The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice?

Abstract

Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue.

Factors of the evolution of fatigue dimensions in patients with breast cancer during the 2 years after surgery

“…12 Other authors have shown opposite results with regard to chemotherapy. 10,29,30 Our results showed reduced risk of mental fatigue and reduced motivation for optimistic women, which was confirmed by other authors. Chemotherapy would certainly have been more associated if we had considered only the adjuvant therapy period.…”

Symptom clusters and quality of life in breast cancer survivors after cancer treatment in a tertiary hospital in Korea

“…The most frequent symptoms in breast cancer patients are fatigue, anxiety, depression, pain and sleep disturbance (Denieffe, Cowman, & Gooney, ), which tend to occur even after treatment and have a negative effect on QOL (Roiland & Heidrich, ). It is reported that breast cancer survivors continuously experience various symptoms after acute treatments, such as fatigue, pain, lymphedema, menopausal symptoms and sleep disturbance (Capelan et al, ; Fabi et al, ; Moon, Hunter, Moss‐Morris, & Hughes, ; Palesh et al, ; Reichart, ). Furthermore, breast cancer survivors report experiences of psychological distress related to worrying about recurrence, difficulty in resumption of work and family relationships, and concern about social roles (Andreu et al, ).…”

“…cancer survivors continuously experience various symptoms after acute treatments, such as fatigue, pain, lymphedema, menopausal symptoms and sleep disturbance (Capelan et al, 2017;Fabi et al, 2017;Moon, Hunter, Moss-Morris, & Hughes, 2017;Palesh et al, 2013;Reichart, 2017). Furthermore, breast cancer survivors report experiences of psychological distress related to worrying about recurrence, difficulty in resumption of work and family relationships, and concern about social roles (Andreu et al, 2012).…”

Assessing the effect of patient navigator assistance for psychosocial support services on health‐related quality of life in a randomized clinical trial in Latino breast, prostate, and colorectal cancer survivors

“…Recent advances in prevention, screening, and treatment have resulted in longer survival for cancer survivors, particularly those diagnosed with early‐stage disease . However, a significant proportion of these survivors continue to experience decrements to health‐related quality of life (HRQOL) even years after the completion of their cancer treatment, including chronic pain, fatigue, sexual dysfunction, and psychosocial concerns such as depression, anxiety, and decreased social support . Compared with non‐Latino whites (NLWs), Latinos face disproportionately higher mortality and worse HRQOL after the diagnosis and treatment of the 3 most common nonskin cancers: prostate, breast, and colorectal cancer .…”

“…2,3 However, a significant proportion of these survivors continue to experience decrements to healthrelated quality of life (HRQOL) even years after the completion of their cancer treatment, [4][5][6][7][8][9] including chronic pain, fatigue, sexual dysfunction, and psychosocial concerns such as depression, anxiety, and decreased social support. 3,[10][11][12][13][14][15][16][17][18][19][20] Compared with non-Latino whites (NLWs), Latinos face disproportionately higher mortality and worse HRQOL after the diagnosis and treatment of the 3 most common nonskin cancers: prostate, breast, and colorectal cancer. [21][22][23][24][25][26] Latinos are also more likely to have less educational attainment, live below the federal poverty level, and lack both health insurance and a primary care provider in comparison with NLWs.…”