Predictors and course of chronic fatigue in long-term breast cancer survivors

Abstract

BackgroundThe course of fatigue in long-term breast cancer survivors (BCSs) is unknown. The current study examined chronic fatigue (CF) cross-sectionally and longitudinally in relapse-free women up to 10 years after multimodal treatment for BC stage II/III. The prevalence of persistent fatigue (PF: having CF at two assessments separated by >2 years) and its predictors were also investigated.MethodsData from questionnaires (including the Fatigue Questionnaire and questions regarding socio-demographics and physical symptoms) were collected twice from 249 BCSs: 2.5–7 years post-BC diagnosis (T1) and 2.5–3 years thereafter (T2). A physical examination including blood sampling was performed at T1.ResultsCF was diagnosed in 33% of the women at T1 and in 39% at T2, including 57 (23%) subjects with PF. Current psychological distress, treatment-area related discomfort and high body mass index (BMI) were associated with CF at T1 and predicted PF. Increased leukocyte count also predicted PF. Treatment for mental problems prior to the BC, increased hsCRP-level and respiratory symptoms were associated with CF at T1 but did not predict PF.ConclusionsWomen may experience fatigue up to 10 years after multimodal BC treatment, with about one third having CF and about one fourth having PF.Implications for cancer survivorsDuring follow-up, BCSs and their doctors should maximize their efforts to reduce psychological distress, overweight and pain within the BC-treated area, all linked to the development of persistent fatigue.

Is Dispositional Optimism Associated with Fatigue in Breast Cancer Survivors?

“…In comparison, (using the same instrument to measure severe fatigue as in the present study) 12.6% of the general Norwegian female population report severe fatigue (Loge, Ekeberg, & Kaasa, 1998 of breast cancer survivors reported fatigue ≥ 2 years after diagnosis (Reinertsen et al, 2010). Thus, it appears that fatigue may continue for five years or more following treatment.…”

“…A substantial proportion of breast cancer survivors experience fatigue (Minton & Stone, 2008;Reinertsen et al, 2010). Fatigue involves subjective sensations of tiredness, weakness, and/or lack of energy (J. E. Bower et al, 2006).…”

“…Recent studies have found Body Mass Index (BMI) to be associated with fatigue (Levkovich et al, 2015;Reinertsen et al, 2010).…”

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).…”

“…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).…”