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Yuan Y, Liu C, Shi W, Wang Y, Chen L. Trajectory patterns and predictors of cancer-related fatigue in postoperative lung cancer patients receiving chemotherapy. Support Care Cancer 2024; 32:525. [PMID: 39023748 DOI: 10.1007/s00520-024-08715-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a chronic symptom that can affect the overall functioning of lung cancer patients throughout the course of the disease. However, there is limited research on the trajectory and predictors of CRF specifically in lung cancer patients. Furthermore, few studies have investigated the predictive role of positive psychological and social factors in relation to CRF. This study aimed to explore the trajectory of CRF and its predictors in postoperative chemotherapy patients with lung cancer. METHODS A total of 202 lung cancer patients who underwent surgery and received adjuvant chemotherapy were recruited for this study. Baseline questionnaires were completed, covering sociodemographic information, disease details, CRF levels, personality traits, psychological resilience, and social support. CRF was assessed at three time points: first chemotherapy (T1), 3 months after chemotherapy (T2), and 6 months after chemotherapy (T3). Latent class growth modeling (LCGM) was used to identify distinct developmental trajectories of CRF. Logistic regression analysis was employed to examine predictors of CRF within different patient groups. RESULTS The LCGM analysis revealed three distinct CRF trajectories: persistent high fatigue group (30.7%), rising fatigue group (30.7%), and no fatigue group (38.6%). Cancer stage (OR = 7.563, 95% CI = 2.468-23.182, P < 0.001), melancholic personality (OR = 6.901, 95% CI = 1.261-37.764, P = 0.026), and high psychological resilience (OR = 0.171, 95% CI = 0.041-0.706, P = 0.015) were associated with the CRF trajectory. On the other hand, sanguine personality (OR = 0.254, 95% CI = 0.071-0.916, P = 0.036) and high social support (OR = 0.168, 95% CI = 0.045-0.627, P = 0.008) were associated with the increasing fatigue trajectory. CONCLUSIONS This study demonstrated that 60% of lung cancer patients experienced persistent fatigue throughout the assessment period. Moreover, it confirmed the heterogeneity of CRF trajectories among lung cancer patients. The severity of CRF was found to be higher in patients with advanced clinical stages, depressive personality traits, and lower psychological resilience.
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Affiliation(s)
- Yaqing Yuan
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Cuiping Liu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Wen Shi
- Department of Vascular Surgery, Shandong First Medical University Affiliated Provincial Hospital, Jinan, China
| | - Ying Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Liping Chen
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
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2
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Keane KF, Wickstrom J, Livinski AA, Blumhorst C, Wang TF, Saligan LN. The definitions, assessment, and dimensions of cancer-related fatigue: A scoping review. Support Care Cancer 2024; 32:457. [PMID: 38916815 PMCID: PMC11199267 DOI: 10.1007/s00520-024-08615-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/29/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is challenging to diagnose and manage due to a lack of consensus on its definition and assessment. The objective of this scoping review is to summarize how CRF has been defined and assessed in adult patients with cancer worldwide. METHODS Four databases (PubMed, Embase, CINAHL Plus, PsycNet) were searched to identify eligible original research articles published in English over a 10-year span (2010-2020); CRF was required to be a primary outcome and described as a dimensional construct. Each review phase was piloted: title and abstract screening, full-text screening, and data extraction. Then, two independent reviewers participated in each review phase, and discrepancies were resolved by a third party. RESULTS 2923 articles were screened, and 150 were included. Only 68% of articles provided a definition for CRF, of which 90% described CRF as a multidimensional construct, and 41% were identical to the National Comprehensive Cancer Network definition. Studies were primarily conducted in the United States (19%) and the majority employed longitudinal (67%), quantitative (93%), and observational (57%) study designs with sample sizes ≥ 100 people (57%). Participant age and race were often not reported (31% and 82%, respectively). The most common cancer diagnosis and treatment were breast cancer (79%) and chemotherapy (80%; n = 86), respectively. CRF measures were predominantly multidimensional (97%, n = 139), with the Multidimensional Fatigue Inventory (MFI-20) (26%) as the most common CRF measure and "Physical" (76%) as the most common CRF dimension. CONCLUSION This review confirms the need for a universally agreed-upon definition and standardized assessment battery for CRF.
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Affiliation(s)
- Kayla F Keane
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Jordan Wickstrom
- Sinai Rehabilitation Center, Sinai Hospital of Baltimore, Baltimore, MD, USA
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alicia A Livinski
- Office of Research Services, Office of the Director, National Institutes of Health Library, National Institutes of Health, Bethesda, MD, USA
| | - Catherine Blumhorst
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Tzu-Fang Wang
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Leorey N Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
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Gray L, Sindall P, Pearson SJ. Does resistance training ameliorate cancer-related fatigue in cancer survivors? A systematic review with meta-analysis. Disabil Rehabil 2024; 46:2213-2222. [PMID: 37345506 DOI: 10.1080/09638288.2023.2226408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is unrelenting. As neither rest nor sleep ameliorates cognitive, emotional, and physical symptoms, quality of life is diminished. This study examines resistance training (RT) effectiveness on CRF in cancer survivors. The secondary aims were to identify the dose-response relationship of RT frequency, intensity, and volume on CRF in different cancer survivor populations. MATERIALS AND METHODS Systematic searches via numerous databases for RCTs were performed in June 2022. Patient-reported outcome measures (PROM), were analysed, pre-to-post intervention, using a random-effects model. The Physiotherapy Evidence Database (PEDro) scale informed methodological quality assessment. RESULTS Eight studies were included (cancer survivors: breast (BCS) = 5; endometrial (ECS) = 1; prostate (PCS) = 2). Overall, RT interventions ≥ 6 weeks elicited large significant reductions in CRF for FACIT-F (SMD = 0.932, p = <0.001) and moderate significant reductions in CRF for PFS-R (SMD = -0.622, p = 0.004). CONCLUSION Main findings indicate that RT ameliorates CRF, especially in BCS; however, individualised approaches should be advocated. Supervised training elicited the greatest positive outcomes, thus should be a pivotal part of the cancer rehabilitation pathway. Future studies should be adequately powered, undertake discrete analyses of different cancer types, and investigate chronic RT effects.
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Affiliation(s)
- Luke Gray
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Paul Sindall
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Stephen J Pearson
- Department of Health and Social Care, University of Salford, Salford, UK
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Shorter E, Engman V, Lanner JT. Cancer-associated muscle weakness - From triggers to molecular mechanisms. Mol Aspects Med 2024; 97:101260. [PMID: 38457901 DOI: 10.1016/j.mam.2024.101260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
Skeletal muscle weakness is a debilitating consequence of many malignancies. Muscle weakness has a negative impact on both patient wellbeing and outcome in a range of cancer types and can be the result of loss of muscle mass (i.e. muscle atrophy, cachexia) and occur independently of muscle atrophy or cachexia. There are multiple cancer specific triggers that can initiate the progression of muscle weakness, including the malignancy itself and the tumour environment, as well as chemotherapy, radiotherapy and malnutrition. This can induce weakness via different routes: 1) impaired intrinsic capacity (i.e., contractile dysfunction and intramuscular impairments in excitation-contraction coupling or crossbridge cycling), 2) neuromuscular disconnection and/or 3) muscle atrophy. The mechanisms that underlie these pathways are a complex interplay of inflammation, autophagy, disrupted protein synthesis/degradation, and mitochondrial dysfunction. The current lack of therapies to treat cancer-associated muscle weakness highlight the critical need for novel interventions (both pharmacological and non-pharmacological) and mechanistic insight. Moreover, most research in the field has placed emphasis on directly improving muscle mass to improve muscle strength. However, accumulating evidence suggests that loss of muscle function precedes atrophy. This review primarily focuses on cancer-associated muscle weakness, independent of cachexia, and provides a solid background on the underlying mechanisms, methodology, current interventions, gaps in knowledge, and limitations of research in the field. Moreover, we have performed a mini-systematic review of recent research into the mechanisms behind muscle weakness in specific cancer types, along with the main pathways implicated.
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Affiliation(s)
- Emily Shorter
- Karolinska Institutet, Department of Physiology and Pharmacology, Molecular Muscle Physiology and Pathophysiology, Biomedicum, Stockholm, Sweden
| | - Viktor Engman
- Karolinska Institutet, Department of Physiology and Pharmacology, Molecular Muscle Physiology and Pathophysiology, Biomedicum, Stockholm, Sweden
| | - Johanna T Lanner
- Karolinska Institutet, Department of Physiology and Pharmacology, Molecular Muscle Physiology and Pathophysiology, Biomedicum, Stockholm, Sweden.
