Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors

Abstract

Background Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life (physical, psychosocial, professional, and socioeconomic). The aim of this study was to assess the severity of cancer-related fatigue in a group of breast cancer patients undergoing chemotherapy and explore the association between fatigue scores and sociodemographic, clinical, biological, psychiatric, and genetic factors. Methods A cross-sectional pilot study carried out at the oncology outpatient unit of Hôtel-Dieu de France University Hospital recruited 67 breast cancer patients undergoing chemotherapy between November 2017 and June 2019 to evaluate fatigue using the EORTC QLQ-C30 scale (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire). Genotyping for seven gene polymorphisms (COMT, DRD2, OPRM1, CLOCK, PER2, CRY2, ABCB1) was performed using the Lightcycler® (Roche). Results The prevalence of fatigue was 46.3%. Multivariable analysis taking the fatigue score as the dependent variable showed that a higher number of cycles and a lower hemoglobin level were significantly associated with higher odds of exhibiting fatigue. Moreover, having at least one C allele for DRD2 SNP (vs. TT) was significantly associated with a 4.09 higher odds of expressing fatigue compared to TT patients. Finally, patients with at least one C allele for CLOCK SNP tended to display higher fatigue levels than TT patients. Conclusions Our study showed that anemic breast cancer patients with a high number of chemotherapy cycles and those carrying at least one C allele for DRD2 and CLOCK SNPs are at greater risk of exhibiting fatigue. Since no previous research has reported such genetic results, future studies are necessary to confirm our findings.

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“…In contrast, the present study suggests that older patients are at a higher risk of experiencing cancer-related fatigue. The breast cancer stage and number of chemotherapy cycles were insignificant in our investigation, while other studies [36,44,45] indicate that patients with more advanced nonmetastatic breast cancer and those receiving more treatments are at higher risk of suffering from cancer-related fatigue. The number of responses and specific problems communicated during our study were not determined by education level, marital, employment or economic status.…”

“…The prevalence of particular symptoms reported during our project is consistent with other studies. Fatigue is known to be the most frequent and distressing symptom for breast cancer patients [33][34][35][36]. In our study, fatigue accounted for the majority of overall problems reported, and triggers activating alerts to the BCNs.…”

Fatigue and associated factors among adult cancer patients receiving cancer treatment at oncology unit in Amhara region, Ethiopia

“…The possible explanation might be due to the healing process of cancer being maximized as the patients fully cover their cycle of treatment and also the psychological factors like anxiety and depression being lowered and psychological adaptability being increased. However, this finding interestingly contrasts with a study conducted in Lebanon [51]. This might be due to a difference in measurement tool, inclusion, and sample size.…”

“…Once the mitochondria are damaged, the energy supply is reduced, which results in fatigue [5,6,8]. However, the prevalence of the current study was much higher than studies which have been conducted in South Korea, 67.2% [50], Lebanon, 46.3% [51], Italy, 43.5%, [52], and Netherlands, 48% [53]. This discrepancy might be due to the difference in study population, sample size, tool, and eligibility criteria [6,54,55].…”

Relationships between fatigue differential experience and anxiety, depression, and serum hormones among Chinese cancer survivors: a cross-sectional study

“…Tumors and anti-tumor therapy are the direct causes of CRF, nevertheless, susceptibilities to exhaustion and levels of fatigue might vary among individuals with the same types of cancer or receiving the same treatments. For instance, one study found that among 67 breast cancer patients receiving simultaneous chemotherapy, 46.3% displayed higher levels of exhaustion and 56.7% displayed lower levels of fatigue 12 , while there were similar differences among tumor patients who received other treatments or did not receive treatment. Female, insomniac, depressed, neurotic, and other factors are widely known as possible in uencing factors of CRF.…”