Fatigue in cancer patients during and after treatment

Servaes, Petra; Verhagen, C.A.H.H.V.M.; Bleijenberg, Gijs

doi:10.1016/s0959-8049(01)00332-x

Cited by 441 publications

(390 citation statements)

References 48 publications

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“…Each subscale consists of 4 items, 2 indicative of fatigue and 2 contraindicative (subscale score range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The responder indicates on a scale of 1 to 5 to what extent the statement applies to him or her.…”

Section: Fatiguementioning

confidence: 99%

“…6 Although inconsistent terminology has been applied when categorizing fatigue dimensions, common classification themes include the physical, psychologic, and motivational dimensions. [7][8][9] For some purposes, a unidimensional assessment of cancer-related fatigue is arguably an appropriate approach (eg, when researching changes in fatigue intensity). For other purposes, such as evaluating treatments targeted at specific dimensions of fatigue, it is arguably more important to examine specific fatigue dimensions.…”

mentioning

confidence: 99%

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A multidimensional examination of correlates of fatigue during radiotherapy

Purcell

Fleming

Bennett

et al. 2009

Cancer

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BACKGROUND: Cancer-related fatigue can be measured as both a unidimensional and a multidimensional construct. Unidimensional fatigue and its symptom correlates have undergone some previous investigation; however, minimal research has considered the differential effect of correlates on individual dimensions of fatigue. The objective of the current study was to investigate cancer-related fatigue in a radiotherapy sample using a multidimensional conceptualization to determine whether correlates of fatigue are consistent across all dimensions or whether each fatigue dimension has its own unique pattern of correlates. METHODS: The study used a prospective cohort design with data collected from radiotherapy patients at 3 time points; before, after, and 6 weeks after radiotherapy treatment. RESULTS: A total of 210 participants were enrolled in the study. Results indicated the following relations. Increased general fatigue was found to be associated with lower performance status, being in a de facto relationship, depression, having treatment to the brain, and reduced vigorous physical activity. Increased physical fatigue was associated with lower performance status, depression, reduced physical activity, reduced productive hours, and nausea. Higher levels of reduced activity were associated with depression, decreased participation in activities of daily living, decreased number of productive hours, and lower performance status. Higher levels of reduced motivation were associated with radiotherapy to the brain, reduced moderate physical activity, and depression. Increased mental fatigue was associated with diagnosis of a brain tumor, anxiety, depression, and sleep problems. CONCLUSIONS: The results of the current study support the recognition of multiple dimensions of fatigue, because each dimension examined had various correlates. These findings further develop our understanding of fatigue and may help clinicians provide more targeted information to people with cancer-related fatigue. Furthermore, these results can guide the development of group or individually tailored interventions that ultimately may reduce the impact of this distressing symptom on people with cancer. Cancer 2010;116:529-37.

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Section: Fatiguementioning

confidence: 99%

mentioning

confidence: 99%

A multidimensional examination of correlates of fatigue during radiotherapy

Purcell

Fleming

Bennett

et al. 2009

Cancer

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“…They involve (1) insufficient coping with the experience of cancer, (2) fear of disease recurrence (Servaes et al, 2003;Young and White, 2006), (3) dysfunctional cognitions concerning fatigue (Broeckel et al, 1998;Servaes et al, 2002c), (4) dysregulation of sleep (Servaes et al, 2002b;Prue et al, 2006), (5) dysregulation of activity (Servaes et al, 2002a;Prue et al, 2006;Young and White, 2006) and (6) low social support and negative social interactions (Servaes et al, 2002c).…”

Section: Interventionmentioning

confidence: 99%

“…Because of the existence of large differences within the group of fatigued cancer survivors (Servaes et al, 2002a), therapy was adapted to each individual. To determine which modules were necessary, each perpetuating factor was measured with specific questionnaires.…”

Section: Interventionmentioning

confidence: 99%

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Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up

2007

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An earlier randomised-controlled trial demonstrated the positive effects of cognitive behaviour therapy (CBT), especially designed for fatigued cancer survivors in reducing fatigue, functional impairments and psychological distress. In the current prospective study, we were able to examine the long-term effect of CBT in patients who completed the therapy. Predictors of fatigue severity at follow-up were exploratory investigated. Sixty-eight patients who completed CBT were assessed at pretreatment, post-treatment and at follow-up (mean follow-up 1.9 years (s.d. 1.0), range: 1 -4 years). To analyse possible predictors of treatment outcome a linear regression (enter) was carried out. Improvements on fatigue severity, functional impairment and psychological distress after CBT appeared to remain stable during a follow-up period. Patients who were not fatigued anymore at follow-up were not different from a reference group of non-fatigued cancer survivors. The explorative regression analysis showed that fatigue severity, psychological distress and somatic attributions at pretreatment contributed to persistent fatigue severity at follow-up. Cognitive behaviour therapy, especially designed for post-cancer fatigue, is successful in reducing fatigue and functional impairment in cancer survivors. Moreover, these positive effects were maintained at about 2 years after finishing CBT.

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Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue

et al. 2017

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IMPORTANCE Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy. OBJECTIVE To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF—exercise, psychological, combined exercise and psychological, and pharmaceutical—and to identify independent variables associated with treatment effectiveness. DATA SOURCES PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Library were searched from the inception of each database to May 31, 2016. STUDY SELECTION Randomized clinical trials in adults with cancer were selected. Inclusion criteria consisted of CRF severity as an outcome and testing of exercise, psychological, exercise plus psychological, or pharmaceutical interventions. DATA EXTRACTION AND SYNTHESIS Studies were independently reviewed by 12 raters in 3 groups using a systematic and blinded process for reconciling disagreement. Effect sizes (Cohen d) were calculated and inversely weighted by SE. MAIN OUTCOMES AND MEASURES Severity of CRF was the primary outcome. Study quality was assessed using a modified 12-item version of the Physiotherapy Evidence-Based Database scale (range, 0–12, with 12 indicating best quality). RESULTS From 17 033 references, 113 unique studies articles (11525 unique participants; 78% female; mean age, 54 [range, 35–72] years) published from January 1, 1999, through May 31, 2016, had sufficient data. Studies were of good quality (mean Physiotherapy Evidence-Based Database scale score, 8.2; range, 5–12) with no evidence of publication bias. Exercise (WES, 0.30; 95% CI, 0.25–0.36; P < .001), psychological (WES, 0.27; 95% CI, 0.21–0.33; P < .001), and exercise plus psychological interventions (WES, 0.26; 95% CI, 0.13–0.38; P < .001) improved CRF during and after primary treatment, whereas pharmaceutical interventions did not (WES, 0.09; 95% CI, 0.00–0.19; P = .05). Results also suggest that CRF treatment effectiveness was associated with cancer stage, baseline treatment status, experimental treatment format, experimental treatment delivery mode, psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures (WES range, −0.91 to 0.99). Results suggest that the effectiveness of behavioral interventions, specifically exercise and psychological interventions, is not attributable to time, attention, and education, and specific intervention modes may be more effective for treating CRF at different points in the cancer treatment trajectory (WES range, 0.09–0.22). CONCLUSIONS AND RELEVANCE Exercise and psychological interventions are effective for reducing CRF during and after cancer treatment, and they are significantly better than the available pharmaceutical options. Clinicians should prescribe exercise or psychological interventions as first-line treatments for CRF.

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Fatigue in cancer patients during and after treatment

Cited by 441 publications

References 48 publications

A multidimensional examination of correlates of fatigue during radiotherapy

A multidimensional examination of correlates of fatigue during radiotherapy

Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up

Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue

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