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Trudel G, Lebel S, Stephens RL, Leclair CS, Leach CR, Westmaas JL. Afraid and tired: A longitudinal study of the relationship between cancer-related fatigue and fear of cancer recurrence in long-term cancer survivors. Cancer Med 2024; 13:e7313. [PMID: 38845458 PMCID: PMC11157147 DOI: 10.1002/cam4.7313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) and fear of cancer recurrence (FCR) are two common concerns experienced by cancer survivors. However, the relationship between these two concerns is poorly understood, and whether CRF and FCR influence each other over time is unclear. METHODS Data were from a national, prospective, longitudinal study, the American Cancer Society's Study of Cancer Survivors-I (SCS-I). Surveys were completed by 1395 survivors of 10 different cancer types at three time-points, including assessment 1.3 years (T1), 2.2 years (T2) and 8.8 years (T3) following their cancer diagnosis. CRF was assessed using the fatigue-inertia subscale of the Profile of Mood States, and FCR by the FCR subscale of the Cancer Problems in Living Scale. Multiple group random intercepts cross-lagged panel models investigated prospective associations between CRF and FCR. RESULTS For younger participants (at or below median age of 55 years, n = 697), CRF at T1 and T2 marginally and significantly predicted FCR at T2 and T3, respectively, but no lagged effects of FCR on subsequent CRF were observed. Cross-lagged effects were not observed for survivors over 55 years of age. CONCLUSION Both CRF and FCR are debilitating side effects of cancer and its treatments. Given that CRF may be predictive of FCR, it possible that early detection and intervention for CRF could contribute to lowering FCR severity.
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Affiliation(s)
| | - Sophie Lebel
- School of PsychologyUniversity of OttawaOttawaOntarioCanada
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Calderon C, Gustems M, Obispo B, García-García T, Hernández R, Fernández-Montes A, Jiménez-Fonseca P. The Mediating Role of Exercise in Depression and Fatigue in Patients with Advanced Cancer. Curr Oncol 2024; 31:3006-3016. [PMID: 38920713 PMCID: PMC11203259 DOI: 10.3390/curroncol31060229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/14/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
This study explored the interconnections between sociodemographic elements, depression, fatigue, and exercise in patients suffering from incurable neoplasm, particularly emphasizing the mediating influence of exercise on the relationship between depression and fatigue This was a prospective, multicenter, observational study involving 15 hospitals across Spain. After three months of systemic cancer treatment, participants completed the Brief Symptom Inventory (BSI), the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and the Fatigue Assessment Scale (FAS) to measure levels of depression, fatigue, and exercise, respectively. A total of 616 subjects participated in this study. Activity levels differed markedly according to educational attainment, marital, and work status. There was a negative correlation between physical activity and depression, and a positive correlation between depression and fatigue (β = -0.18, and β = 0.46, respectively). Additionally, physical activity inversely influenced fatigue levels (β = 0.21). Physical activity served as a partial intermediary in the link between depression and fatigue among patients with advanced, unresectable cancer. Healthcare providers are urged to consider both the physical and emotional dimensions of cancer treatment, implementing physical activity programs to enhance overall patient quality of life and mental health.
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Affiliation(s)
- Caterina Calderon
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Marina Gustems
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Berta Obispo
- Department of Medical Oncology, Hospital Infanta Leonor, 28031 Madrid, Spain
| | - Teresa García-García
- Department of Medical Oncology, Hospital General Universitario Santa Lucia, 30202 Cartagena, Spain
| | - Raquel Hernández
- Department of Medical Oncology, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Ana Fernández-Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, 32005 Ourense, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias, ISPA, 33011 Oviedo, Spain
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Sperisen N, Kohler D, Steck N, Dietrich PY, Rapiti E. Domains and Categories of Needs in Long-Term Follow-Up of Adult Cancer Survivors: A Scoping Review of Systematic Reviews. Healthcare (Basel) 2024; 12:1058. [PMID: 38891133 PMCID: PMC11172118 DOI: 10.3390/healthcare12111058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
The number of long-term cancer survivors increases continually. Understanding their needs is crucial to ensure an adequate follow-up. The aim of our study was to summarize the current literature concerning needs and what influences these needs. A scoping review of systematic reviews was conducted according to the recommendations of the Joanna Briggs Institute. Four electronic databases were searched. Of 414 retrieved papers, 11 met the eligibility criteria. Needs were aggregated into six domains (health-related information, health system, mental, practical, relationship and physical) and 15 categories. The lack of adequate information and the lack of access and/or continuity of supportive care were the most prominent needs. Female gender, younger age, a low level of family and/or social support, and higher educational level were identified as risk factors. Employment and relationship status can affect the needs both in a positive and negative way. The weeks or months after the end of the treatments are particularly critical, and needs can be emphasized during this period. The experience of cancer could also lead to positive changes. The variety of needs affects the quality of life of cancer survivors. Needs assessments should be systematically provided to ensure a better awareness of health professionals and to allow an individual, holistic, and integrated follow-up.
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Affiliation(s)
- Nicolas Sperisen
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
- Swiss Cancer League, 3001 Bern, Switzerland; (D.K.); (N.S.)
| | - Dimitri Kohler
- Swiss Cancer League, 3001 Bern, Switzerland; (D.K.); (N.S.)
| | - Nicole Steck
- Swiss Cancer League, 3001 Bern, Switzerland; (D.K.); (N.S.)
| | - Pierre-Yves Dietrich
- Clinique des Grangettes, Hirslanden, 1224 Geneva, Switzerland;
- Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Elisabetta Rapiti
- Geneva Cancer Registry, Institute of Global Health, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland;
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8
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Zhang Z, Lao J, Liu M, Zheng S, Zhao M, Zhang M. Symptom cluster among cancer survivors from a nationally representative survey: a network analysis. Support Care Cancer 2024; 32:333. [PMID: 38713314 DOI: 10.1007/s00520-024-08531-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE To identify the symptom cluster among cancer survivors and examine their subgroup differences via network analysis based on nationally representative data. METHODS This cross-sectional study included 2966 survivors participating in the 2020 National Health Interview Survey (NHIS). Participants self-reported the presence of 14 symptoms capturing four clusters (physical, somatic, sleep, and psychologic problems). Network analysis models were used to reveal the relationships between symptoms and those interactions. Network comparison tests were applied to compare subgroups. RESULTS The core symptoms of the symptom cluster were fatigue (Bet = 33, Clo = 0.0067, Str = 0.9397), pain (Bet = 11, Clo = 0.0060, Str = 0.9226), wake up well rested (Bet = 25, Clo = 0.0057, Str = 0.8491), and anxiety (Bet = 5, Clo = 0.0043, Str = 0.9697) among cancer survivors. The core symptoms, network structure, and global strength were invariant between time since diagnoses (< 2 years vs. ≥ 2 years) or between numbers of cancers (1 vs. ≥ 2), yet varied between the comorbidity group and non-comorbidity group (≥ 1 vs. 0). CONCLUSIONS Fatigue would be a potential target for alleviating other symptoms through a negative feedback loop of other related symptoms of cancer survivors. In particular, cancer survivors with other chronic diseases should be the focus of attention and strengthen targeted intervention.
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Affiliation(s)
- Zhen Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Jiahui Lao
- The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Mingming Liu
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Shenglong Zheng
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Ming Zhao
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Min Zhang
- Department of Nursing, Qilu Hospital, Shandong University, Jinan, China.
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Urbano Chamorro I, de la Torre-Montero JC. Cancer-related fatigue and activities of daily living: lessons learned from the COVID-19 pandemic. BMC Palliat Care 2024; 23:110. [PMID: 38678234 PMCID: PMC11055275 DOI: 10.1186/s12904-024-01437-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cancer-related fatigue is a prevalent condition in all stages of oncologic disease that is poorly diagnosed, with a negative impact on physical function to perform activities of daily living. Fatigue is also one of the main manifestations in post-COVID-19 syndrome, and few studies have explored the functionality of cancer patients after infection by the new coronavirus. This study was designed to assess cancer-related fatigue symptoms and their implications on physical function and quality of life during the pandemic. METHODOLOGY An observational study with a cross-sectional survey in cancer patients ≥ 18 years of age was conducted. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), the perception of asthenia and performance status were evaluated, and the differences between groups according to the history of COVID-19 were calculated. RESULTS A total of 60 cancer patients had an average age of 33.5 ± 10.11 years, 73.3% were female, and 98.3% had an Eastern Cooperative Oncology Group-Performance Status level < 2. Severe fatigue was found in 43.3% of patients, and the average FACIT-F score was 33.5 ± 10.11. The proportion of coronavirus infection was 13,3%, and the performance of this group was worse on the scale compared to the group without infection (25 ± 10,40 vs. 34,81 ± 9,50 [p = 0,009]). There was a significant correlation between visual analog scale values and FACIT-F scale scores (Pearson's r = -0.76). CONCLUSION SARS-CoV-2 infection could increase cancer-related fatigue symptoms, limiting activities of daily living and impairing quality of life.
