84% were white. No severe (≥grade 3) adverse events related to the study drug were reported. Of the 24 evaluable patients, 21 (87%) had an improved (by ≥3 points) FACIT-F score by day 15. The mean ESAS score (standard deviation) for well-being improved from 4.67 (2.04) to 3.50 (2.34) ( P = .01374), and mean score for appetite improved from 4.29 (2.79) to 2.96 (2.46) ( P = .0097). GSE score of PG for fatigue was ≥3 in 15/24 patients (63%) with median improvement of 5. Conclusion. PG is safe and improves CRF fatigue as well as overall quality of life, appetite, and sleep at night. Randomized controlled trials of PG for CRF are justified.

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“…In particular, behavioral side effects of cancer treatment have become a focus of research and clinical attention. The most common and distressing side effect of cancer treatment is fatigue (Lawrence et al, 2004). Fatigue occurs across different types of cancer and cancer treatments and may persist for months or years after successful treatment completion.…”

Section: Introductionmentioning

confidence: 99%

Cancer-related fatigue: Links with inflammation in cancer patients and survivors

Bower

2007

Brain, Behavior, and Immunity

219

153

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Fatigue is one of the most common and distressing side effects of cancer and its treatment and may persist long after successful treatment completion. Emerging evidence suggests that inflammatory processes may be involved in cancer-related fatigue both during and after treatment. In this review, we consider the evidence for an association between inflammation and fatigue in cancer patients and survivors. Further, we identify potential mechanisms for persistent inflammation, focusing on the HPA axis. Risk factors and treatments for cancer-related fatigue are also discussed.

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Evidence Report on the Occurrence, Assessment, and Treatment of Fatigue in Cancer Patients

Cited by 322 publications

References 94 publications

Fatigue in colorectal cancer patients: prevalence and associated factors

Fatigue in colorectal cancer patients: prevalence and associated factors

High-Dose Asian Ginseng (Panax Ginseng) for Cancer-Related Fatigue

Cancer-related fatigue: Links with inflammation in cancer patients and survivors

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