Factors associated with cancer-related fatigue in breast cancer patients undergoing endocrine therapy in an urban setting: a cross-sectional study

Abstract

BackgroundFatigue is prevalent in breast cancer survivors and has profound effects on daily life. The interference of fatigue with endocrine therapy may be difficult to separate. This study investigates the prevalence and severity of fatigue and identifies the demographic, clinical, and lifestyle factors associated with cancer-related fatigue (CRF) in breast cancer patients undergoing endocrine therapy in an urban area.MethodsWomen with stage I-IIIA breast cancer were recruited and asked to participate (n = 371) in the study. The 315 women who responded to the questionnaire (84.9%), 54 (17.1%) had completed endocrine therapy and 261 (82.9%) were still undergoing endocrine therapy. The patients had been diagnosed at an average of 31 months prior to recruitment (range, 7 to 60 months); the average age was 48 (range, 33 to 72) years. The 11-point scale and Visual Analog Scale (VAS) were employed to quantify the level of fatigue experienced by the patients. Logistic regression analyses and a trend test method were performed to evaluate factors associated with CRF.ResultsAmong the 315 patients, 189 (60%) had experienced or were experiencing CRF during endocrine therapy. Logistic regression analysis was performed to identify factors associated with CRF, including BMI (body mass index), clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet. Factors unrelated to CRF were age, marital status, treatment, endocrine therapy drugs, alcohol intake, and smoking. The trend test method revealed an association between physical activity and dietary level and the intensity of CRF.ConclusionsThe present findings suggest that fatigue is an important problem in the majority of breast cancer patients during endocrine therapy. We found that BMI, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet are associated with fatigue. Future research should focus on the impact factors of CRF and lifestyle in the management of breast cancer patients.

Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial

“…Our findings are consistent with previous observational studies that found higher quality diets [27, 32], as well as diets high in fiber [30], fruits, and vegetables [1], omega-3 fatty acids relative to omega-6 fatty acids [2] were associated with a lower likelihood and less severe persistent fatigue in breast cancer survivors. In contrast to our study, which emphasized at least two servings per day of omega-3 fatty acid-rich foods, and thus encouraged targeted fat consumption, one study found that diets high in fat were associated with increased fatigue [30].…”

“…It has been posited that diets high in antioxidants and other specific micronutrients could help to counter the elevated inflammatory state and thus help to alleviate fatigue. In several observational studies in breast cancer survivors, higher quality diets [27, 32]; diets high in fiber, lower in total fat [30], and high in fruits and vegetables [1]; and those high in omega-3 fatty acids relative to omega-6 fatty acids [2] were associated with a lower likelihood of having persistent fatigue in breast cancer survivors [2]. Likewise, we found that diets high in fatty fish, nuts and seeds, whole grains, and vegetables (in particular green leafy vegetables and tomatoes) were associated with both a lower chance of having fatigue and less severe fatigue in adult cancer survivors, and cancer survivors reporting no-fatigue had significantly higher intakes of certain antioxidant nutrients [55].…”

Cognitive and Occupational Function in Survivors of Adolescent Cancer

“…Other factors related to the incidence and severity of fatigue in patients with cancer include body mass index, clinical stage, menopausal status, duration of endocrine therapy, physical activity, and diet. 59 Pain frequently accompanies cancer, particularly in advanced disease, as well as specific cancer therapies. Results from a meta-analysis showed that greater than 50% of patients with cancer (across disease types and stages) reported experiencing pain.…”

Screening, evaluation, and management of cancer‐related fatigue: Ready for implementation to practice?

“…Nutritional deficits also can contribute to fatigue . Poor appetite, gastrointestinal symptoms, weight loss, and low albumin may signal a nutritional problem.…”