Fatigue in hormone-naïve prostate cancer patients treated with radical prostatectomy or definitive radiotherapy

Abstract

Chronic fatigue (CF) is a distressing symptom that follows cancer treatment; however, it has rarely been studied in hormone-naïve prostate cancer survivors after radical prostatectomy (RP) or definitive radiotherapy (RAD). We investigated CF in prostate cancer survivors after RP or RAD as monotherapy and explored associations between CF and medical and psychosocial variables. A population-based, cross-sectional postal survey in 2006 included Norwegian hormone-naïve survivors with the diagnosis of prostate cancer in 2004 who were treated with RP (n ¼ 337) or RAD (n ¼ 184). The primary outcome variable was prevalence of CF (defined as fatigue lasting 6 months or longer). Twelve to 32 months after RP and RAD, 13.4 and 26.1% of the patients after, respectively, RP and RAD reported CF inversely associated with pretreatment age (P ¼ 0.003). In multivariate analysis, high neuroticism, post-treatment co-morbidity, pain, urinary and intestinal dysfunction, but not sexual dysfunction, were positively associated with reporting CF. Further studies of CF in prostate cancer survivors should take into consideration the survivors' pretreatment medical and psychosocial situation.

Can sexual bother after radical prostatectomy be predicted preoperatively? Findings from a prospective national study of the relation between sexual function, activity and bother

“…Chronic fatigue was defi ned as a sum score of ≥ 4 after dichotomization of the responses and duration for ≥ 6 months [ 14,15 ] .…”

Kronisk tretthet hos voksne kreftoverlevere

“…Norwegian studies have shown that 25-35 % of long-term survivors of breast cancer, lymphoma and cervical cancer are affected by chronic fatigue (4,(13)(14)(15), and that 26 % and 13 % of hormone-naïve men reported chronic fatigue two years after radical radiotherapy and radical prostatectomy for prostate cancer, respectively (16). Recently it was demonstrated that the prevalence of chronic fatigue in Norwegian testicular cancer survivors increased from 15 % twelve years after treatment to 27 % seven years later (17).…”

“…Recently, however, a metaanalysis showed that the risk of severe fatigue among breast cancer survivors increased after combined treatment with surgery, chemotherapy and radiotherapy compared with surgery or surgery and radiotherapy alone (24). Radiotherapy has also been discussed as a possible aetiological factor for the development of chronic fatigue in prostate cancer survivors (16).…”

“…Comorbid conditions or other late effects and symptoms such as cardiovascular disease, pulmonary disease, overweight, sleep disturbance, hormonal changes, peripheral neuropathy, and persistent pain may also be contributory factors (3,13,14,16,17).…”

“…The inflammation hypothesis is supported by relatively consistent findings on a correlation between fever, weight loss and night sweats (B symptoms), and chronic fatigue in lymphoma survivors. A possible explanation for radiotherapy as an aetiological factor for developing chronic fatigue in prostate cancer survivors may be that such treatment more than surgery can induce long-lasting inflammatory processes (16).…”