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Affiliation(s)
- Iveth Urbano Chamorro
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain.
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Julio C de la Torre-Montero
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain
- Fundación San Juan de Dios, Madrid, Spain
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Manfuku M, Inoue J, Yamanaka N, Kanamori H, Sumiyoshi K, Osumi M. Effects of taxane-induced peripheral neuropathy on hand dexterity impairment: evaluation of quantitative and subjective assessments. Support Care Cancer 2024; 32:304. [PMID: 38652168 DOI: 10.1007/s00520-024-08504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/14/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Chemotherapy-induced peripheral neuropathy (CIPN) commonly involves hand dexterity impairment. However, the factors affecting hand dexterity impairment are unknown and there is currently no established treatment. The purpose of the current study was to clarify factors influencing hand dexterity impairment in taxane-induced peripheral neuropathy using subjective and objective assessments. METHODS We assessed patient characteristics, treatment-related factors, subjective symptoms of CIPN (Patient Neurotoxicity Questionnaire [PNQ]), psychological symptoms, and upper limb dysfunction (Quick Disabilities of the Arm, Shoulder and Hand [Quick DASH]). Quantitative assessments were pinch strength, sensory threshold, hand dexterity impairment, and grip force control. Multiple regression analysis was performed using hand dexterity impairment as the dependent variable and age and PNQ, Quick DASH, and control of grip force as independent variables. RESULTS Forty-three breast cancer patients were included in the analysis. Hand dexterity impairment in taxane-induced peripheral neuropathy patients was significantly correlated with age, grip force control, and PNQ sensory scores (p < 0.008). Multiple regression analysis demonstrated that PNQ sensory scores and grip force control were significantly associated with hand dexterity impairment (p < 0.01). CONCLUSION Subjective symptoms (numbness and pain) and grip force control contributed to impaired hand dexterity in taxane-induced peripheral neuropathy.
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Affiliation(s)
- Masahiro Manfuku
- Department of Rehabilitation, Breast Care Sensyu Clinic, Osaka, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Hyogo, Japan
| | - Nobuki Yamanaka
- Department of Rehabilitation Medicine, Nara Medical University, Nara, Japan
| | - Hiroe Kanamori
- Department of Breast Surgery, Breast Care Sensyu Clinic, Osaka, Japan
| | | | - Michihiro Osumi
- Graduate School of Health Science, Kio University, 4-2-2 Umaminaka, Koryo-Cho, Kitakatsuragi-Gun, Nara, 635-0832, Japan.
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Gu Z, Yang C, Zhang K, Wu H. Development and validation of a nomogram for predicting sever cancer-related fatigue in patients with cervical cancer. BMC Cancer 2024; 24:492. [PMID: 38637740 PMCID: PMC11025233 DOI: 10.1186/s12885-024-12258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/15/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) has been considered the biggest influencing factor for cancer patients after surgery. This study aimed to develop and validate a nomogram for severe cancer-related fatigue (CRF) patients with cervical cancer (CC). METHODS A cross-sectional study was conducted to develop and validate a nomogram (building set = 196; validation set = 88) in the Department of Obstetrics and Gynecology of a Class III hospital in Shenyang, Liaoning Province. We adopted the questionnaire method, including the Cancer Fatigue Scale (CFS), Medical Uncertainty in Illness Scale (MUIS), Medical Coping Modes Questionnaire (MCMQ), Multidimensional Scale of Perceived Social Support (MSPSS), and Sense of Coherence-13 (SOC-13). Binary logistic regression was used to test the risk factors of CRF. The R4.1.2 software was used to develop and validate the nomogram, including Bootstrap resampling method, the ability of Area Under Curve (AUC), Concordance Index (C-Index), Hosmer Lemeshow goodness of fit test, Receiver Operating Characteristic (ROC) curve, Calibration calibration curve, and Decision Curve Analysis curve (DCA). RESULTS The regression equation was Logit(P) = 1.276-0.947 Monthly income + 0.989 Long-term passive smoking - 0.952 Physical exercise + 1.512 Diagnosis type + 1.040 Coping style - 0.726 Perceived Social Support - 2.350 Sense of Coherence. The C-Index of the nomogram was 0.921 (95% CI: 0.877∼0.958). The ROC curve showed the sensitivity of the nomogram was 0.821, the specificity was 0.900, and the accuracy was 0.857. AUC was 0.916 (95% CI: 0.876∼0.957). The calibration showed that the predicted probability of the nomogram fitted well with the actual probability. The DCA curve showed when the prediction probability was greater than about 10%, the benefit of the nomogram was positive. The results in the validation group were similar. CONCLUSION This nomogram had good identifiability, accuracy and clinical practicality, and could be used as a prediction and evaluation tool for severe cases of clinical patients with CC.
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Affiliation(s)
- ZhiHui Gu
- Department of Social Medicine, School of Health Management, China Medical University, No.77 PuHe Road, Shenyang North New District, 110122, Shenyang, Liaoning, People's Republic of China
| | - ChenXin Yang
- Department of Social Medicine, School of Health Management, China Medical University, No.77 PuHe Road, Shenyang North New District, 110122, Shenyang, Liaoning, People's Republic of China
| | - Ke Zhang
- Department of Social Medicine, School of Health Management, China Medical University, No.77 PuHe Road, Shenyang North New District, 110122, Shenyang, Liaoning, People's Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Health Management, China Medical University, No.77 PuHe Road, Shenyang North New District, 110122, Shenyang, Liaoning, People's Republic of China.
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Chen CY, Huang BS, Hong JH, Chang JTC, Chen MC, Tang WR, Shun SC, Chen ML. Persistent Fatigue in Patients With Hepatocellular Carcinoma Receiving Radiotherapy. J Nurs Res 2024; 32:e319. [PMID: 38506576 DOI: 10.1097/jnr.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Radiation therapy has attracted much attention in the treatment of patients with hepatocellular carcinoma (HCC). However, the association between radiotherapy-related fatigue and HCC has been examined in only a few studies. PURPOSE This study was designed to explore the change over time in fatigue in patients with HCC treated with radiotherapy and related factors. METHODS One hundred patients were enrolled in this prospective longitudinal study using convenience sampling at a medical center in northern Taiwan. The Functional Assessment of Chronic Illness Therapy-Fatigue scale, the Brief Pain Inventory-Short Form, and the psychological subscale of Memorial Symptom Assessment Scale-Short Form were used to assess the symptoms at five time points: before radiotherapy (T0), during treatment (T1), and at 1 month (T2), 3 months (T3), and 6 months (T4) after radiotherapy. The generalized estimating equations method was used to determine the changes in fatigue and the influencing factors. RESULTS Fatigue levels at T1, T2, T3, and T4 were significantly higher than that at T0. Higher fatigue was significantly associated with lower income and poorer functional status. Having worse pain levels and psychological symptoms were both associated with higher fatigue. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The results indicate fatigue does not recover to the baseline (pretherapy) level by 6 months after radiotherapy. Thus, fatigue in patients with HCC receiving radiotherapy should be regularly and effectively assessed, and patients experiencing pain and psychological symptoms should be given greater attention from clinicians.
