101
|
Impact of sleep disorders in cognitive function of thyroid cancer survivors. Support Care Cancer 2017; 25:2675-2676. [PMID: 28577232 DOI: 10.1007/s00520-017-3765-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 05/22/2017] [Indexed: 12/11/2022]
|
102
|
Poort H, Kaal SEJ, Knoop H, Jansen R, Prins JB, Manten-Horst E, Servaes P, Husson O, van der Graaf WTA. Prevalence and impact of severe fatigue in adolescent and young adult cancer patients in comparison with population-based controls. Support Care Cancer 2017; 25:2911-2918. [PMID: 28528350 PMCID: PMC5527068 DOI: 10.1007/s00520-017-3746-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 05/08/2017] [Indexed: 12/12/2022]
Abstract
Purpose The current study determined the prevalence of severe fatigue in adolescent and young adult (AYA) cancer patients (aged 18–35 years at diagnosis) consulting a multidisciplinary AYA team in comparison with gender- and age-matched population-based controls. In addition, impact of severe fatigue on quality of life and correlates of fatigue severity were examined. Methods AYAs with cancer (n = 83) completed questionnaires including the Checklist Individual Strength (CIS-fatigue), Quality of Life (QoL)-Cancer Survivor, Hospital Anxiety and Depression Scale (reflecting psychological distress), and the Cancer Worry Scale (reflecting fear of cancer recurrence or progression). Results The vast majority of participants had been treated with chemotherapy (87%) and had no active treatment at the time of participation (73.5%). Prevalence of severe fatigue (CIS-fatigue score ≥35) in AYAs with cancer (48%, n = 40/83) was significantly higher in comparison with matched population-based controls (20%, n = 49/249; p < .001). Severely fatigued AYAs with cancer reported lower QoL compared to non-severely fatigued AYAs with cancer (p < .05). Female gender, being unemployed, higher disease stage (III–IV) at diagnosis, receiving active treatment at the time of study participation, being treated with palliative intent, having had radiotherapy, higher fear of recurrence or progression, and higher psychological distress were significantly correlated with fatigue severity (p < .05). Conclusions Severe fatigue based on a validated cut-off score was highly prevalent in this group of AYAs with cancer. QoL is significantly affected by severe fatigue, stressing the importance of detection and management of this symptom in those patients affected by a life-changing diagnosis of cancer in late adolescence or young adulthood.
Collapse
Affiliation(s)
- Hanneke Poort
- Department of Medical Psychology, Expert Center for Chronic Fatigue, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam Public Health research institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Medical Psychology, Expert Center for Chronic Fatigue, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Petra Servaes
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.,The Institute of Cancer Research, United Kingdom and the Royal Marsden NHS Foundation Trust, London, UK
| |
Collapse
|
103
|
Nogueira IC, Araújo AS, Morano MT, Cavalcante AG, Bruin PFD, Paddison JS, Silva GPD, Pereira ED. Assessment of fatigue using the Identity-Consequence Fatigue Scale in patients with lung cancer. J Bras Pneumol 2017; 43:169-175. [PMID: 28125149 PMCID: PMC5687946 DOI: 10.1590/s1806-37562016000000033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/14/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To evaluate the properties of the Identity-Consequence Fatigue Scale (ICFS) in patients with lung cancer (LC), assessing the intensity of fatigue and associated factors. METHODS: This was a cross-sectional study involving LC patients, treated at a teaching hospital in Brazil, who completed the ICFS. Patients with chronic heart disease (CHD) and healthy controls, matched for age and gender, also completed the scale. Initially, a Brazilian Portuguese-language version of the ICFS was administered to 50 LC patients by two independent interviewers; to test for reproducibility, it was readministered to those same patients. At baseline, the LC patients were submitted to spirometry and the six-minute walk test, as well as completing the Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), and Fatigue Severity Scale (FSS). Inflammatory status was assessed by blood C-reactive protein (CRP) levels. To validate the ICFS, we assessed the correlations of its scores with those variables. RESULTS: The sample comprised 50 patients in each group (LC, CHD, and control). In the LC group, the intraclass correlation coefficients for intra-rater and inter-rater reliability regarding ICFS summary variables ranged from 0.94 to 0.76 and from 0.94 to 0.79, respectively. The ICFS presented excellent internal consistency, and Bland-Altman plots showed good test-retest reliability. The ICFS correlated significantly with FSS, HADS, and SF-36 scores, as well as with CRP levels. Mean ICFS scores in the LC group differed significantly from those in the CHD and control groups. CONCLUSIONS: The ICFS is a valid, reliable instrument for evaluating LC patients, in whom depression, quality of life, and CRP levels seem to be significantly associated with fatigue. OBJETIVO: Avaliar as propriedades da Escala de Identificação e Consequências da Fadiga (EICF) em pacientes com câncer de pulmão (CP), analisando a intensidade da fadiga e fatores associados. MÉTODOS: Estudo transversal com pacientes com CP, atendidos em um hospital-escola no Brasil, que preencheram a EICF. Pacientes com doenças cardíacas crônicas (DCC) e controles saudáveis, pareados por idade e sexo, também preencheram a escala. Inicialmente, uma versão brasileira da escala foi aplicada a 50 pacientes com CP por dois entrevistadores independentes; para testar a reprodutibilidade, ela foi reaplicada aos mesmos pacientes. No momento basal, os pacientes com CP realizaram espirometria e teste de caminhada de seis minutos, bem como preencheram a Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e Fatigue Severity Scale (FSS). O estado inflamatório foi avaliado pelos níveis de proteína C reativa (PCR) no sangue. Para validar a EICF, avaliamos as correlações entre as pontuações na mesma e essas variáveis. RESULTADOS: A amostra foi composta por 50 pacientes em cada grupo (CP, DCC e controle). No grupo CP, os coeficientes de correlação intraclasse para confiabilidade intra e interobservador para as variáveis resumidas da EICF variaram de 0,94 a 0,76 e de 0,94 a 0,79, respectivamente. A EICF apresentou excelente consistência interna, e as disposições gráficas de Bland-Altman demonstraram boa confiabilidade teste-reteste. A EICF apresentou correlações significativas com as pontuações na FSS, HADS e SF-36, bem como com os níveis de PCR. As médias das pontuações na EICF do grupo CP diferiram significativamente das dos grupos DCC e controle. CONCLUSÕES: A EICF é um instrumento válido e confiável para a avaliação de pacientes com CP, nos quais depressão, qualidade de vida e níveis de PCR parecem estar significativamente associados à fadiga.
Collapse
Affiliation(s)
- Ingrid Correia Nogueira
- . Universidade Federal do Ceará - UFC - Fortaleza (CE) Brasil
- . Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil
| | - Amanda Souza Araújo
- . Universidade Federal do Ceará - UFC - Fortaleza (CE) Brasil
- . Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil
| | - Maria Tereza Morano
- . Universidade Federal do Ceará - UFC - Fortaleza (CE) Brasil
- . Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil
- . Universidade de Fortaleza - UNIFOR - Fortaleza (CE) Brasil
| | | | | | | | - Guilherme Pinheiro da Silva
- . Universidade de Fortaleza - UNIFOR - Fortaleza (CE) Brasil
- . Universidade de Fortaleza - UNIFOR - Fortaleza (CE) Brasil
| | - Eanes Delgado Pereira
- . Universidade Federal do Ceará - UFC - Fortaleza (CE) Brasil
- . Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil
| |
Collapse
|
104
|
Fontes F, Gonçalves M, Maia S, Pereira S, Severo M, Lunet N. Reliability and validity of the Pittsburgh Sleep Quality Index in breast cancer patients. Support Care Cancer 2017; 25:3059-3066. [DOI: 10.1007/s00520-017-3713-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/17/2017] [Indexed: 12/21/2022]
|
105
|
Bergin ART, Hovey E, Lloyd A, Marx G, Parente P, Rapke T, de Souza P. Docetaxel-related fatigue in men with metastatic prostate cancer: a descriptive analysis. Support Care Cancer 2017; 25:2871-2879. [PMID: 28429147 DOI: 10.1007/s00520-017-3706-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 04/10/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Fatigue is a prevalent and debilitating side effect of docetaxel chemotherapy in metastatic prostate cancer. A better understanding of the kinetics and nature of docetaxel-related fatigue may provide a framework for intervention. METHODS This secondary analysis was performed using the MOTIF database, from a phase III, randomised, double-blind, placebo-controlled study of modafinil (200 mg/day for 15 days) for docetaxel-related fatigue in men with metastatic prostate cancer [1]. The pattern of fatigue was analysed using the MDASI (MD Anderson Symptom Inventory) score. The impact of modafinil, cumulative docetaxel exposure, age and smoking status on fatigue kinetics were explored. Fatigue-related symptoms were assessed using the SOMA6 (fatigue and related symptoms) subset of the SPHERE (Somatic and Psychological Health Report). Mood was tracked using the short form 36 health survey questionnaire (SF-36). RESULTS Across four docetaxel cycles, fatigue scores were higher in the first week and decreased over weeks two and three. Whilst men randomised to modafinil had reduced fatigue scores, cumulative docetaxel had little impact. Younger men (55-68 years) had significantly reduced fatigue scores, whereas current and ex-smokers had higher scores. There was no significant change in mood status or haemoglobin across treatment cycles. Men described both 'somnolence' and 'muscle fatigue' contributing significantly to their symptom complex. CONCLUSIONS Assessment and management of docetaxel-related fatigue remains an important challenge. Given the complex, multifactorial nature of fatigue, identification through structured interview and interventions targeted to specific 'at risk' groups may be the most beneficial. Understanding the temporal pattern (kinetics) and nature of fatigue is critical to guide this process.
