The Relationships Among Physiologic Variables, Quality of Life, and Fatigue in Patients With Multiple Myeloma

Abstract

Nurses play an integral role in the assessment and management of cancer-related fatigue. Greater understanding of the pathophysiology of fatigue may lead to progress in assessment and intervention, with the ultimate goal of reducing cancer-related fatigue and improving QOL.

The biology of cancer-related fatigue: a review of the literature

“…The remaining studies used medical record review (2) [13, 14], saliva (3) [15-17], a combination of blood and saliva (1) [18], blood and urine (1) [19], and 2 studies did not state the source of the biological markers [20-21]. Biomarkers with significant associations with CRF were related to immune/inflammatory response, metabolic, neuroendocrine function, and genetics.…”

“…In slightly more than half of the 24 articles (13/24, 54%) cut-off scores were used to define CRF: in 6 articles cut-off scores for clinically significant CRF were defined [14, 23, 25-28], in 5 articles cut-off scores were used to dichotomize the study participants into fatigue groups [29-33], and in 2 articles cut-off scores were used to define chronic fatigue [34-35]. Biomarkers were measured predominantly from peripheral blood (n=21/24); in two articles, data obtained from medical records were used and in one study the source of biologic data was not identified [13-14, 20]. Most of the studies (20/24; 83%) looked at a panel of immune and inflammatory biologic markers.…”

“…Higher CRP levels were associated with chronic fatigue in testicular cancer survivors [35] and with fatigue in those with advanced disease [42]. In addition, CRP was found to be a good predictor of CRF in patients with multiple myeloma [13] and was independently associated with CRF among disease-free breast cancer survivors [33, 41]. Investigators of several studies, however, did not find empirical support for the association between CRP and CRF [20, 29, 40].…”

Inflammation and Traumatic Stress

“…For example, a recent study in male veterans of behavioral activation, a psychological therapy that involves physical exposure to reminders of a trauma while being provided positive reinforcement, reduced PTSD symptoms as well as increased health-related quality of life (Jakupcak et al, 2010). Higher health-related quality of life has been linked to reductions in inflammation in other studies (Baturone et al, 2009;Booker, Olson, Pilarski, Noon, & Bahlis, 2009;Mommersteeg, Kupper, Schoormans, Emons, & Pedersen, 2010;Unden et al, 2007). Smoking cessation, which has been linked to reductions in peripheral inflammation (Goncalves et al, 2011), reduced PTSD symptoms and increased perceived health quality in male veterans .…”

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients

“…A cross-sectional study employing a convenience sample of 95 African American demonstrated that a higher belief in powerful others was related to a greater self-esteem [7]. Quality of life in cancer patients has often been studied regarding treatments and symptoms [19,20]. However, patients' sense of transitoriness and its relationship to uncertainty, LOC, and quality of life as symptoms of a cancer diagnosis in patients with lung and GI cancer have yet to be examined in detail.…”