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Affiliation(s)
- Chiao-Yi Chen
- MS, RN, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Bing-Shen Huang
- MD, Associate Professor, Department of Radiation Oncology, Chang Gung Memorial Hospital; and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ji-Hong Hong
- MD, PhD, Professor, Department of Radiation Oncology, Chang Gung Memorial Hospital; and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Joseph Tung-Chieh Chang
- MD, MHA, Professor, Department of Radiation Oncology, Chang Gung Memorial Hospital; and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Min-Chi Chen
- PhD, Professor, Department of Public Health and Biostatistics Consulting Center, College of Medicine, Chang Gung University, Taoyuan; and Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Woung-Ru Tang
- PhD, RN, Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shiow-Ching Shun
- PhD, RN, Professor, School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mei-Ling Chen
- PhD, RN, Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan; Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan; and Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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13
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Wang Y, Yang L, Lin G, Huang B, Sheng X, Wang L, Chen L, Qiu X, Wu X, Lin R. The efficacy of progressive muscle relaxation training on cancer-related fatigue and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled studies. Int J Nurs Stud 2024; 152:104694. [PMID: 38281450 DOI: 10.1016/j.ijnurstu.2024.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Cancer-related fatigue is one of the most common symptoms in cancer patients, usually accompanied by anxiety, depression and insomnia, which seriously affect patients' quality of life. Progressive muscle relaxation training is widely used for cancer-related fatigue, but the overall effect is unclear. OBJECTIVES The aim of this study was to summarize the evidence on the effects of progressive muscle relaxation training on cancer-related fatigue and quality of life in cancer patients. DESIGN Systematic review and meta-analysis. METHODS Nine electronic databases (PubMed, Excerpta Medica Database (Embase), The Cochrane Library (Cochrane Central Register of Controlled Trials, CENTRAL), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang Database) were explored for randomized controlled trials (RCTs) published before February 2023. This study was reported based on the PRISMA 2020 statement. The Cochrane Collaboration's risk of bias assessment tool was used for methodological assessment, and the GRADE pro online assessment tool was used for evidence evaluation. The data were analyzed with the Review Manager 5.4 software. RESULTS Twelve studies involving 1047 patients were included. Meta-analysis showed that progressive muscle relaxation training plus routine nursing produced more positive effects than routine nursing in improving cancer-related fatigue [SMD = -1.06, 95 % CI -1.49, -0.62, P < 0.00001], anxiety [SMD = -1.09, 95 % CI -1.40, -0.77, P < 0.00001], depression [SMD = -1.43, 95 % CI -1.76, -1.10, P < 0.00001], and quality of sleep [MD = -1.41, 95 % CI -1.74, -1.08, P < 0.00001]. However, there was no significant difference in improving quality of life [SMD = 0.27, 95 % CI -0.62, 1.15, P = 0.55]. Progressive resistance exercise plus routine nursing improved cancer-related fatigue more than progressive muscle relaxation training plus routine nursing [SMD = 1.11, 95 % CI 0.43, 1.78, P = 0.001]. There was low certainty of evidence that progressive muscle relaxation training improved cancer-related fatigue and quality of sleep, and the evidence that improved quality of life, anxiety and depression was very low. CONCLUSION Current evidence suggested that progressive muscle relaxation training has the potential to improve cancer-related fatigue, anxiety, depression and quality of sleep in patients with cancer and is a low-load, simple exercise worthy of recommendation for cancer patients in fatigue state. Future research should focus on improving the methodological quality of randomized controlled trials to enhance the persuasive evidence of progressive muscle relaxation training efficacy.
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Affiliation(s)
- Yajiao Wang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Liu Yang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Guijiao Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Bichun Huang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xia Sheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ligang Wang
- Xiamen University Xiamen Cardiovascular Hospital, Xiamen, Fujian, China
| | - Liuyin Chen
- The Second Hospital of Longyan, Fujian, China
| | - Xiahua Qiu
- Longyan Medical Treatment Security Data Monitoring Center, Longyan, Fujian, China
| | - Xinlei Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Rujia Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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14
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Belloni S, Caruso R, Giacon C, Baroni I, Conte G, Magon A, Arrigoni C. Microbiome-Modifiers for Cancer-Related Fatigue Management: A Systematic Review. Semin Oncol Nurs 2024; 40:151619. [PMID: 38503656 DOI: 10.1016/j.soncn.2024.151619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVES This study systematically investigates the evidence regarding the use of probiotics in managing cancer-related fatigue (CRF). STUDY DESIGN We conducted a systematic review of randomized controlled trials. DATA SOURCES The systematic search encompassed six databases: PubMed, CINHAL, Cochrane Database of Systematic Reviews, Web of Science, Scopus, and EMBASE, covering the period from inception to December 2023. The assessment of risk of bias employed the Cochrane risk of bias tool (RoB 2). A narrative synthesis and an exploratory meta-analysis were conducted to summarize the evidence. RESULTS Among 460 records, three studies met the eligibility criteria and were included in the review. These studies involved a total of 284 participants with colorectal and breast cancer. One study demonstrated a marginal improvement in CRF postchemotherapy in colorectal cancer patients using probiotics. Another study, also using probiotics, reported a significant reduction in CRF among colorectal cancer patients undergoing chemotherapy. Additionally, a study employing synbiotics showed a substantial decrease in CRF severity in breast cancer patients receiving chemotherapy. CONCLUSION The study presents initial but varied evidence suggesting the potential of probiotics and synbiotics as adjunctive therapies in managing CRF alongside anticancer treatments. IMPLICATIONS FOR NURSING PRACTICE In nursing practice, large-scale clinical trials are urgently needed to evaluate the effectiveness of probiotics in treating cancer-related fatigue during cancer therapy. Insights from this review could guide nurses in selecting appropriate probiotic strains and integrating microbiome modifiers into comprehensive care plans, potentially enhancing the quality of life for cancer patients.
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Affiliation(s)
- Silvia Belloni
- Gastroenterology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | - Chiara Giacon
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
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15
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Wagner AS, Milzer M, Steindorf K, Kiermeier S, Schmidt ME, Maatouk I. Cancer-related fatigue: Quality, credibility, usability, and readability of information on websites of health care institutions in Germany. PATIENT EDUCATION AND COUNSELING 2024; 121:108135. [PMID: 38199176 DOI: 10.1016/j.pec.2024.108135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVES This study aimed to portray available information on cancer-related fatigue on German health care institution websites considering the idea of patient empowerment. METHODS Based on website quality criteria, we developed a website-rating tool comprising 18 items. Descriptive analyses, a KruskalWallis test, and corresponding post hoc tests comparing rating sum scores between institution groups were performed. RESULTS Websites of 283 systematically compiled health care institutions were included in the rating. Cancer-related fatigue was introduced on 21.9% and detailed information was provided on 27.9% of the websites. Information material was offered on 9.2% of the websites, while fatigue treatment offers were presented on 21.6% of the websites. The rating sum scores differed between institution groups (p < 0.001), with Comprehensive Cancer Centers scoring significantly higher than the others. CONCLUSION The rating revealed an overall sparse provision of information, with fatigue being addressed on less than half of the websites. PRACTICE IMPLICATIONS For patients who have access to at least one introduction about fatigue, institutions need to extend their websites. Patients could further be referred to external institutions or information booklets. The naming of contact persons may help linking patients to providers.
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Affiliation(s)
- Anna S Wagner
- Julius-Maximilians-University, Department of General Internal Medicine II, Section of Psychosomatics, Psychotherapy and Psychooncology, Würzburg, Germany
| | - Marlena Milzer
- German Cancer Research Center (DKFZ), Division of Physical Activity, Prevention and Cancer, Heidelberg, Germany; University of Heidelberg, Medical Faculty, Heidelberg, Germany
| | - Karen Steindorf
- German Cancer Research Center (DKFZ), Division of Physical Activity, Prevention and Cancer, Heidelberg, Germany
| | - Senta Kiermeier
- Julius-Maximilians-University, Department of General Internal Medicine II, Section of Psychosomatics, Psychotherapy and Psychooncology, Würzburg, Germany
| | - Martina E Schmidt
- German Cancer Research Center (DKFZ), Division of Physical Activity, Prevention and Cancer, Heidelberg, Germany
| | - Imad Maatouk
- Julius-Maximilians-University, Department of General Internal Medicine II, Section of Psychosomatics, Psychotherapy and Psychooncology, Würzburg, Germany.
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16
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Zhou Y, Huang RQ, Xu JJ, Yi JH, Wang F, Zhou XY, Zhang J, Wang T, Liu Y, Chen C, Chen WW, Lu GT, Li ZS, Wang D, Hu LH. Prevalence and risk factors of fatigue and its association with quality of life among patients with chronic pancreatitis: A cross-sectional study. Pancreatology 2024; 24:211-219. [PMID: 38302312 DOI: 10.1016/j.pan.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 01/20/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Fatigue is a debilitating symptom found in various chronic diseases and is associated with more severe symptoms and worse quality of life (QoL). However, this symptom has not been adequately addressed in chronic pancreatitis (CP), and there have been no studies on fatigue in patients with CP. METHODS This cross-sectional study was conducted at the Changhai Hospital in Shanghai, China. Data on the patients' sociodemographic, disease, and therapeutic characteristics were collected. Fatigue was assessed using the Multidimensional Fatigue Inventory-20. QoL was assessed utilizing the European Organization for the Research and Treatment of Cancer of QoL questionnaire (EORTC-QLQ-C30). Sleep quality, anxiety and depression, and pain was assessed using Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, and the Brief Pain Inventory, respectively. RESULTS The prevalence of fatigue among Chinese patients with CP was 35.51 % (87/245). Multivariate analysis showed that steatorrhea (OR = 2.638, 95 % CI: 1.117-6.234), history of smoking (OR = 4.627, 95 % CI: 1.202-17.802), history of endoscopic treatment (OR = 0.419, 95 % CI: 0.185-0.950), depression (OR = 5.924, 95 % CI: 2.462-14.255), and sleep disorder (OR = 6.184, 95 % CI: 2.543-15.034) were influencing factors for the presence of fatigue. The scores for global health and all functional dimensions in the EORTC-QLQ-C30 significantly decreased, whereas the scores for all symptom dimensions significantly increased in patients with fatigue. CONCLUSIONS This study indicated that Fatigue is a common symptom and has a negative impact on the QoL of patients with CP. Steatorrhea, smoking history, endoscopic treatment, depression, and sleep disorders were associated with fatigue.
