Fatigue after treatment for early stage breast cancer

Jacobsen, Paul B.; Donovan, Kristine A.; Small, Brent J.; Jim, Heather; Münster, Pamela N.; Andrykowski, Michael A.

doi:10.1002/cncr.22993

Cited by 66 publications

(51 citation statements)

References 35 publications

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“…Fatigue was elevated in this group relative to comparison samples of healthy individuals, consistent with previous research on survivors of breast cancer after treatment. 51 Genotype frequencies were consistent with those previously observed in the Single Nucleotide Polymorphism Database and fell at Hardy-Weinberg equilibrium (departure 2 tests all P Ͼ .23). Figure 1A shows the distribution of patients at each level of the additive genetic risk score.…”

Section: Resultssupporting

confidence: 87%

Cytokine Genetic Variations and Fatigue Among Patients With Breast Cancer

Bower

Ganz

Irwin

et al. 2013

JCO

112

105

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Purpose Fatigue is a common adverse effect of cancer treatment and may persist for years after treatment completion. However, risk factors for post-treatment fatigue have not been determined. On the basis of studies suggesting an inflammatory basis for fatigue, this study tested the hypothesis that expression-regulating polymorphisms in proinflammatory cytokine genes would predict post-treatment fatigue in breast cancer survivors. Patients and Methods Women diagnosed with early-stage breast cancer (n = 171) completed questionnaires to assess fatigue and other behavioral symptoms (ie, depressive symptoms, memory complaints, sleep disturbance) and provided blood for genotyping within 3 months after primary treatment. Genomic DNA was extracted from peripheral-blood leukocytes and assayed for single nucleotide polymorphisms (SNPs) in the promoter regions of three cytokine genes: ILB −511 C>T (rs16944), IL6 −174 G>C (rs1800795), and TNF −308 G>A (rs1800629). An additive genetic risk score was computed by summing the number of high-expression alleles (zero, one, or two) across all three polymorphisms. Results The genetic risk index was significantly associated with fatigue; as the number of high-expression alleles increased, so did self-reported fatigue severity (P = .002). Analyses of individual SNPs showed that TNF −308 and IL6 −174 were independently associated with fatigue (P = .032). The genetic risk index was also associated with depressive symptoms (P = .007) and memory complaints (P = .016). Conclusion These findings further implicate inflammatory processes as contributors to cancer-related fatigue and suggest a new strategy for identifying and treating patients at risk for this symptom based on genetic variants in proinflammatory cytokine genes.

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Section: Resultssupporting

confidence: 87%

Cytokine Genetic Variations and Fatigue Among Patients With Breast Cancer

Bower

Ganz

Irwin

et al. 2013

JCO

112

105

View full text Add to dashboard Cite

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“…Additional information regarding eligibility criteria and procedures for this separate parent study have been described. [23][24] Eligibility criteria for the present cross-sectional study consisted of participation in the parent study.…”

Section: Participantsmentioning

confidence: 99%

Attitudes Toward Information About Genetic Risk for Cognitive Impairment After Cancer Chemotherapy: Breast Cancer Survivors Compared With Healthy Controls

Andrykowski

Burris²,

Walsh³

et al. 2010

JCO

Self Cite

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A B S T R A C T PurposeThe trend toward personalized medicine will involve cancer treatment increasingly being tailored to the genetic characteristics of individuals. However, the availability of genetic information does not imply this information is desired or would impact treatment decision making. MethodsOne hundred sixty breast cancer survivors (BC group) and 205 healthy controls (HC group) were randomly assigned to respond to two different clinical scenarios varying in genetic-related risk of cognitive impairment (CI; little v very likely) and severity of CI (little v moderate problem) after chemotherapy. Ratings of the importance of being told this genetic information (information importance) and the likelihood this information would affect their decision to receive chemotherapy (information impact) were obtained. ResultsResults indicated the importance ascribed to genetic information was greatest when CI likelihood and severity were both high or low (P Ͻ .05). Information impact ratings were not sensitive to differences in CI likelihood or severity; the BC group was less likely to indicate genetic information would affect their decision to receive chemotherapy than the HC group (P Ͻ .001). ConclusionResults suggest lessened enthusiasm for genetic information that maintains or increases uncertainty about a specific course of action and highlight the importance of including clinically relevant groups in treatment decision-making research that employs hypothetical scenarios. Although women generally believe it is important to receive genetic information, they might benefit from assistance (eg, decision aid) in the difficult task of integrating information about survival and risk for adverse late effects from cancer treatment.

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“…Advanced disease appears to be associated with worsening in severity of CRF symptoms [4]. Fatigue is also one of the most common side effects reported by long-term breast cancer survivors [5]. The mechanisms underlying CRF development have not yet been elucidated; however, chemotherapy, molecularly targeted therapy, radiation therapy, surgery, and anemia have been suggested as potential contributory factors [6].…”

Section: Introductionmentioning

confidence: 99%