Collapse
Affiliation(s)
- A R T Bergin
- Eastern Health, Box Hill Hospital, 8 Arnold St, Box Hill, Victoria, Australia.
| | - E Hovey
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Barker St, Randwick, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia
| | - A Lloyd
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Barker St, Randwick, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia.,Inflammation and Infection Research Centre (IIRC), School of Medical Sciences and National Centre for Cancer Survivorship (NCCS), Randwick, New South Wales, Australia
| | - G Marx
- Sydney Adventist Hospital Clinical Trials Unit & Integrated Cancer Centre, 185 Fox Valley Rd, Wahroonga, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - P Parente
- Eastern Health, Box Hill Hospital, 8 Arnold St, Box Hill, Victoria, Australia.,Eastern Health, Monash University Clinical School, 5 Arnold St, Box Hill, Victoria, Australia
| | - T Rapke
- Sanofi Aventis, Sydney, New South Wales, Australia
| | - P de Souza
- Liverpool Hospital, Goulburn Street, Liverpool, New South Wales, Australia.,Western Sydney University, Penrith, New South Wales, Australia
| |
Collapse
|
106
|
Medysky ME, Temesi J, Culos-Reed SN, Millet GY. Exercise, sleep and cancer-related fatigue: Are they related? Neurophysiol Clin 2017; 47:111-122. [PMID: 28392007 DOI: 10.1016/j.neucli.2017.03.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Cancer-related fatigue (CRF) is a commonly reported and debilitating side effect of cancer and/or cancer treatment. Sleep disorders are also highly reported in the cancer population; however it is unknown if sleep is associated with fatigue. In the general population, exercise has been shown to improve sleep, however in the cancer population this idea is under investigation. The primary purposes of this review were to: (i) review the prevalence and causes of sleep disorders in cancer patients and survivors, (ii) examine the relationship between sleep and CRF and (iii) review the impact of exercise interventions on sleep in cancer patients and survivors. A scoping review of the literature was conducted regarding exercise interventions in cancer patients and survivors with sleep as at least one outcome measure. A search of the literature revealed limited studies (n=21) assessing the effect of exercise on sleep disorders in the cancer population. Methodological issues are evident because assessing sleep is often not the main outcome of interest. The reviewed studies revealed that exercise positively impacts sleep quality and quantity. There seems to be possible relationship between sleep disorders, exercise and CRF. Further investigation of this relationship is necessary, specifically using objective measurement tools, in large, controlled studies, focusing on sleep as the primary outcome.
Collapse
Affiliation(s)
- Mary E Medysky
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - John Temesi
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Susan Nicole Culos-Reed
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada; Department of Oncology, Cumming School of Medicine, Calgary, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada
| | - Guillaume Y Millet
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
| |
Collapse
|
107
|
Gonzalez VJ, McMillan SC, Groer M, Imbert S, Pedro E, Tome J. Symptom Burden: Experiences of Puerto Rican Men With Prostate Cancer Prior to External Beam Radiation Therapy. Clin J Oncol Nurs 2017; 21:104-112. [PMID: 28107324 DOI: 10.1188/17.cjon.104-112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Prostate cancer is the most frequently diagnosed cancer in men in Puerto Rico, and external beam radiation therapy (EBRT) is a popular treatment. Although symptom management is a clinical priority of comprehensive oncology care, symptom assessment at the time of primary or adjuvant EBRT has received limited attention. OBJECTIVES This article examines the prevalence and severity of symptoms experienced by 54 Puerto Rican men prior to EBRT. METHODS Participants completed a demographic form and the MD Anderson Symptom Inventory. Descriptive statistics were generated. FINDINGS Most participants had received hormonal treatment, and about a third had received no treatment prior to EBRT. About a third of those who received hormonal treatment reported experiencing side effects before EBRT, and disturbed sleep, numbness and tingling, fatigue, and dry mouth were the most severe. Puerto Rican men with prostate cancer who receive hormonal treatment are at increased risk for experiencing symptom burden prior to EBRT. Greater need for symptom surveillance, treatment, and control may be needed among this population.
Collapse
|
108
|
Peoples AR, Roscoe JA, Block RC, Heckler CE, Ryan JL, Mustian KM, Janelsins MC, Peppone LJ, Moore DF, Coles C, Hoelzer KL, Morrow GR, Dozier AM. Nausea and disturbed sleep as predictors of cancer-related fatigue in breast cancer patients: a multicenter NCORP study. Support Care Cancer 2016; 25:1271-1278. [PMID: 27995318 DOI: 10.1007/s00520-016-3520-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/28/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a prevalent and distressing side effect of cancer and its treatment that remains inadequately understood and poorly managed. A better understanding of the factors contributing to CRF could result in more effective strategies for the prevention and treatment of CRF. The objectives of this study were to examine the prevalence, severity, and potential predictors for the early onset of CRF after chemotherapy cycle 1 in breast cancer patients. METHODS We report on a secondary data analysis of 548 female breast cancer patients from a phase III multi-center randomized controlled trial examining antiemetic efficacy. CRF was assessed by the Brief Fatigue Inventory at pre- and post-chemotherapy cycle 1 as well as by the four-day diary. RESULTS The prevalence of clinically relevant post-CRF was 75%. Linear regression showed that pre-treatment CRF, greater nausea, disturbed sleep, and younger age were significant risk factors for post-CRF (adjusted R2 = 0.39; P < 0.0001). Path modeling showed that nausea severity influenced post-CRF both directly and indirectly by influencing disturbed sleep. Similarly, pre-treatment CRF influenced post-CRF directly as well as indirectly through both nausea severity and disturbed sleep. Pearson correlations showed that changes in CRF over time were significantly correlated with concurrent changes in nausea severity (r = 0.41; P < 0.0001) and in disturbed sleep (r = 0.20; P < 0.0001). CONCLUSION This study showed a high prevalence (75%) of clinically relevant CRF in breast cancer patients following their initial chemotherapy, and that nausea severity, disturbed sleep, pre-treatment CRF, and age were significant predictors of symptom.
Collapse
Affiliation(s)
- Anita R Peoples
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA.
| | - Joseph A Roscoe
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA
| | - Robert C Block
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Charles E Heckler
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA
| | - Julie L Ryan
- Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA
| | - Karen M Mustian
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA
| | - Michelle C Janelsins
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA
| | - Luke J Peppone
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA
| | | | - Charlotte Coles
- Metro Minnesota Community Oncology Research Consortium, Saint Louis Park, MN, USA
| | | | - Gary R Morrow
- Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA
| | - Ann M Dozier
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| |
Collapse
|
109
|
Browall M, Brandberg Y, Nasic S, Rydberg P, Bergh J, Rydén A, Xie H, Eriksson I, Wengström Y. A prospective exploration of symptom burden clusters in women with breast cancer during chemotherapy treatment. Support Care Cancer 2016; 25:1423-1429. [PMID: 27981366 PMCID: PMC5378737 DOI: 10.1007/s00520-016-3527-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 12/05/2016] [Indexed: 11/03/2022]
Abstract
PURPOSE The aim was to prospectively map symptom clusters in patients with stage I-IIIa breast cancer during standard chemotherapy treatment in a randomised study. METHODS Participants completed the Memorial Symptom Assessment Scale (MSAS) at baseline, day 12 after the first and third cycle of FEC 75 or FEC 100, and day 12 after the last cycle of Taxotere. Cut-off values for symptom scores, a mean value based on each individual reporting a symptom including occurrence, frequency, severity and distress for inclusion in analysis, were determined. RESULTS The symptom burden cluster analysis was conducted in two steps and included symptoms with high frequency and high levels of distress. The factor analysis revealed three symptom clusters; physical, gastro (phys/gastro) and emotional, with core symptoms that remained stable over time. The most prevalent symptoms for the total sample during all cycles were as follows: lack of energy (range between 48 and 90%), feeling sad (48-79%), difficulty sleeping (54-78%), difficulty concentrating (53-74%), worrying (54-74%) and pain (29-67%). CONCLUSION In summary, we have prospectively established that symptom clusters remain stable over time with a basis of core symptoms. This knowledge will aid in the development of effective core symptom-focused interventions to minimise symptom burden for patients treated with chemotherapy for breast cancer.
Collapse
Affiliation(s)
- Maria Browall
- Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden. .,School of Health and Education, University of Skövde, Skövde, Sweden.
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Salmir Nasic
- Research and Development Centre, Skaraborg Hospital, Skövde, Sweden
| | - Per Rydberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Bergh
- Radiumhemmet and Cancer Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Rydén
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Hanjing Xie
- Radiumhemmet and Cancer Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Irene Eriksson
- School of Health and Education, University of Skövde, Skövde, Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.,Radiumhemmet and Cancer Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
110
|
Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue. Bone Marrow Transplant 2016; 52:279-284. [PMID: 27941775 PMCID: PMC5288285 DOI: 10.1038/bmt.2016.248] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 11/09/2022]
Abstract
Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patients from pre to post transplant. Patients undergoing HSCT (N=138) completed questionnaires at pre-transplant and during the 12 months following transplant. Questionnaires assessed sleep and cognitive problems as well as commonly co-occurring symptoms: depressive symptoms, fatigue and pain. Post hoc analyses examined the relationship of specific sleep problems with cognitive problems. Sleep problems covaried with cognitive problems even after controlling for depressive symptoms, fatigue and pain. Depressive symptoms and fatigue were also uniquely related to cognitive problems. Post hoc analyses suggest that sleep somnolence, shortness of breath, snoring and perceptions of inadequate sleep may contribute to the association found between sleep and cognitive problems. Findings suggest that sleep problems are associated with and may contribute to cognitive problems for HSCT patients. However, sleep problems are rarely screened for or discussed during clinic visits. Assessing and treating specific sleep problems in addition to depressive symptoms and fatigue may have implications for improving cognitive problems for HSCT patients.