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Affiliation(s)
- You Zhou
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China; Pancreatic Center, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Ren-Qian Huang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jin-Jie Xu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jin-Hui Yi
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Fan Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xiao-Yu Zhou
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jie Zhang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Teng Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yu Liu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Cui Chen
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Wei-Wei Chen
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Guo-Tao Lu
- Pancreatic Center, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Dan Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Liang-Hao Hu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.
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17
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Kiebach J, de Vries-Ten Have J, van Duijnhoven FJB, Kok DE, van Lanen AS, Kouwenhoven EA, de Wilt JHW, Schrauwen RWM, Kampman E, Winkels RM, Wesselink E. Hematocrit Is Associated with Cancer-Related Fatigue in Colorectal Cancer Survivors: A Longitudinal Analysis. Cancer Epidemiol Biomarkers Prev 2024; 33:411-418. [PMID: 38180352 DOI: 10.1158/1055-9965.epi-23-1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/03/2023] [Accepted: 01/03/2024] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a frequent symptom in colorectal cancer survivors. It is unknown to what extent anemia may contribute to CRF in colorectal cancer survivors. This study aimed to investigate the association between hematocrit, as marker for anemia, and CRF among colorectal cancer survivors from diagnosis until two years thereafter. METHODS The study population included 1,506 newly diagnosed colorectal cancer survivors at any stage of disease from a prospective cohort study. Hematocrit and CRF (EORTC QLQ-C30) were assessed at diagnosis, six months, and two years after diagnosis. Multivariable logistic regression or multivariable linear mixed models were used to assess the associations of hematocrit with CRF prevalence, or CRF severity over time, respectively. RESULTS A low hematocrit (levels <40% men/<36% women) was present in a third of the survivors at diagnosis and six months thereafter, and among 16% two years after diagnosis. The prevalence of CRF was 15% at diagnosis, peaked at 27% at six months, and was 14% two years after diagnosis. Hematocrit was associated with the prevalence of CRF at diagnosis [OR, 0.92; confidence interval (CI), 0.88-0.95], 6 months (OR, 0.89; 95% CI, 0.86-0.92), and 2 years (OR, 0.91; CI, 0.87-0.96) after diagnosis. Lower hematocrit was associated with higher severity of CRF over time (beta-coefficient = 1.3; CI, 1.5-1.1). CONCLUSIONS Lower hematocrit levels were longitudinally associated with a higher prevalence and severity of CRF in colorectal cancer. IMPACT Our findings emphasize the importance of long-term anemia monitoring and a potential role of anemia in CRF among colorectal cancer survivors.
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Affiliation(s)
- Joann Kiebach
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Judith de Vries-Ten Have
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
- Consumption and Healthy Lifestyles Chair group, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Anne-Sophie van Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ruud W M Schrauwen
- Department of Gastroenterology and Hepatology, Bernhoven, Uden, the Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
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18
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Zhang X, Perry RJ. Metabolic underpinnings of cancer-related fatigue. Am J Physiol Endocrinol Metab 2024; 326:E290-E307. [PMID: 38294698 DOI: 10.1152/ajpendo.00378.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/01/2024]
Abstract
Cancer-related fatigue (CRF) is one of the most prevalent and detrimental complications of cancer. Emerging evidence suggests that obesity and insulin resistance are associated with CRF occurrence and severity in cancer patients and survivors. In this narrative review, we analyzed recent studies including both preclinical and clinical research on the relationship between obesity and/or insulin resistance and CRF. We also describe potential mechanisms for these relationships, though with the caveat that because the mechanisms underlying CRF are incompletely understood, the mechanisms mediating the association between obesity/insulin resistance and CRF are similarly incompletely delineated. The data suggest that, in addition to their effects to worsen CRF by directly promoting tumor growth and metastasis, obesity and insulin resistance may also contribute to CRF by inducing chronic inflammation, neuroendocrinological disturbance, and metabolic alterations. Furthermore, studies suggest that patients with obesity and insulin resistance experience more cancer-induced pain and are at more risk of emotional and behavioral disruptions correlated with CRF. However, other studies implied a potentially paradoxical impact of obesity and insulin resistance to reduce CRF symptoms. Despite the need for further investigation utilizing interventions to directly elucidate the mechanisms of cancer-related fatigue, current evidence demonstrates a correlation between obesity and/or insulin resistance and CRF, and suggests potential therapeutics for CRF by targeting obesity and/or obesity-related mediators.
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Affiliation(s)
- Xinyi Zhang
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
| | - Rachel J Perry
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
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Schurr M, Junne F, Martus P, Paul G, Jürgensen JS, Allwang C, Binneböse M, Wallis H, Mikolajczyk R, Galante-Gottschalk A, Zipfel S, Ehehalt S, Giel KE. SARS-CoV-2 infection is associated with physical but not mental fatigue - Findings from a longitudinal controlled population-based study. J Psychosom Res 2024; 178:111598. [PMID: 38277895 DOI: 10.1016/j.jpsychores.2024.111598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/11/2024] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Fatigue has been identified as the core symptom of long-Covid, however, putative pandemic-related influences remain largely unclear. We investigated trajectories of total, physical and mental fatigue and the factors associated with it in previously infected and non-infected individuals up to one year post- infection. METHODS We used data from a longitudinal cohort study of German adults with two samples: A representative probability sample and a sample of individuals with proven SARS-CoV-2 infection. Surveys were conducted in spring 2020(T1), autumn 2020(T2) and summer 2021(T3). Fatigue was assessed using the FAS, distinguishes between physical and mental fatigue. Depression, anxiety and stress were assessed using PHQ-4 and PSQ. RESULTS 1990 participants [mean age 47.2 (SD = 17.0), 30.5% previously infected] were included in the survey at T1 (n = 1118 at T2, n = 692 at T3). Total and physical fatigue, but not mental fatigue were significantly higher in the previously infected compared to the non-infected sample at T2, but this group difference disappeared at T3. We identified Covid-infection as a factor associated with transient total and physical fatigue at T2. Depression, anxiety and stress at T1 were associated with total, physical and mental fatigue at both follow-ups. CONCLUSIONS Our results highlight the importance of considering physical and mental fatigue as separate entities, while suggesting a greater relevance of the physical signs of fatigue in understanding long-Covid. The results further showed that baseline mental health symptoms were the most strongly associated with fatigue trajectories.
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Affiliation(s)
- Marisa Schurr
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and applied Biostatistics, University Hospital Tuebingen, Tuebingen, Germany
| | - Gregor Paul
- Department of Gastroenterology, Hepatology, Pneumology and Infectious Diseases, Klinikum Stuttgart, Stuttgart, Germany; Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Christine Allwang
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marius Binneböse
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Hannah Wallis
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Rafael Mikolajczyk
- Martin Luther University Halle-Wittenberg, Interdisciplinary Center for Health Sciences; Institute of Medical Epidemiology, Biometrics and Informatics, Halle (Saale), Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Stefan Ehehalt
- Public Health Department, State Capital-City Stuttgart, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
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20
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Fontvieille A, Parent-Roberge H, Fülöp T, Pavic M, Riesco E. The Mechanisms Underlying the Beneficial Impact of Aerobic Training on Cancer-Related Fatigue: A Conceptual Review. Cancers (Basel) 2024; 16:990. [PMID: 38473351 DOI: 10.3390/cancers16050990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Cancer-related fatigue (CRF) is a prevalent and persistent issue affecting cancer patients, with a broad impact on their quality of life even years after treatment completion. The precise mechanisms underlying CRF remain elusive, yet its multifaceted nature involves emotional, physical, and cognitive dimensions. The absence of effective medical treatments has prompted researchers to explore integrative models for potential insights. Notably, physical exercise emerges as a promising strategy for managing CRF and related symptoms, as studies showed a reduction in CRF ranging from 19% to 40%. Current recommendations highlight aerobic training at moderate intensity as beneficial, although questions about a dose-response relationship and the importance of exercise intensity persist. Despite the positive impact of exercise on CRF, the underlying mechanisms remain elusive. This review aims to provide a theoretical model explaining how aerobic exercise may alleviate CRF. Focusing on acute exercise effects, this review delves into the potential influence on peripheral and neural inflammation, immune function dysregulation, and neuroendocrine system disruptions. The objective is to enhance our understanding of the intricate relationship between exercise and CRF, ultimately paving the way for tailored interventions and potential pharmacological treatments for individuals unable to engage in physical exercise.
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Affiliation(s)
- Adeline Fontvieille
- Faculty of Physical Activity Sciences, University of Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, 1036 Rue Belvédère Sud, Sherbrooke, QC J1H 4C4, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, 12e Avenue N Porte 6, Sherbrooke, QC J1H 5N4, Canada
| | - Hugo Parent-Roberge
- Faculty of Physical Activity Sciences, University of Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, 1036 Rue Belvédère Sud, Sherbrooke, QC J1H 4C4, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, 12e Avenue N Porte 6, Sherbrooke, QC J1H 5N4, Canada
| | - Tamás Fülöp
- Research Centre on Aging, 1036 Rue Belvédère Sud, Sherbrooke, QC J1H 4C4, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, QC J1H 5N4, Canada
| | - Michel Pavic
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, 12e Avenue N Porte 6, Sherbrooke, QC J1H 5N4, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue N, Sherbrooke, QC J1H 5N4, Canada
| | - Eléonor Riesco
- Faculty of Physical Activity Sciences, University of Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, 1036 Rue Belvédère Sud, Sherbrooke, QC J1H 4C4, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, 12e Avenue N Porte 6, Sherbrooke, QC J1H 5N4, Canada
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21
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Matsunaga M, He Y, Khine MT, Shi X, Okegawa R, Li Y, Yatsuya H, Ota A. Prevalence, severity, and risk factors of cancer-related fatigue among working cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2024:10.1007/s11764-024-01557-8. [PMID: 38418754 DOI: 10.1007/s11764-024-01557-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE The aim of this study is to evaluate the prevalence, severity, and risk factors of cancer-related fatigue among currently working cancer survivors. METHODS We searched the PubMed, Embase, Scopus, CINAHL, Cochrane Library, and ICHUSHI databases. The risk of bias was evaluated independently using the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS). A meta-analysis was conducted to determine the prevalence, severity, and related factors associated with cancer-related fatigue among currently working cancer survivors. RESULTS Our meta-analysis included 18 studies and revealed that 42.2% of currently working cancer survivors experience cancer-related fatigue. The fatigue severity in this group was significantly higher than that in workers without cancer (absolute standardized mean difference (SMD) = 0.67), but lower than that in cancer survivors who had previously worked and were not currently working (absolute SMD = 0.72). Distress was identified as a potential risk factor for cancer-related fatigue in working cancer survivors (partial correlation coefficient = 0.38). CONCLUSIONS The high prevalence of cancer-related fatigue among employed cancer survivors underscores the need for targeted workplace interventions and fatigue management strategies. While the severity of fatigue is less than that seen in non-working survivors, the comparison with the general working population highlights a significant health disparity. The association between distress and fatigue suggests the necessity for a holistic approach to fatigue management that considers both physical and mental factors in working cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Our findings highlight the critical need for healthcare professionals and employers to monitor fatigue levels among working cancer survivors and offer appropriate support.
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Affiliation(s)
- Masaaki Matsunaga
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan.
| | - Yupeng He
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan
| | - May Thet Khine
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan
| | - Xuliang Shi
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan
| | - Ryusei Okegawa
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan
| | - Yuanying Li
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Nagoya, 466-8550, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Nagoya, 466-8550, Japan
| | - Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan
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22
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Velasco-Durantez V, Cruz-Castellanos P, Hernandez R, Rodriguez-Gonzalez A, Fernandez Montes A, Gallego A, Manzano-Fernandez A, Sorribes E, Zafra M, Carmona-Bayonas A, Calderon C, Jiménez-Fonseca P. Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients. Sci Rep 2024; 14:3188. [PMID: 38326426 PMCID: PMC10850144 DOI: 10.1038/s41598-024-53212-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52-0.84; OR 0.72, 95% CI 0.56-0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43-0.92), depression (OR 0.55, 95% CI 0.37-0.81), and somatization (OR 0.59, 95% CI 0.42-0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.
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Affiliation(s)
- Veronica Velasco-Durantez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain.
- Universidad de Valladolid, Valladolid, Spain.
| | | | - Raquel Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Adan Rodriguez-Gonzalez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
| | - Ana Fernandez Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | - Alejandro Gallego
- Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain
| | | | - Elena Sorribes
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Marta Zafra
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Avenida Roma sn, 33011, Oviedo, Spain
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23
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Hsiao CP, Von Ah D, Chen MK, Saligan LN. Relationship of cancer-related fatigue with psychoneurophysiological (PNP) symptoms in breast cancer survivors. Eur J Oncol Nurs 2024; 68:102469. [PMID: 38039708 PMCID: PMC10922833 DOI: 10.1016/j.ejon.2023.102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom reported by breast cancer survivors (BCS). CRF has been associated with the co-occurrence of anxiety, depression, poor sleep quality, cognitive impairment, which are collectively termed as psychoneurophysiological (PNP) symptoms. CRF and these PNP symptoms are often reported during and after treatment with long-lasting distress. It is unclear how CRF and these PNP symptoms influence each other. This study aimed to explore predictive factors (i.e., PNP symptoms and social-demographic factors) of CRF, and test exploratory path models of the relationships of CRF with PNP symptoms (depression, anxiety, sleep disturbance, pain, and cognitive function) in BCS. METHODS This paper is part of a larger descriptive, correlational, and cross-sectional study. Validated and reliable instruments assessed CRF, depression, anxiety, sleep disturbance, pain, and cognitive function. Descriptive statistics, Pearson correlation, multiple linear regression models, and path analysis were employed. RESULTS Patients (N = 373) who reported less bodily pain had worst CRF (r = -0.45, p < .01). Significant predictors of CRF included depression, sleep disorder, bodily pain, perceived cognitive ability, and dispositional (state) optimism. Depression alone accounted for 31% of the variance in CRF. An integrative path model with bodily pain, neuropathic pain, CRF, and depression showed a good fit across different indices (CFI = 0.993, RMSEA = 0.047, 90% CI 0-0.12, SRMR = 0.027). CONCLUSIONS This study identified significant predictors of CRF and revealed a good fit mediation model with significant pathways for CRF, suggesting that a common etiology may underpin the co-occurrence of CRF with PNP symptoms (pain and depression). However, further investigation with longitudinal design is necessary to explore the causal relationships of these symptoms. Evidence-based strategies/interventions are needed to reduce or eliminate the burden of these symptoms on the lives of BCS.
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Affiliation(s)
- Chao-Pin Hsiao
- Case Western Reserve University School of Nursing, Cleveland, OH, USA
| | - Diane Von Ah
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Mei-Kuang Chen
- The University of Arizona Department of Psychology, Tucson, AZ, USA
| | - Leorey N Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
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24
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Vanrusselt D, Sleurs C, Arif M, Lemiere J, Verschueren S, Uyttebroeck A. Biomarkers of fatigue in oncology: A systematic review. Crit Rev Oncol Hematol 2024; 194:104245. [PMID: 38141868 DOI: 10.1016/j.critrevonc.2023.104245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023] Open
Abstract
Cancer-related fatigue (CRF) is a distressing side effect of cancer and treatment, affecting both patients during active treatment and survivors, negatively impacting quality of life. While its exact cause remains uncertain, various mechanisms such as immune dysfunction, HPA-axis dysfunction, and treatment toxicity are proposed. Inflammatory biomarkers of CRF have been explored in previous research, but non-inflammatory markers have not been comprehensively studied. This systematic review analysed 33 studies to identify non-inflammatory peripheral blood biomarkers associated with CRF. Promising markers included Hb, blood coagulation factors, BDNF, tryptophan, GAA, mtDNA, platinum, CA125, and cystatin-C. Inconsistent findings were observed for other markers like VEGF, leptin, and stress hormones. Most studies focused on adults. Research in pediatrics is limited. This review showed partial evidence for the inflammaging hypothesis (neurotoxicity due to neuro-inflammation) laying at the basis of CRF. Further research, especially in pediatrics, is needed to confirm this hypothesis and guide future biomarker studies.
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Affiliation(s)
- Deveny Vanrusselt
- Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium.
| | - Charlotte Sleurs
- Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium; Department of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Mahnoor Arif
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | | | - Anne Uyttebroeck
- Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
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25
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Huang L, Li S, Xie X, Huang X, Xiao LD, Zou Y, Jiang W, Zhang F. Prevalence of postprandial hypotension in older adults: a systematic review and meta-analysis. Age Ageing 2024; 53:afae022. [PMID: 38411408 PMCID: PMC10898335 DOI: 10.1093/ageing/afae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Older adults with postprandial hypotension (PPH) increase susceptibility to falls, syncope, stroke, acute cardiovascular diseases and even death. However, the prevalence of this condition varies significantly across studies. We aimed to determine the prevalence of PPH in older adults. METHODS Web of Science, PubMed, Cochrane Library, Embase and CINAHL were searched from their inception until February 2023. Search terms included 'postprandial period', 'hypotension' and 'postprandial hypotension'. Eligible studies were assessed using the Joanna Briggs Institute tool. Meta-analyses were performed among similar selected studies. RESULTS Thirteen eligible studies were included, and data from 3,021 participants were pooled. The meta-analysis revealed a PPH prevalence of 40.5% [95% confidence interval (CI): 0.290-0.519] in older adults, and this was prevalent in the community (32.8%, 95% CI: 0.078-0.647, n = 1,594), long-term healthcare facility (39.4%, 95% CI: 0.254-0.610, n = 1,062) and geriatrics department of hospitals (49.3%, 95% CI: 0.357-0.630, n = 365). The pooled results showed significant heterogeneity (I2 > 90%), partially related to the different ages, sex, pre-prandial systolic blood pressure levels of participants, or the different criteria and methodology used to diagnose PPH. CONCLUSIONS PPH is a prevalent condition in older adults. Further research is needed to confirm this result, and priority should be given to establishing international consensus on PPH diagnostic criteria and designing its diagnostic procedure.