Collapse
|
111
|
Jeyaram S, Veeraiah S, Elangovan V. Validation of the symbolic assessment of fatigue extent (SAFE)—a cancer fatigue tool with visual response formats. Support Care Cancer 2016; 25:1111-1119. [DOI: 10.1007/s00520-016-3499-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/14/2016] [Indexed: 11/12/2022]
|
112
|
Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: a randomised controlled trial. Br J Cancer 2016; 115:1304-1312. [PMID: 27811855 PMCID: PMC5129819 DOI: 10.1038/bjc.2016.356] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 09/21/2016] [Accepted: 09/28/2016] [Indexed: 12/28/2022] Open
Abstract
Background: Sleep disturbances and poor rest-activity rhythms, which can reduce the quality of life, are highly prevalent among patients with lung cancer. Methods: This trial investigated the effects of a 12-week exercise intervention including home-based walking exercise training and weekly exercise counseling on 111 lung cancer patients. Participants were randomly allocated to receive the intervention or usual-care. Outcomes included objective sleep (total sleep time, TST; sleep efficiency, SE; sleep onset latency, SOL; and wake after sleep onset, WASO), subjective sleep (Pittsburgh Sleep Quality Index, PSQI), and rest-activity rhythms (r24 and I<O). Outcomes were assessed at baseline and 3 and 6 months after intervention. Results: The PSQI (Wald χ2=15.16, P=0.001) and TST (Wald χ2=7.59, P=0.023) of the patients in the exercise group significantly improved 3 and 6 months after intervention. The moderating effect of I<O on TST was significant (β of group × I<O=3.70, P=0.032). Conclusions: The walking program is an effective intervention for improving the subjective and objective sleep quality of lung cancer patients and can be considered an optional component of lung cancer rehabilitation.
Collapse
|
113
|
Barata PC, Cardoso A, Custodio MP, Alves M, Papoila AL, António B, Lawlor PG. Symptom clusters and survival in Portuguese patients with advanced cancer. Cancer Med 2016; 5:2731-2739. [PMID: 27624994 PMCID: PMC5083726 DOI: 10.1002/cam4.860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/09/2016] [Accepted: 07/17/2016] [Indexed: 01/15/2023] Open
Abstract
This study aimed to identify clusters of symptoms, to determine the patient characteristics associated with identified, and determine their strength of association with survival in patients with advanced cancer (ACPs). Consecutively eligible ACPs not receiving cancer‐specific treatment, and referred to a Tertiary Palliative Care Clinic, were enrolled in a prospective cohort study. At first consultation, patients rated 9 symptoms through the Edmonton Symptom Assessment System (0–10 scale) and 10 others using a Likert scale (1–5). Principal component analysis was used in an exploratory factor analysis to identify. Of 318 ACPs, 301 met eligibility criteria with a median (range) age of 69 (37–94) years. Three SCs were identified: neuro‐psycho‐metabolic (NPM) (tiredness, lack of appetite, lack of well−being, dyspnea, depression, and anxiety); gastrointestinal (nausea, vomiting, constipation, hiccups, and dry mouth) and sleep impairment (insomnia and sleep disturbance). Exploratory factor analysis accounted for 40% of variance of observed variables in all SCs. Shorter survival was observed for patients with the NPM cluster (58 vs. 23, P < 0.001), as well as for patients with two or more SCs (45 vs. 21, P = 0.005). In a multivariable model for survival at 30‐days, age (HR: 0.98; 95% CI: 0.97–0.99; P = 0.008), hospitalization at inclusion (HR: 2.27; 95% CI: 1.47–3.51; P < 0.001), poorer performance status (HR: 1.90, 95% CI: 1.24–2.89; P = 0.003), and NPM (HR: 1.64; 95% CI: 1.17–2.31; P = 0.005), were associated with worse survival. Three clinically meaningful SC in patients with advanced cancer were identifiable. The NPM cluster and the presence of two or more SCs, had prognostic value in relation to survival.
Collapse
Affiliation(s)
- Pedro C Barata
- Medical Oncology, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
| | - Alice Cardoso
- Palliative Care, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Maria P Custodio
- Medical Oncology, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Marta Alves
- Epidemiology and Statistics Unit, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Ana L Papoila
- Epidemiology and Statistics Unit, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Barbosa António
- Centre of Bioethics, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - Peter G Lawlor
- Bruyere Continuing Care, Division of Palliative Care, Department of Medicine, Bruyere and Ottawa Hospital Research Institutes, University of Ottawa, Ottawa, Canada
| |
Collapse
|
114
|
Mendoza ME, Capafons A, Gralow JR, Syrjala KL, Suárez-Rodríguez JM, Fann JR, Jensen MP. Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors. Psychooncology 2016; 26:1832-1838. [PMID: 27467589 DOI: 10.1002/pon.4232] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/05/2016] [Accepted: 07/21/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study evaluated the efficacy of an intervention combining the Valencia model of waking hypnosis with cognitive-behavioral therapy (VMWH-CBT) in managing cancer-related pain, fatigue, and sleep problems in individuals with active cancer or who were post-treatment survivors. We hypothesized that four sessions of VMWH-CBT would result in greater improvement in participants' symptoms than four sessions of an education control intervention. Additionally, we examined the effects on several secondary outcome domains that are associated with increases in these symptoms (depression, pain interference, pain catastrophizing, and cancer treatment distress). METHODS The study design was a randomized controlled crossover clinical trial comparing the VMWH-CBT intervention with education control. Participants (N = 44) received four sessions of both treatments, in a counterbalanced order (n = 22 per order condition). RESULTS Participants were 89% female (N = 39) with mean age of 61 years (SD = 12.2). They reported significantly greater improvement after receiving the active treatment relative to the control condition in all the outcome measures. Treatment gains were maintained at 3-month follow-up. CONCLUSIONS This study supports the beneficial effects of the VMWH-CBT intervention relative to a control condition and that treatment gains remain stable. VMWH-CBT-trained clinicians should be accessible for managing symptoms both during and after cancer treatment, though the findings need to be replicated in larger samples of cancer survivors.
Collapse
Affiliation(s)
- M E Mendoza
- Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - A Capafons
- Personalitat, Avaluació i Tractaments Psicològics, University of Valencia, Valencia, Spain
| | - J R Gralow
- Oncology, University of Washington School of Medicine, Seattle, WA, USA
| | - K L Syrjala
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - J M Suárez-Rodríguez
- Mètodes de Investigació i Diagnòstic en Educació, University of Valencia, Valencia, Spain
| | - J R Fann
- Psychiatry and Psychology Service, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - M P Jensen
- Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| |
Collapse
|
115
|
Tian L, Lin L, Li HL, Chen KJ, Zhang XJ, Qian SJ, Hu Y. Prevalence and Associated Factors of Cancer-Related Fatigue Among Cancer Patients in Eastern China. Oncologist 2016; 21:1349-1354. [PMID: 27449523 DOI: 10.1634/theoncologist.2015-0537] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 06/09/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a subjective and distressing symptom, and its associated factors in developing countries remain ambiguous. The goal of this study was to determine the prevalence of and factors associated with CRF among cancer patients in China. METHODS This study was designed as a cross-sectional study to determine the prevalence of and factors associated with CRF among cancer patients in eastern China, regardless of their diagnoses. Data were collected by using a questionnaire survey (including demographic information and brief fatigue inventory) after informed written consent was obtained. A chi-square test was used to analyze the correlations between single categorical factors and CRF, and multiple logistic regression analysis was used to evaluate the associations of potential risk factors with the presence of CRF. RESULTS Out of a total population of 1,938 cancer patients, 1,749 had completed the study questionnaire; 52.07% (n = 904) reported clinically significant fatigue (score ≥4 on Brief Fatigue Inventory). Four hundred twenty-seven (48.47%) patients younger than age 58 years (the median age) and 475 (55.69%) patients age 58 years or older reported clinically significant fatigue. In multivariate analysis, higher sleep quality (p < .01) was negatively associated with CRF, whereas never engaging in physical exercise (p < .01) and higher clinical stage of cancer (p < .01) were positively associated factors that could increase the odds of CRF. CONCLUSION The results of this study suggest that effective management of the two changeable contributing factors of CRF may reduce CRF and thus could be used as references for CRF management. IMPLICATIONS FOR PRACTICE The two modifiable factors of cancer-related fatigue (CRF)-sleep disturbance and physical exercise-should be specifically assessed and managed to mitigate CRF.
Collapse
Affiliation(s)
- Li Tian
- School of Nursing, Fudan University, Shanghai, People's Republic of China
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Lu Lin
- School of Nursing, Soochow University, Suzhou, People's Republic of China
| | - Hui L Li
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Ke J Chen
- School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Xiao J Zhang
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Shu J Qian
- School of Nursing, Soochow University, Suzhou, People's Republic of China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| |
Collapse
|
116
|
Basnet S, Merikanto I, Lahti T, Männistö S, Laatikainen T, Vartiainen E, Partonen T. Associations of common chronic non-communicable diseases and medical conditions with sleep-related problems in a population-based health examination study. Sleep Sci 2016; 9:249-254. [PMID: 28123670 PMCID: PMC5241609 DOI: 10.1016/j.slsci.2016.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/18/2016] [Accepted: 11/14/2016] [Indexed: 12/31/2022] Open
Abstract
A cross-sectional population-based survey, the National FINRISK 2012 Study, designed to monitor chronic diseases and their risk factors in Finland. A random sample of 10,000 adults aged 25-74 years, and of them, 64% (n=6424) participated the study. Participants subjectively reported the total durations for sleep and naps (n=6238), sleep quality (n=5878), bedtimes and wake-up times separately for working days and weekends yielding the amount of sleep debt (n=5878), and the seasonal variation in sleep duration (n=4852). The participants were asked whether they were diagnosed or treated for common chronic diseases in the past 12 months. Logistic regression models were adopted to analysis and adjusted for a range of covariates as potential confounding factors. Total sleep duration and nap duration prolonged in depression and other mental disorder (p<.001 for all). Seasonal variation in sleep duration was associated with depression (p=.014), hypertension (p=.018) and angina pectoris (p=.024). Participants with gallstones, cardiac insufficiency, depression, or degenerative arthritis had poor sleep quality (odds ratios of 1.6-6.3, p=.001 or less for each). Those with degenerative arthritis had sleep debt less (p<.05) and those with angina pectoris more (p<.05) than individuals without these medical conditions. Depression is significantly associated with sleep problems, albeit no sleep debt. Cardiovascular diseases, degenerative arthritis, and gallstones had significant associations with one or more sleep problems. There is therefore a need for more successful management of sleep problems in chronic diseases to improve the quality of life, to reduce treatment relapses, and to increase health and longevity in a population.
Collapse
Affiliation(s)
- Syaron Basnet
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ilona Merikanto
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Tuuli Lahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Hospital District of North Karelia, Joensuu, Finland
| | - Erkki Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
117
|
Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial. PLoS One 2016; 11:e0156911. [PMID: 27341675 PMCID: PMC4920431 DOI: 10.1371/journal.pone.0156911] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/20/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy. Methods This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients’ self-reported health related quality of life-HRQoL. Chi-square tests (X2), independent T-tests and Linear Mixed Models were calculated. Results Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.0001) [PRE-POST: Intervention: Pain 4.2(2.5) - 2.5(1.6), Fatigue 27.6(4.1) - 19.3(4.1), HRQoL 54.9(22.7) - 64.5(23), Control: Pain 3.5(1.7) - 4.8(1.5), Fatigue 28.7(4.1) - 32.5(3.8), HRQoL 51.9(22.3)– 41.2(24.1)]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)– 20.6(5.6) compared to the control group (17.8(6.5)– 22.7(5.3) (F = 58.50 p<0.0001). More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02). Conclusion This study provided evidence that the combination of GI and PMR can be effective in the management of a cluster of symptoms in cancer patients receiving chemotherapy. These techniques can complement existing management measures to achieve a comprehensive management of this symptom cluster and increase patients HRQoL. Trial Registration ClinicalTrials.gov NCT01275872
Collapse
|
118
|
A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors. Sleep Med Rev 2016; 27:20-8. [DOI: 10.1016/j.smrv.2015.07.001] [Citation(s) in RCA: 197] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 06/30/2015] [Accepted: 07/13/2015] [Indexed: 11/20/2022]
|
119
|
Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C. Cancer-Related Fatigue, Version 2.2015. J Natl Compr Canc Netw 2016; 13:1012-39. [PMID: 26285247 DOI: 10.6004/jnccn.2015.0122] [Citation(s) in RCA: 499] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.
Collapse
|
120
|
Hunskar GS, Bjorvatn B, Wensaas KA, Hanevik K, Eide GE, Langeland N, Rortveit G. Excessive daytime sleepiness, sleep need and insomnia 3 years after Giardia infection: a cohort study. Sleep Health 2016; 2:154-158. [PMID: 28923259 DOI: 10.1016/j.sleh.2016.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/04/2016] [Accepted: 03/21/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate whether prior infection with Giardia lamblia is associated with excessive daytime sleepiness, insomnia, and level of sleep need. DESIGN A questionnaire was sent to all confirmed cases of giardiasis 3 years after the outbreak and a control group matched on age and gender. Associations were evaluated by use of multiple regression analysis. RESULTS Excessive daytime sleepiness (score ≥11 on the Epworth Sleepiness Scale) was reported by 31.5% of the Giardia-exposed and 14.1% of the controls. In multivariate analysis, excessive daytime sleepiness was independently associated with Giardia exposure, with an adjusted odds ratio of 1.40 (95% confidence interval [CI], 1.06-1.86). Insomnia was reported by 15.4% of Giardia-exposed and 8.8% of controls, adjusted odds ratio was 0.93 (95% CI, 0.65-1.35). Mean (SD) self-reported sleep need was 8 (1.4) hours among Giardia-exposed and 7.5 (1.1) hours in the control group (P < .001). The adjusted regression coefficient was 0.12 (95% CI, 0.01-0.24). CONCLUSION Being exposed to Giardia was independently associated with excessive daytime sleepiness and larger sleep need, but not with insomnia.
Collapse
Affiliation(s)
- Gunnhild S Hunskar
- Research Group for General Practice, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Bjørn Bjorvatn
- Research Group for General Practice, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Knut-Arne Wensaas
- Research Unit for General Practice, Uni Research Health, Bergen, Norway
| | - Kurt Hanevik
- Department of Clinical Science, University of Bergen, Bergen, Norway; National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Geir Egil Eide
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway; Research Group for Lifestyle Epidemiology, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway; National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Guri Rortveit
- Research Group for General Practice, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Research Unit for General Practice, Uni Research Health, Bergen, Norway
| |
Collapse
|
121
|
Jalali R, Rezaei M, Khaledi Paveh B, Aznab M, AmiriFard N, Mohammadi E. Sleep Disorder and its Correlates in Patients Undergoing Chemotherapy. ACTA ACUST UNITED AC 2016. [DOI: 10.29252/ijn.29.99.100.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
122
|
López E, de la Torre-Luque A, Lazo A, Álvarez J, Buela-Casal G. Assessment of sleep disturbances in patients with cancer: Cross-sectional study in a radiotherapy department. Eur J Oncol Nurs 2016; 20:71-6. [DOI: 10.1016/j.ejon.2014.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 12/27/2014] [Accepted: 12/31/2014] [Indexed: 11/17/2022]
|
123
|
Abstract
Lung cancer is the most common cancer worldwide and is the leading cause of cancer death for both men and women in the USA. Symptom burden in patients with advanced lung cancer is very high and has a negative impact on their quality of life (QOL). Palliative care with its focus on the management of symptoms and addressing physical, psychosocial, spiritual, and existential suffering, as well as medically appropriate goal setting and open communication with patients and families, significantly adds to the quality of care received by advanced lung cancer patients. The Provisional Clinical Opinion (PCO) of American Society of Clinical Oncology (ASCO) as well as the National Cancer Care Network's (NCCN) clinical practice guidelines recommends early integration of palliative care into routine cancer care. In this chapter, we will provide an overview of palliative care in lung cancer and will examine the evidence and recommendations with regard to a comprehensive and interdisciplinary approach to symptom management, as well as discussions of goals of care, advance care planning, and care preferences.
Collapse
Affiliation(s)
- Arvind M Shinde
- Department of Hematology and Oncology, Samuel Oschin Cancer Center, 8700 Beverly Blvd, AC1045, Los Angeles, CA, 90048, USA.
- Department of Medicine, Supportive Care Medicine Program, Cedars Sinai Medical Center, Becker Bldg., B224, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
| | - Azadeh Dashti
- Department of Medicine, Supportive Care Medicine Program, Cedars Sinai Medical Center, Becker Bldg., B224, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| |
Collapse
|
124
|
Seok SH, Jun SE. Factors Affecting Sleep Quality in Women with Cancer Undergoing Radiotherapy. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.1.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sung-Hee Seok
- Department of Nursing, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sang-Eun Jun
- College of Nursing, Keimyung University, Daegu, Korea
| |
Collapse
|
125
|
Zhao SG, Alexander NB, Djuric Z, Zhou J, Tao Y, Schipper M, Feng FY, Eisbruch A, Worden FP, Strath SJ, Jolly S. Maintaining physical activity during head and neck cancer treatment: Results of a pilot controlled trial. Head Neck 2015; 38 Suppl 1:E1086-96. [PMID: 26445898 DOI: 10.1002/hed.24162] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Concurrent chemoradiotherapy (concurrent CRT) to treat head and neck cancer is associated with significant reductions of weight, mobility, and quality of life (QOL). An intervention focusing on functional exercise may attenuate these losses. METHODS We allocated patients to a 14-week functional resistance and walking program designed to maintain physical activity during cancer treatment (MPACT group; n = 11), or to usual care (control group; n = 9). Outcomes were assessed at baseline, and 7 and 14 weeks. RESULTS Compared to controls, the MPACT participants had attenuated decline or improvement in several strength, mobility, physical activity, diet, and QOL endpoints. These trends were statistically significant (p < .05) in knee strength, mental health, head and neck QOL, and barriers to exercise. CONCLUSION In this pilot study of patients with head and neck cancer undergoing concurrent CRT, MPACT training was feasible and maintained or improved function and QOL, thereby providing the basis for larger future interventions with longer follow-up. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1086-E1096, 2016.