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Affiliation(s)
- Lei Huang
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, Sichuan, 610041, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaofeng Xie
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, Sichuan, 610041, China
| | - Xiaoli Huang
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Ying Zou
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, Sichuan, 610041, China
| | - Wenyi Jiang
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, Sichuan, 610041, China
| | - Fengying Zhang
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, 37, Guoxue Alley, Chengdu, Sichuan, 610041, China
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Duranti E, Cordani N, Villa C. Edaravone: A Novel Possible Drug for Cancer Treatment? Int J Mol Sci 2024; 25:1633. [PMID: 38338912 PMCID: PMC10855093 DOI: 10.3390/ijms25031633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Despite significant advancements in understanding the causes and progression of tumors, cancer remains one of the leading causes of death worldwide. In light of advances in cancer therapy, there has been a growing interest in drug repurposing, which involves exploring new uses for medications that are already approved for clinical use. One such medication is edaravone, which is currently used to manage patients with cerebral infarction and amyotrophic lateral sclerosis. Due to its antioxidant and anti-inflammatory properties, edaravone has also been investigated for its potential activities in treating cancer, notably as an anti-proliferative and cytoprotective drug against side effects induced by traditional cancer therapies. This comprehensive review aims to provide updates on the various applications of edaravone in cancer therapy. It explores its potential as a standalone antitumor drug, either used alone or in combination with other medications, as well as its role as an adjuvant to mitigate the side effects of conventional anticancer treatments.
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Affiliation(s)
| | | | - Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.D.); (N.C.)
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27
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Garcia P, Block A, Mark S, Mackin L, Paul SM, Cooper BA, Conley YP, Hammer MJ, Levine JD, Miaskowski C. Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy. Cancer Nurs 2024:00002820-990000000-00209. [PMID: 38259094 DOI: 10.1097/ncc.0000000000001304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms. OBJECTIVES The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping. METHODS Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles. RESULTS Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment. CONCLUSIONS More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles. IMPLICATIONS FOR PRACTICE Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.
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Affiliation(s)
- Philip Garcia
- Author Affiliations: School of Nursing, University of California, San Francisco (Mr Garcia, Ms Block, and Drs Mark, Mackin, Paul, Cooper, and Miaskowski); School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); School of Medicine, University of California, San Francisco (Drs Miaskowski and Levine)
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28
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Karakuş Z, Yangöz ŞT, Özer Z. The Effect of Psychoeducational Interventions on Cancer-Related Fatigue: A Systematic Review and Meta-analysis of Randomized Controlled Studies. Cancer Nurs 2024:00002820-990000000-00208. [PMID: 38230946 DOI: 10.1097/ncc.0000000000001315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Cancer-related fatigue is one of the most common symptoms of cancer patients. Psychoeducation is often used in the management of cancer-related fatigue. OBJECTIVE The aim of this study was to synthesize the effects of psychoeducational interventions on cancer-related fatigue. METHODS This article is a systematic review and meta-analysis of randomized controlled studies. The 11 electronic databases were searched, and studies using psychoeducational interventions to manage cancer-related fatigue were included. Data synthesis was performed using Comprehensive Meta-Analysis software version 3.0. The random-effects model was used to pool the effect size for intervention. The subgroup analysis was conducted to investigate the effect of the characteristics of psychoeducational interventions. This study was reported according to the Cochrane Handbook for Systematic Reviews of Intervention version 6.3 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. RESULTS This analysis included 10 studies with a total of 1369 participants. Most of the included studies compared the psychoeducational intervention group with the passive control group. Our meta-analysis revealed that psychoeducational intervention has a positive medium effect on improving cancer-related fatigue with a low quality of evidence. Subgroup analyses indicated no difference between group and individual interventions, between face-to-face and digital interventions, or between ≤3 and >3 sessions. CONCLUSIONS Psychoeducational interventions can improve cancer-related fatigue. Additional well-designed randomized controlled studies are needed to upgrade the quality of evidence for psychoeducational interventions on cancer-related fatigue. IMPLICATIONS FOR PRACTICE Nurses may practice psychoeducational interventions to manage cancer-related fatigue and may use this study design for randomized controlled studies for psychoeducational interventions on cancer-related fatigue.
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Affiliation(s)
- Zeynep Karakuş
- Author Affiliations: Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University (Drs Karakuş and Özer), Antalya; and Department of Internal Medicine Nursing, Faculty of Health Sciences, Pamukkale University (Dr Yangöz), Denizli, Türkiye
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29
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Grégoire C, Baussard L, Ernst M, Diep A, Faymonville ME, Devos M, Jerusalem G, Vanhaudenhuyse A. Evaluation of a psychoneurological symptom cluster in patients with breast or digestive cancer: a longitudinal observational study. BMC Cancer 2024; 24:51. [PMID: 38195471 PMCID: PMC10777491 DOI: 10.1186/s12885-023-11799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND A psychoneurological symptom cluster composed of cancer-related fatigue, emotional distress, sleep difficulties, and pain is very common among patients with cancer. Cognitive difficulties are also frequently associated with this cluster. Network analyses allow for an in-depth understanding of the relationships between symptoms in a cluster. This paper details the study protocol of a longitudinal assessment of the psychoneurological symptom cluster in two distinct cohorts: breast cancer and digestive cancer survivors, using network analyses. METHODS Over two years, the symptoms involved in the psychoneurological symptom cluster, along with other common symptoms (e.g., digestive symptoms, financial difficulties) and variables (i.e., self-compassion, coping strategies) will be assessed in two cohorts: breast cancer survivors (N = 240) and digestive cancer survivors (N = 240). Online questionnaires will be completed at baseline, then 6, 12 and 24 months later. Network analyses will be used to assess the configuration of the symptom cluster at each measurement time and in each cohort. Comparison of networks between two measurement times or between the two cohorts will also be done with network comparison tests. DISCUSSION This study will enable a better understanding of the relationships between common symptoms endured by patients with cancer. The results will be employed to develop more cost-effective interventions which, ultimately, will significantly improve the quality of life of patients with breast or digestive cancer. TRIAL REGISTRATION ClinicalTrials.gov (NCT05867966). Registered on the 27th of April 2023. url: https://classic. CLINICALTRIALS gov/ct2/show/NCT05867966 .
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Affiliation(s)
- Charlotte Grégoire
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium.
| | | | - Marie Ernst
- Biostatistics and Research Method Center, University Hospital and University of Liège, Liège, Belgium
| | - Anh Diep
- Biostatistics and Research Method Center, University Hospital and University of Liège, Liège, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
- Arsène Burny Cancerology Institute, University Hospital of Liège, Liège, Belgium
| | - Martine Devos
- Arsène Burny Cancerology Institute, University Hospital of Liège, Liège, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, University Hospital and University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
- Algology Interdisciplinary Center, University Hospital of Liège, Liège, Belgium
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30
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Blickle P, Schmidt ME, Steindorf K. Post-traumatic growth in cancer survivors: What is its extent and what are important determinants? Int J Clin Health Psychol 2024; 24:100418. [PMID: 37867603 PMCID: PMC10585376 DOI: 10.1016/j.ijchp.2023.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023] Open
Abstract
Background/Objective The aim was to investigate the extent and longitudinal determinants of post-traumatic growth (PTG) in cancer survivors. Methods A sample of 1316 cancer survivors with various cancer types was examined using the EORTC QLQ-FA12 to assess fatigue, the EORTC QLQ-C30 pain items to assess pain and the Patient Health Questionnaire (PHQ-4) to assess emotional distress two years after diagnosis (t0). Additionally, patients rated how well they felt informed about fatigue at t0. PTG was assessed with the 21-item PTG-Inventory four years after diagnosis (t1) comprising the five subdimensions appreciation of life, relation to others, personal strengths, new possibilities and spiritual change. Results Regarding the extent of PTG, most positive developments were experienced in the PTG subdimension appreciation of life whereas the subdimension spiritual change was the least pronounced domain. Fatigue, pain and emotional distress were longitudinal but non-linear predictors of long-term PTG. Additionally, poor informedness about fatigue was associated with less PTG. Conclusions PTG can be perceived even years after a traumatic cancer event and is longitudinally associated with common cancer side effects like fatigue, emotional distress and pain. Further research into the role of individuals' informedness contributing to PTG is needed.