Collapse
Affiliation(s)
- Shuang G Zhao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Neil B Alexander
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.,Geriatrics Research, Education and Clinical Center, University of Michigan, Ann Arbor, Michigan
| | - Zora Djuric
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jessica Zhou
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Yebin Tao
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Matthew Schipper
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.,Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Felix Y Feng
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Francis P Worden
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Scott J Strath
- Department of Kinesiology, Center for Aging and Translational Research, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Shruti Jolly
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.,Department of Radiation Oncology, Veterans Affairs Ann Arbor Health Care System, Ann Arbor, Michigan
| |
Collapse
|
126
|
Helvig A, Wade S, Hunter-Eades L. Rest and the associated benefits in restorative sleep: a concept analysis. J Adv Nurs 2015; 72:62-72. [PMID: 26370516 DOI: 10.1111/jan.12807] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ashley Helvig
- Byrdine F. Lewis School of Nursing and Health Professions; Georgia State University; Atlanta Georgia USA
| | - Sonya Wade
- Byrdine F. Lewis School of Nursing and Health Professions; Georgia State University; Atlanta Georgia USA
| | - Lee Hunter-Eades
- Byrdine F. Lewis School of Nursing and Health Professions; Georgia State University; Atlanta Georgia USA
| |
Collapse
|
127
|
Affiliation(s)
- Maria Die Trill
- Hospital Universitario Gregorio Marañón, Psycho-Oncology Unit, Madrid, Spain
| |
Collapse
|
128
|
He Y, Meng Z, Jia Q, Hu F, He X, Tan J, Zhang G, Li X, Zhang J, Zhang Q, Liu L, Zhao L, Li J, Wang Y, Qian Y, Hou S, Liu H, Wang S, Wang R, Zheng W, Hu T, Liu N, Upadhyaya A, Liu Y. Sleep Quality of Patients with Differentiated Thyroid Cancer. PLoS One 2015; 10:e0130634. [PMID: 26083787 PMCID: PMC4471198 DOI: 10.1371/journal.pone.0130634] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/21/2015] [Indexed: 12/31/2022] Open
Abstract
Objective We aimed to measure prevalence of sleep disturbance in patients with differentiated thyroid cancer (DTC) by calculating Pittsburgh Sleep Quality Index (PSQI), and compare these data with patients with benign thyroid nodules or normal participants. Methods Three groups of patients participated in this cross-sectional study. In the first group, 162 patients with DTC received total thyroidectomy, and then 131I therapy. The second group consisted of 84 patients with benign thyroid nodules, who received partial thyroidectomy. The third group was 78 normal healthy control cases. PSQI was used to assess the sleep quality. Inter-group differences were analyzed by Kruskal-Wallis test or independent samples T test. χ2 test was also used to check prevalence differences of poor sleep quality among the groups. Differences of PSQI score and poor sleep quality prevalence before and after 131I therapy in the same group of DTC participants were analyzed by paired T test and Mcnemar's test. Results Higher PSQI score (7.59 ± 4.21) and higher rate of poor sleep quality (54.32%) were shown in DTC patients than in any other group. After 131I therapy, PSQI score and prevalence of poor sleep quality in DTC patients increased significantly to 8.78 ± 4.72 and 70.99%. Then DTC patients were divided into two subgroups based on their metastatic status. DTC patients with metastasis (87/162 cases, 53.70%) had significantly higher PSQI score (10.87 ± 5.18) and higher prevalence of poor sleep quality (79.31%). Conclusion DTC patients suffer from sleep disturbance, 131I therapy and awareness of metastatic status could worsen sleep problem. Psychological fear of cancer, nuclear medicine therapy and metastasis could be one major underlying reason. Longitude and interventional studies are necessary for further investigations.
Collapse
Affiliation(s)
- Yajing He
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
- * E-mail: (ZM); (JT)
| | - Qiang Jia
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Fang Hu
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Xianghui He
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Jian Tan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
- * E-mail: (ZM); (JT)
| | - Guizhi Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Xue Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Jianping Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Li Liu
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Lili Zhao
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Jing Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Yuling Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Yumei Qian
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Shuling Hou
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Hua Liu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Sheng Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Renfei Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Wei Zheng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Tianpeng Hu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Na Liu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Arun Upadhyaya
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| | - Yang Liu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China
| |
Collapse
|
129
|
Hampson JP, Zick SM, Khabir T, Wright BD, Harris RE. Altered resting brain connectivity in persistent cancer related fatigue. NEUROIMAGE-CLINICAL 2015; 8:305-13. [PMID: 26106555 PMCID: PMC4474178 DOI: 10.1016/j.nicl.2015.04.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 12/20/2022]
Abstract
There is an estimated 3 million women in the US living as breast cancer survivors and persistent cancer related fatigue (PCRF) disrupts the lives of an estimated 30% of these women. PCRF is associated with decreased quality of life, decreased sleep quality, impaired cognition and depression. The mechanisms of cancer related fatigue are not well understood; however, preliminary findings indicate dysfunctional activity in the brain as a potential factor. Here we investigate the relationship between PCRF on intrinsic resting state connectivity in this population. Twenty-three age matched breast cancer survivors (15 fatigued and 8 non-fatigued) who completed all cancer-related treatments at least 12 weeks prior to the study, were recruited to undergo functional connectivity magnetic resonance imaging (fcMRI). Intrinsic resting state networks were examined with both seed based and independent component analysis methods. Comparisons of brain connectivity patterns between groups as well as correlations with self-reported fatigue symptoms were performed. Fatigued patients displayed greater left inferior parietal lobule to superior frontal gyrus connectivity as compared to non-fatigued patients (P < 0.05 FDR corrected). This enhanced connectivity was associated with increased physical fatigue (P = 0.04, r = 0.52) and poor sleep quality (P = 0.04, r = 0.52) in the fatigued group. In contrast greater connectivity in the non-fatigued group was found between the right precuneus to the periaqueductal gray as well as the left IPL to subgenual cortex (P < 0.05 FDR corrected). Mental fatigue scores were associated with greater default mode network (DMN) connectivity to the superior frontal gyrus (P = 0.05 FDR corrected) among fatigued subjects (r = 0.82) and less connectivity in the non-fatigued group (r = -0.88). These findings indicate that there is enhanced intrinsic DMN connectivity to the frontal gyrus in breast cancer survivors with persistent fatigue. As the DMN is a network involved in self-referential thinking we speculate that enhanced connectivity between the DMN and the frontal gyrus may be related to mental fatigue and poor sleep quality. In contrast, enhanced connectivity between the DMN and regions in the subgenual cingulate and brainstem may serve a protective function in the non-fatigued group.
Collapse
Key Words
- BA, Brodmann area
- BCS, breast cancer survivors
- BFI, brief fatigue inventory
- BOLD, blood-oxygen level dependence
- Breast cancer survivors
- CFS, chronic fatigue syndrome
- DMN, default mode network
- Default mode network (DMN)
- FDR, false discovery rate
- FWHM, Full width at half maximum
- Functional connectivity magnetic resonance imaging (fcMRI)
- HADS, hospital anxiety and depression scale
- ICA, independent component analysis
- IPL, inferior parietal lobule
- Independent component analysis (ICA)
- MFI, multidimensional fatigue Inventory
- MNI, Montreal Neurological Institute
- PC, posterior cingulate
- PCRF, persistent cancer related fatigue
- PSQI, Pittsburgh sleep quality index
- Persistent cancer related fatigue (PCRF)
- SFG, superior frontal gyrus
- SPM, statistical parametric mapping
- STR, spatio-temporal regression
- fcMRI, functional connectivity magnetic resonance imaging
Collapse
Affiliation(s)
- Johnson P. Hampson
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48106, USA
- Corresponding author at: Chronic Pain and Fatigue Research Center, Department of Anesthesiology, 24 Frank Lloyd Wright Drive, P.O. Box 385, Lobby M, Ann Arbor, MI 48106, USA. Tel.: +1 734 998 7019; fax: +1 734 998 6900.
| | - Suzanna M. Zick
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Tohfa Khabir
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin D. Wright
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Richard E. Harris
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48106, USA
| |
Collapse
|
130
|
Relationships of Circadian Rhythms and Physical Activity With Objective Sleep Parameters in Lung Cancer Patients. Cancer Nurs 2015; 38:215-23. [DOI: 10.1097/ncc.0000000000000163] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
131
|
Akman T, Yavuzsen T, Sevgen Z, Ellidokuz H, Yilmaz AU. Evaluation of sleep disorders in cancer patients based on Pittsburgh Sleep Quality Index. Eur J Cancer Care (Engl) 2015; 24:553-9. [PMID: 25727241 DOI: 10.1111/ecc.12296] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/28/2022]
Abstract
Insomnia, poor sleep quality and short sleep durations are the most common problems seen in cancer patients. More studies are needed about sleep disorders in cancer patients. In our study, we aimed to investigate the prevalence of sleep disorders and the impact of these problems on the quality of life in cancer patients. Pittsburgh Sleep Quality Index (PSQI) was given to a total of 314 patients. The psychometric evaluation of the Turkish version of PSQI in cancer patients revealed that 127 (40.4%) patients had global PSQI scores >5, indicating poor sleep quality. There was no statistically significant relationship between PSQI scores and sexuality, marital status, cancer stage and chemotherapy type (P > 0.05); while the patients with bone and visceral metastasis had much lower PSQI scores (P = 0.006). Patients with Eastern Cooperative Oncology Group performance scores of 3 or more had also significantly lower PSQI scores (P = 0.02). In conclusion, PSQI questionnaire may be used to evaluate the sleep disorders in cancer patients. Consistent use of multi-item measures such as PSQI with established reliability and validity would improve our understanding of difficulties experienced by cancer patients with chronic insomnia.
Collapse
Affiliation(s)
- Tulay Akman
- Tepecik Education and Research Hospital, Division of Medical Oncology, Izmir, Turkey
| | - Tugba Yavuzsen
- Dokuz Eylul University Medical School, Division of Medical Oncology, Izmir, Turkey
| | - Zeynep Sevgen
- Dokuz Eylul University Medical School, Department of Internal Medicine, Izmir, Turkey
| | - Hulya Ellidokuz
- Dokuz Eylul University Medical School, Department of Preventive Oncology, Izmir, Turkey
| | - Ahmet Ugur Yilmaz
- Medical Park, Izmir University, Division of Medical Oncology, Izmir, Turkey
| |
Collapse
|
132
|
Liu W, Schaffer L, Herrs N, Chollet C, Taylor S. Improved sleep after Qigong exercise in breast cancer survivors: A pilot study. Asia Pac J Oncol Nurs 2015; 2:232-239. [PMID: 27981118 PMCID: PMC5123500 DOI: 10.4103/2347-5625.170537] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: Sleep disorder and fatigue are among a few major concerns of breast cancer survivors across the survivorship trajectory. The purpose of this pilot study was to examine feasibility and trends in multiple outcomes after a 6-week Qigong exercise program in breast cancer survivors. Methods: Eight female adults (mean age 55.4 ± 9.4 years, mean time after the completion of cancer treatment 3.9 ± 5.7 years) who had a diagnosis of breast cancer and were at least 3 months postcompletion of primary cancer treatment prior to participation in this study. Baseline evaluation was administered using subjective questionnaires on sleep quality, insomnia, fatigue, and quality of life. All subjects participated in two training sessions to learn the “Six Healing Sound” Qigong exercise and attended group Qigong sessions once per week in the following 6 weeks. In addition to the group sessions, subjects were asked to perform the Qigong exercises twice at home right before going to bed in the evening and immediately after getting up in the morning. Following the 6-week intervention, subjects were re-assessed using the same questionnaires. Pre- and post-intervention scores were analyzed for statistical significance. Results: Compliance rate was 89.6% for group sessions and 78.5% (ranging from 65.6% to 90.7%) for daily home Qigong exercises. No participant reported any adverse event or side effect during the study. All participants indicated in the end-intervention questionnaire that they would highly recommend the intervention to others. Significant improvements were observed in sleeping quality score (from 10.3 ± 3.6 to 5.4 ± 2.3, P < 0.01), insomnia index score (from 16.2 ± 3.2 to 6.8 ± 4.8, P < 0.01), fatigue score (from 60.3 ± 9.4 to 49.1 ± 8.6, P < 0.01), and SF-36 score (from 66.8 ± 7.7 to 80.9 ± 3.9, P < 0.01). Conclusions: Results of this single arm pilot study showed the feasibility and potential of “Six Healing Sounds” Qigong exercise for improving sleep and other symptoms in breast cancer survivors.
Collapse
Affiliation(s)
- Wen Liu
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lauren Schaffer
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Natalie Herrs
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christine Chollet
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sarah Taylor
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| |
Collapse
|
133
|
Incorporating measures of sleep quality into cancer studies. Support Care Cancer 2014; 23:1145-55. [PMID: 25510361 DOI: 10.1007/s00520-014-2537-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/21/2014] [Indexed: 12/31/2022]
Abstract
INTRODUCTION/BACKGROUND Sleep disturbance may influence the development of cancer and responses to treatment. It is also closely tied to recovery and quality of life in cancer patients, survivors, and caregivers, and recent studies have begun to show beneficial effects of sleep-promoting interventions. Despite the importance of sleep to cancer and its treatment and the availability of numerous tools for measuring sleep quality and quantity, sleep measurements are underutilized in cancer studies. METHODS This review, written for cancer researchers interested in incorporating sleep measures into their studies, is designed to raise awareness about the importance of sleep and suggests strategies for including sleep evaluation in cancer studies. CONCLUSIONS Inclusion of readily available sleep measures may ultimately improve cancer care by facilitating studies that lead to a greater understanding of how sleep and sleep disturbance influence all aspects of cancer care and the patient experience.
Collapse
|
134
|
Fong SSM, Ng SSM, Lee HW, Pang MYC, Luk WS, Chung JWY, Wong JYH, Masters RSW. The Effects of a 6-Month Tai Chi Qigong Training Program on Temporomandibular, Cervical, and Shoulder Joint Mobility and Sleep Problems in Nasopharyngeal Cancer Survivors. Integr Cancer Ther 2014; 14:16-25. [DOI: 10.1177/1534735414556508] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Introduction. Nasopharyngeal cancer (NPC) survivors often sustain head–neck–shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. Methods. Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. Results. Intention-to-treat analysis revealed improvement in cervical side flexion ROM only ( P < .008) and unchanged shoulder and TMJ mobility ( P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time ( P < .008). Sleep problems also decreased in the TC Qigong group ( P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training ( P < .05). Conclusions. The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.
Collapse
Affiliation(s)
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - H. W. Lee
- Institute of Human Performance, The University of Hong Kong, Hong Kong
| | - Marco Y. C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - W. S. Luk
- The Association of Licentiates of the Medical Council of Hong Kong, Hong Kong
| | - Joanne W. Y. Chung
- Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong
| | - Janet Y. H. Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rich S. W. Masters
- Institute of Human Performance, The University of Hong Kong, Hong Kong
- Department of Sport and Leisure Studies, University of Waikato, Hamilton, New Zealand
| |
Collapse
|
135
|
Waldman L, Morrison LJ. Sleep disorders and fatigue: special issues in the older adult with cancer. Cancer J 2014; 20:352-7. [PMID: 25299145 DOI: 10.1097/ppo.0000000000000072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Older adults with cancer reporting fatigue and sleep disorders often have coexisting geriatric syndromes and are at high risk of further functional decline. This review summarizes special considerations in the diagnosis and treatment of sleep disorders and fatigue when older persons with cancer present with multiple comorbidities, polypharmacy, dementia, delirium, and/or falls. Physicians caring for these older adults need to be aware of the unique diagnostic and treatment concerns in this population so that these patients can receive optimal care.
Collapse
Affiliation(s)
- Louis Waldman
- From the Yale University School of Medicine, Yale-New Haven Hospital, New Haven, CT
| | | |
Collapse
|
136
|
Faiz SA, Balachandran D, Hessel AC, Lei X, Beadle BM, William WN, Bashoura L. Sleep-related breathing disorders in patients with tumors in the head and neck region. Oncologist 2014; 19:1200-6. [PMID: 25273079 DOI: 10.1634/theoncologist.2014-0176] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sleep disturbance is a prominent complaint of cancer patients. Most studies have focused on insomnia and cancer-related fatigue. Obstructive sleep apnea (OSA) has been reported in small studies and case reports. METHODS In a retrospective review of patients who underwent formal sleep evaluation and polysomnography (PSG) from 2006 to 2011, 56 patients with tumors in the head and neck region were identified. Clinical characteristics, sleep-related history, and PSG data were reviewed. RESULTS Most patients had active cancer (80%), and the majority had squamous pathology (68%). Prominent symptoms included daytime fatigue (93%), daytime sleepiness (89%), and snoring (82%). Comorbid conditions primarily included hypertension (46%) and hypothyroidism (34%). Significant sleep-related breathing disorder was noted in 93% of patients, and 84% met clinical criteria for OSA. A male predominance (77%) was noted, and patients were not obese (body mass index <30 kg/m(2) in 52%). The majority of patients (79%) underwent radiation prior to sleep study, of which 88% had OSA, and in the group without prior radiation, 67% had OSA. Adherence to positive airway pressure (PAP) therapy was slightly better when compared with the general population. A subset of patients with persistent hypoxia despite advanced forms of PAP required tracheostomy. Multivariate analysis revealed that patients with active disease and radiation prior to PSG were more likely to have OSA. CONCLUSION Sleep-related breathing disorder was common in patients with tumors in the head and neck region referred for evaluation of sleep disruption, and most met clinical criteria for OSA. Daytime fatigue and sleepiness were the most common complaints. OSA was prevalent in male patients, and most with OSA were not obese. Architectural distortion from the malignancy and/or treatment may predispose these patients to OSA by altering anatomic and neural factors. A heightened clinical suspicion for sleep-related breathing disorder and referral to a sleep specialist would be beneficial for patients with these complaints.
Collapse
Affiliation(s)
- Saadia A Faiz
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diwakar Balachandran
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy C Hessel
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xiudong Lei
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Beth M Beadle
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - William N William
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lara Bashoura
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
137
|
|
138
|
Innominato PF, Roche VP, Palesh OG, Ulusakarya A, Spiegel D, Lévi FA. The circadian timing system in clinical oncology. Ann Med 2014; 46:191-207. [PMID: 24915535 DOI: 10.3109/07853890.2014.916990] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The circadian timing system (CTS) controls several critical molecular pathways for cancer processes and treatment effects over the 24 hours, including drug metabolism, cell cycle, apoptosis, and DNA damage repair mechanisms. This results in the circadian time dependency of whole-body and cellular pharmacokinetics and pharmacodynamics of anticancer agents. However, CTS robustness and phase varies among cancer patients, based on circadian monitoring of rest- activity, body temperature, sleep, and/or hormonal secretion rhythms. Circadian disruption has been further found in up to 50% of patients with metastatic cancer. Such disruption was associated with poor outcomes, including fatigue, anorexia, sleep disorders, and short progression-free and overall survival. Novel, minimally invasive devices have enabled continuous CTS assessment in non-hospitalized cancer patients. They revealed up to 12-hour differences in individual circadian phase. Taken together, the data support the personalization of chronotherapy. This treatment method aims at the adjustment of cancer treatment delivery according to circadian rhythms, using programmable-in-time pumps or novel release formulations, in order to increase both efficacy and tolerability. A fixed oxaliplatin, 5-fluorouracil and leucovorin chronotherapy protocol prolonged median overall survival in men with metastatic colorectal cancer by 3.3 months as compared to conventional delivery, according to a meta-analysis (P=0.009). Further analyses revealed the need for the prevention of circadian disruption or the restoration of robust circadian function in patients on chronotherapy, in order to further optimize treatment effects. The strengthening of external synchronizers could meet such a goal, through programmed exercise, meal timing, light exposure, improved social support, sleep scheduling, and the properly timed administration of drugs that target circadian clocks. Chrono-rehabilitation warrants clinical testing for improving quality of life and survival in cancer patients.
Collapse
Affiliation(s)
- Pasquale F Innominato
- INSERM, UMRS 776 'Biological Rhythms and Cancers', Campus CNRS , 7 rue Guy Môquet, 94801 Villejuif Cedex , France
| | | | | | | | | | | |
Collapse
|
139
|
Cheng MJ, Hourigan CS, Smith TJ. Adult Acute Myeloid Leukemia Long-term Survivors. JOURNAL OF LEUKEMIA (LOS ANGELES, CALIF.) 2014; 2:26855. [PMID: 25243197 PMCID: PMC4167020 DOI: 10.4172/2329-6917.1000135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The number of leukemia patients and survivors is growing. This review summarizes what is known regarding the health related quality of life (HRQOL) and medical complications associated with acute myeloid leukemia (AML) disease and treatment and highlights understudied aspects of adult AML survivorship care, and potential novel areas for intervention.
Collapse
Affiliation(s)
- M Jennifer Cheng
- Pain and Palliative Service, Clinical Center, National Institutes of Health (MJC), National Heart, Lung, and Blood Institute, (CSH) and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland (TJS)
| | - Christopher S Hourigan
- Pain and Palliative Service, Clinical Center, National Institutes of Health (MJC), National Heart, Lung, and Blood Institute, (CSH) and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland (TJS)
| | - Thomas J Smith
- Pain and Palliative Service, Clinical Center, National Institutes of Health (MJC), National Heart, Lung, and Blood Institute, (CSH) and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland (TJS)
| |
Collapse
|
140
|
Ratcliff CG, Lam CY, Arun B, Valero V, Cohen L. Ecological momentary assessment of sleep, symptoms, and mood during chemotherapy for breast cancer. Psychooncology 2014; 23:1220-8. [PMID: 24706506 DOI: 10.1002/pon.3525] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 02/18/2014] [Accepted: 02/28/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study examined the association of sleep before and during a chemotherapy (CT) cycle for breast cancer with symptoms and mood during a CT cycle. METHODS Twenty women undergoing CT for breast cancer completed the Pittsburgh Sleep Quality Index (PSQI) 1 h prior to a CT infusion. For 3 weeks following infusion, participants estimated sleep efficiency, minutes to sleep (sleep latency), number of nocturnal awakenings (sleep fragmentation (SF)), and sleep quality (SQ) each morning and rated symptoms (nausea, fatigue, numbness, and difficulty thinking) and mood three times daily (morning, afternoon, and evening) via ecological momentary assessments using automated handheld computers. RESULTS The results showed that disturbed sleep (PSQI score > 5) prior to CT infusion was associated with greater fatigue, and more negative and anxious mood throughout the 3-week CT cycle, and good pre-CT infusion sleep (PSQI score < 5) buffered anxious mood in the first days following infusion. Time-lagged analyses controlling for mood/symptom ratings reported the previous evening revealed that longer sleep latency and greater SF were associated with greater daytime fatigue; poorer SQ and greater SF were antecedents of worse morning negative mood, and greater SF was associated with feeling more passive and drowsy. No evening symptom or mood ratings were related to subsequent SQ. CONCLUSIONS These findings suggest that disturbed sleep before and after a CT infusion exacerbates fatigue, and negative, anxious, and drowsy mood during a CT cycle. Reducing sleep disturbance may be an important way to improve quality of life during CT.
Collapse
Affiliation(s)
- Chelsea G Ratcliff
- Department of Clinical Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, USA
| | | | | | | | | |
Collapse
|
141
|
Abstract
There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although sub-clinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of 'cardiometabolic disease' and 'sleep disturbance' are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed.
Collapse
Affiliation(s)
- Michael A Grandner
- Behavioral Sleep Medicine Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA
| |
Collapse
|
142
|
Muls AC. Acta Oncologica Lecture. Gastrointestinal consequences of cancer treatment and the wider context: a bad gut feeling. Acta Oncol 2014; 53:297-306. [PMID: 24460087 DOI: 10.3109/0284186x.2013.873140] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The percentage of people living with a diagnosis of cancer is rising globally. Between 20% and 25% of people treated for cancer experience a consequence of cancer which has an adverse impact on the quality of their life. Gastrointestinal (GI) symptoms are the most common of all consequences of cancer treatment and have the greatest impact on daily activity. PATHOPHYSIOLOGY OF LONG-TERM BOWEL DAMAGE AFTER PELVIC RADIOTHERAPY: Long-term damage to the bowel after radiotherapy is mediated by ischaemic changes and fibrosis. Each fraction of radiotherapy causes a series of repetitive injuries to the intestinal tissue resulting in an altered healing process, which affects the integrity of the repair and changes the architecture of the bowel wall. THE NATURE OF GI SYMPTOMS THAT DEVELOP: Patient-reported outcome measures show that diarrhoea, urgency, increased bowel frequency, tenesmus and flatulence are the five most prevalent GI symptoms with a moderate or severe impact on patients' daily lives after treatment with pelvic radiotherapy. Many patients also experience fatigue, urinary problems and have sexual concerns. SYSTEMATIC ASSESSMENT AND MANAGEMENT: The complex nature of those symptoms warrants systematic assessment and management. The use of a tested algorithm can assist in achieving this. The most common contributing factors to ongoing bowel problems after pelvic radiotherapy are small intestinal bacterial overgrowth, bile acid malabsorption, pancreatic insufficiency, rectal bleeding and its impact on bone health. THE WIDER CONTEXT Symptom burden, socio-psychosocial impact, memory and cognitive function, fatigue, urinary problems and sexual concerns need to be taken into account when thinking about consequences of cancer treatment. CONCLUSION As our understanding of consequences of cancer treatments continues to emerge and encompass a wide variety of specialties, a holistic, multifaceted and multidisciplinary approach is required to manage those consequences long-term.
Collapse
|
143
|
Koornstra RHT, Peters M, Donofrio S, van den Borne B, de Jong FA. Management of fatigue in patients with cancer -- a practical overview. Cancer Treat Rev 2014; 40:791-9. [PMID: 24576643 DOI: 10.1016/j.ctrv.2014.01.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 01/27/2014] [Accepted: 01/30/2014] [Indexed: 11/16/2022]
Abstract
Cancer-related fatigue (CRF) is a serious clinical problem and is one of the most common symptoms experienced by cancer patients. CRF has deleterious effects on many aspects of patient quality of life including their physical, psychological and social well-being. It can also limit their ability to function, socialise and participate in previously enjoyable activities. The aetiology of CRF is complex and multidimensional, involving many potentially contributing elements. These include tumour-related factors and comorbid medical/psychological conditions and also side effects associated with anti-cancer therapies or other medications. Barriers to the effective management of CRF exist both on the side of physicians and patients, and as a result CRF often remains unrecognised and undiscussed in clinical practice. A change of approach is required, where fatigue is treated as central to patient management during and after systemic anti-cancer treatment. In this review we summarise factors involved in the aetiology of CRF and the barriers to its effective management, as well as factors involved in the screening, diagnosis and treatment of cancer patients experiencing fatigue. Pharmacological and non-pharmacological approaches to its management are also reviewed. We suggest an algorithm for the process of managing CRF, guided by our experiences in The Netherlands, which we hope may provide a useful tool to healthcare professionals dealing with cancer patients in their daily practice. Although CRF is a serious and complex clinical problem, if it is worked through in a structured and comprehensive way, effective management has the potential to much improve patient quality of life.
Collapse
Affiliation(s)
| | - Marlies Peters
- Radboud University Medical Center, Nijmegen, The Netherlands.
| | | | | | | |
Collapse
|
144
|
Zhang S, Zeng D, Peng Y, Yang Y, Zhuang X, Li Z, Wang M, Chen L, Zhang H. Cancer-related fatigue and chemotherapy-associated adverse effects: correlation with TNF-α, IL-1 and 17-hydroxycorticosteroids. Future Oncol 2014; 10:1619-26. [PMID: 24450574 DOI: 10.2217/fon.14.15] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AIM We sought to determine the relationship between cancer-related fatigue, chemotherapy-associated adverse effects in patients with advanced stages of cancer, and the levels of TNF-α, IL-1 and 17-hydroxycorticosteroids (17-HCS). PATIENTS & METHODS Two hundred cancer patients were recruited. They were given a Cancer Fatigue Scale survey to assess their general state of health before and after chemotherapy. Their plasma levels of TNF-α and IL-1 and urine levels of 17-HCS were also measured. RESULTS Increased levels of TNF-α and IL-1 are common in cancer patients. Thirty-five (17.5%) patients suffered from chemotherapy-associated adverse effects, but their plasma levels of TNF-α and IL-1 were not significantly elevated after chemotherapy. However, the urinary levels of 17-HCS levels were significantly elevated in 23 patients after chemotherapy. CONCLUSION Patients who had elevated urinary levels of 17-HCS before chemotherapy are accompanied by chemotherapy-associated adverse effects. Thus, elevated 17-HCS in urine could be a possible predictor for chemotherapy-associated adverse effects.
Collapse
Affiliation(s)
- Shuyao Zhang
- Department of Pharmacy, Affiliated Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | | | | | | | | | | | | | | | | |
Collapse
|
145
|
Kröz M, Reif M, Bartsch C, Heckmann C, Zerm R, Schad F, Girke M. Impact of autonomic and self-regulation on cancer-related fatigue and distress in breast cancer patients--a prospective observational study. J Cancer Surviv 2013; 8:319-28. [PMID: 24253954 DOI: 10.1007/s11764-013-0314-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/26/2013] [Indexed: 01/06/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) has a major impact on the quality of life in breast cancer patients (BC). So far, only a few prospective studies have investigated the effect of adaptive salutogenic mechanisms on CRF. The aim of our study was to evaluate the possible prospective influence of autonomic Regulation (aR) and self-regulation (SR) on CRF and distress in long-term survivors. METHODS 95 BC and 80 healthy female controls (C) had been included in the observational study between 2000 and 2001 and completed the questionnaires on aR, SR and Hospital Anxiety and Depression Scale (HADS). Of these, 62 BC, and 58 C participated in the re-evaluation 6.6 years later: 16 participants were deceased (14 BC and 2 C). During follow-up, participants were requested to answer questions involving (Cancer Fatigue Scales) CFS-D, aR, SR and HADS. Multiple regression analysis was used to evaluate the influence of aR, SR, age, Charlson co-morbidity-index and diagnosis on CFS-D and HADS, and to select further potentially relevant factors. RESULTS High aR values showed significant effects, namely inverse relationships with CFS-D, cognitive fatigue, anxiety and depression. SR showed a reduced influence on anxiety and depression (all p < 0.05). CONCLUSIONS Autonomic regulation might have an independent, reductive influence on global fatigue, cognitive fatigue and--together with self-regulation--it seems to have a protective influence on anxiety and depression. The connection between these parameters is still unclear and awaits further evaluation. IMPLICATION FOR CANCER SURVIVORS AR seems to be a prognostic factor in breast cancer survivors, capable of reducing cancer-related fatigue and self-regulation distress as well. Further research is necessary in order to show how aR can be improved by therapeutic interventions.
Collapse
Affiliation(s)
- M Kröz
- Research Institute Havelhöhe (FIH), Berlin, Germany,
| | | | | | | | | | | | | |
Collapse
|
146
|
Pertl MM, Hevey D, Boyle NT, Hughes MM, Collier S, O'Dwyer AM, Harkin A, Kennedy MJ, Connor TJ. C-reactive protein predicts fatigue independently of depression in breast cancer patients prior to chemotherapy. Brain Behav Immun 2013; 34:108-19. [PMID: 23928287 DOI: 10.1016/j.bbi.2013.07.177] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 07/31/2013] [Accepted: 07/31/2013] [Indexed: 12/15/2022] Open
Abstract
Heightened inflammatory activity has been proposed as a mechanism for the development of cancer-related fatigue (CRF), a common and distressing condition that can negatively affect quality of life. Inflammation is also implicated in the pathogenesis of depression, and depression is a strong predictor of CRF. Thus, the role of the pro-inflammatory cytokine network in CRF may be mediated by depression or both conditions may share similar underlying physiological processes. The current study investigated associations between fatigue, depression and inflammatory cytokine (IFN-γ, IL-6, TNF-α) and CRP concentrations, as well as kynurenine pathway (KP) activation, in 61 breast cancer patients prior to chemotherapy. Changes in inflammatory markers and KP activation over time were also explored, and associations with changes in fatigue and depression were examined. Higher levels of CRP were significantly correlated with fatigue and depression before chemotherapy; nevertheless, CRP predicted fatigue independently of depression. Although greater kynurenine concentrations were associated with increased immune activation, there was no evidence that the KP played a role in fatigue or depression. Furthermore, no relationships emerged between either fatigue or depression and IFN-γ, IL-6, or TNF-α before chemotherapy. Nevertheless, kynurenine levels pre- and post-treatment significantly predicted changes in depression, suggesting that heightened KP activation may contribute to depressive symptoms in patients treated for cancer. In addition, IL-6 significantly covaried with fatigue. These preliminary findings provide some support for the idea that low-grade inflammation contributes to the development of CRF, independently of depression; however, there was no evidence that this is mediated by KP activity.
Collapse
Affiliation(s)
- Maria M Pertl
- School of Psychology, Trinity College, Dublin 2, Ireland.
| | | | | | | | | | | | | | | | | |
Collapse
|
147
|
Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Ann Behav Med 2013; 45:329-37. [PMID: 23508468 DOI: 10.1007/s12160-012-9459-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Anxiety, depression, insomnia, fatigue, and pain are frequently reported by cancer patients. These symptoms are highly interrelated. However, few prospective studies have documented the sequence with which symptoms occur during cancer care. PURPOSE This longitudinal study explored the temporal relationships between anxiety, depression, insomnia, fatigue, and pain over an 18-month period in a large population-based sample of nonmetastatic cancer patients (N = 828), using structural equation modeling. METHODS The patients completed a battery of self-report scales at baseline and 2, 6, 10, 14, and 18 months later. RESULTS The relationships between the same symptom at two consecutive assessments showed the highest coefficients (β = 0.29 to 0.78; all ps ≤ 0.05). Cross-loading parameters (β = 0.06 to 0.19; ps ≤ 0.05) revealed that fatigue frequently predicted subsequent depression, insomnia, and pain, whereas anxiety predicted insomnia. CONCLUSIONS Fatigue and anxiety appear to constitute important risk factors of other cancer-related symptoms and should be managed appropriately early during the cancer care trajectory.
Collapse
|
148
|
Hsu MC, Tu CH. Improving quality-of-life outcomes for patients with cancer through mediating effects of depressive symptoms and functional status: a three-path mediation model. J Clin Nurs 2013; 23:2461-72. [PMID: 24112217 DOI: 10.1111/jocn.12399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2013] [Indexed: 01/06/2023]
Abstract
AIMS AND OBJECTIVES To test a hypothetical three-path mediation model evaluating the effects of functional status and depressive symptoms on the relationship between fatigue and quality of life in patients with cancer on the basis of the Theory of Unpleasant Symptoms. BACKGROUND Patients with cancer often experience two or more concurrent, interrelated, mutually influential symptoms. Multiple unpleasant symptoms that have been proposed as mediating variables affecting quality of life in a model proposed in recent cancer studies are scanty. DESIGN This study was a cross-sectional, descriptive, correlational design. METHODS Three hundred and twenty-six patients with cancer from oncology clinics were recruited in Taiwan between 2010-2011. Mediation models were tested and confirmed by applying structural modelling using Analysis of Moment Structures and the joint significance test. RESULTS Fatigue affects patient quality of life directly or indirectly through functional status and depressive symptoms. These two mediating variables exhibited direct effects on quality of life. A path analysis approach revealed that 47·28 and 67·70% of the total effects of functional status and depressive symptoms, respectively, on the quality-of-life mediation models are attributable to 29·6 and 44·7% of the total effects between fatigue and quality of life, which mediated through two mediators, respectively. CONCLUSION Quality of life may be enhanced by simultaneously improving physiological and psychological factors. RELEVANCE TO CLINICAL PRACTICE An understanding of mediating effects is valuable in nursing care of patients with cancer, particularly in the early phase of treatment or in newly diagnosed stages I-III or recently treated patients with cancer in different disease stages.
Collapse
Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, Kaohsiung City, Taiwan
| | | |
Collapse
|
149
|
Sreeraman R, Vijayakumar S, Chen AM. Correlation of radiation treatment interruptions with psychiatric disease and performance status in head and neck cancer patients. Support Care Cancer 2013; 21:3301-6. [DOI: 10.1007/s00520-013-1907-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 07/12/2013] [Indexed: 01/14/2023]
|
150
|
Gascón P, Rodríguez CA, Valentín V, Mata JG, Carulla J, Cassinello J, Colomer R, Baró E. Usefulness of the PERFORM questionnaire to measure fatigue in cancer patients with anemia: a prospective, observational study. Support Care Cancer 2013; 21:3039-49. [PMID: 23793142 PMCID: PMC3789890 DOI: 10.1007/s00520-013-1862-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 05/21/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND The PERFORM Questionnaire is a 12-item scale developed for assessing fatigue in cancer patients in the clinical practice. It has advantages over other tools in that it is short and includes beliefs and attitudes of patients about fatigue. It was psychometrically validated in cancer patients with and without anemia. PURPOSE We evaluated the usefulness of the PERFORM scale to measure fatigue in a large study focusing exclusively on anemic patients. METHODS This was an observational, multicenter, prospective, 3-month study in cancer patients with hemoglobin (Hb)≤11 g/dl. Fatigue was assessed using the PERFORM questionnaire. The overall score ranges from 12 (no fatigue) to 60 (maximum fatigue). RESULTS We included 667 patients: 54.1 % women, mean age 60 (standard deviation, 12) years. A highly significant, but mild correlation was observed between low baseline Hb and high patient perception of fatigue (r with PERFORM score=-0.215, p < 0.0001). Of the patients, 65.8 % improved Hb level during follow-up (increase of ≥1 g/dL and/or achieving >11 g/dL), which translated into a significant improvement in the PERFORM score [mean (95 % confidence interval (CI)] change, -1.2 (-0.04 to -2.4), whereas more fatigue was observed in patients without improvement in Hb [change (95 % CI) in PERFORM, +3.3 (1.5 to 5)]. In a multivariate linear regression analysis, the independent factors associated to fatigue at 3 months were a low Hb level, a low Karnofsky index, active chemotherapy, cancer treatment with palliative intention, and transfusion need in the last 3 months. CONCLUSIONS Minimal increases or decreases in Hb of ≥1 g/dL were associated with meaningful changes in patient-perceived fatigue as measured with the PERFORM questionnaire. In addition to anemia severity, other factors such as active chemotherapy and advanced disease contribute to perception of fatigue by cancer patients.
Collapse
Affiliation(s)
- Pere Gascón
- Hospital Clínic de Barcelona, Villarroel 170, ES-08036, Barcelona, Spain,
| | | | | | | | | | | | | | | |
Collapse
|