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Affiliation(s)
- Patricia Blickle
- German Cancer Research Center (DKFZ) Heidelberg, Division Physical Activity, Prevention and Cancer, Germany
- Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Martina E. Schmidt
- German Cancer Research Center (DKFZ) Heidelberg, Division Physical Activity, Prevention and Cancer, Germany
| | - Karen Steindorf
- German Cancer Research Center (DKFZ) Heidelberg, Division Physical Activity, Prevention and Cancer, Germany
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Marker RJ, Wechsler S, Leach HJ. Cancer-related fatigue is associated with objective measures of physical function before and after a clinical exercise program: A retrospective analysis. REHABILITATION ONCOLOGY 2024; 42:31-38. [PMID: 38774708 PMCID: PMC11104554 DOI: 10.1097/01.reo.0000000000000354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Background:
Cancer-related fatigue (CRF) is a common symptom reported by survivors of cancer. CRF is associated with reduced self-reported physical function, but associations with objective measures of physical function are less robust. Exercise programs have been shown to improve both CRF and objective physical function, but the interaction of exercise, CRF, and function has not been explored.
Methods:
Retrospective data were collected from baseline (n = 420) and final assessments (n = 234) of survivors who participated in a 3-month clinical exercise program. Assessments included measures of CRF (Functional Assessment of Chronic Illness Therapy–Fatigue) and physical function (6-minute walk test, usual and fast gait speed, 30-second sit-to-stand test, and the Timed Up and Go test). Multiple regression analyses investigated associations between CRF and physical function before and after the program. CRF and functional changes following the program were calculated and associations investigated with multiple regressions.
Results:
All measures of CRF and physical function significantly improved following the program (P < .01). CRF was associated with all functional measures at baseline (standardized β = −0.18 to 0.29, P < .01) and final assessments (r = −0.27 to 0.26, P < .01). Changes in CRF were associated with changes in function (standardized β = −0.12 to 0.23, P < .05), except usual gait speed (P = .17).
Conclusion:
This investigation demonstrated associations between CRF and objective physical function before and after participation in an exercise program. The 3-way interaction between CRF, physical function, and exercise can be used clinically to personalize rehabilitation strategies. Future studies should investigate changes in CRF and function during an exercise program.
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Affiliation(s)
- Ryan J Marker
- Assistant Professor, Department of Physical Medicine and
Rehabilitation, University of Colorado Anschutz Medical Campus
| | - Stephen Wechsler
- Post-Doctoral Research Fellow, Department of Occupational
Therapy, MGH Institute of Health Professions
| | - Heather J Leach
- Associate Professor, Department of Health and Exercise
Science, Colorado State University
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Wang Y, Tian L, Liu X, Zhang H, Tang Y, Zhang H, Nie W, Wang L. Multidimensional Predictors of Cancer-Related Fatigue Based on the Predisposing, Precipitating, and Perpetuating (3P) Model: A Systematic Review. Cancers (Basel) 2023; 15:5879. [PMID: 38136423 PMCID: PMC10741552 DOI: 10.3390/cancers15245879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/22/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Cancer-related fatigue (CRF) is a widespread symptom with high prevalence in cancer patients, seriously affecting their quality of life. In the context of precision care, constructing machine learning-based prediction models for early screening and assessment of CRF is beneficial to this situation. To further understand the predictors of CRF for model construction, we conducted a comprehensive search in PubMed, Web of Science, Embase, and Scopus databases, combining CRF with predictor-related terms. A total of 27 papers met the inclusion criteria. We evaluated the above studies into three subgroups following the predisposing, precipitating, and perpetuating (3P) factor model. (1) Predisposing factors-baseline fatigue, demographic characteristics, clinical characteristics, psychosocial traits and physical symptoms. (2) Precipitating factors-type and stage of chemotherapy, inflammatory factors, laboratory indicators and metabolic changes. (3) Perpetuating factors-a low level of physical activity and poorer nutritional status. Future research should prioritize large-scale prospective studies with emerging technologies to identify accurate predictors of CRF. The assessment and management of CRF should also focus on the above factors, especially the controllable precipitating factors, to improve the quality of life of cancer survivors.
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Affiliation(s)
- Yiming Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
| | - Lv Tian
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
| | - Xia Liu
- Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China; (X.L.); (Y.T.); (H.Z.)
| | - Hao Zhang
- Yanda Medical Research Institute, Hebei Yanda Hospital, Sanhe 065201, China;
| | - Yongchun Tang
- Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China; (X.L.); (Y.T.); (H.Z.)
| | - Hong Zhang
- Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China; (X.L.); (Y.T.); (H.Z.)
| | - Wenbo Nie
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
| | - Lisheng Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun 130021, China; (Y.W.); (L.T.)
- Yanda Medical Research Institute, Hebei Yanda Hospital, Sanhe 065201, China;
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Yu H, Tan L, Xue B, Feng L, Fang P, Meng X, Luo X. Platelet-to-lymphocyte, neutrophil-to-lymphocyte and lymphocyte-to-monocyte ratios are related to cancer-related fatigue and quality of life in patients with cancer: a cross-sectional study. BMJ Open 2023; 13:e075398. [PMID: 38056937 PMCID: PMC10711903 DOI: 10.1136/bmjopen-2023-075398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/29/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES To explore the association of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) with cancer-related fatigue (CRF) and quality of life (QOL) in cancer patients. DESIGN A cross-sectional study. SETTINGS A grade A tertiary hospital in Wuhan, China. PARTICIPANTS A total of 236 participants were recruited. Participants who were diagnosed with cancer received chemotherapy and/or radiotherapy, and aged ≥18 years were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES The PLR, NLR and LMR were calculated based on the absolute lymphocyte count, neutrophil count, platelet count and monocyte count. The CRF and QOL of patients after the first chemotherapy/radiotherapy were evaluated. RESULTS The median values (IQR) of PLR, NLR and LMR were 174.51 (126.14-261.02), 2.84 (1.64-5.24) and 2.56 (1.30-3.72), respectively. Univariate analysis indicated that high PLR (≥ 174.51), high NLR (≥ 2.84) and low LMR (< 2.56) at baseline significantly correlated with CRF and poor QOL after the first chemotherapy/radiotherapy (p<0.005). Multiple linear regression analysis indicated that elevated PLR might be an independent risk factor for CRF (p<0.001) and QOL (p=0.010) in cancer patients. CONCLUSION PLR, NLR and LMR are associated with CRF and QOL in cancer patients. High PLR may predict severe CRF and poor QOL. Further studies are needed to validate these findings based on the expanded sample size.
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Affiliation(s)
- Huidan Yu
- School of Nursing, Wuhan University, Wuhan, China
| | - Lanhui Tan
- School of Nursing, Wuhan University, Wuhan, China
| | - Bing Xue
- School of Nursing, Wuhan University, Wuhan, China
| | - Ling Feng
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Pei Fang
- School of Nursing, Wuhan University, Wuhan, China
| | - Xianmei Meng
- School of Nursing, Wuhan University, Wuhan, China
| | - Xianwu Luo
- School of Nursing, Wuhan University, Wuhan, China
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Kleckner AS, Kleckner IR, Renn CL, Rosenblatt PY, Ryan AS, Zhu S. Dietary Composition, Meal Timing, and Cancer-Related Fatigue: Insights From the Women's Healthy Eating and Living Study. Cancer Nurs 2023:00002820-990000000-00198. [PMID: 38032743 PMCID: PMC11136880 DOI: 10.1097/ncc.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Cancer-related fatigue is difficult to treat, and dietary interventions are promising yet underused. OBJECTIVE We explored associations between dietary patterns and fatigue, and the effect of a dietary intervention versus control on fatigue using Women's Healthy Eating and Living study data, plus mediators and moderators of the intervention effect. METHODS The Women's Healthy Eating and Living study was a randomized controlled trial among early-stage breast cancer survivors. The 4-year intervention encouraged fruits, vegetables, fiber, and 15% to 20% calories from fat. Fatigue outcomes included a 9-item energy scale and a single-item tiredness question. Dietary quality was estimated using a modified Healthy Eating Index (24-hour dietary recall) and serum carotenoid concentrations. Nutrient timing was obtained from 4-day food logs. RESULTS Among 2914 total participants, lower body mass index was associated with less tiredness and more energy at baseline (P < .001 for both). Earlier start and end times for daily eating windows were associated with less tiredness (P = .014 and P = .027, respectively) and greater energy (P = .006 and P = .102, respectively). The intervention did not lead to improvements in fatigue on average (P > .125). However, the intervention was more effective for participants who were younger, had fewer comorbidities, and did not have radiation treatment. Mediators included increases in serum carotenoids, increases in the modified Healthy Eating Index, and weight loss/maintenance. CONCLUSION Diet quality and earlier eating windows were associated with less fatigue. IMPLICATIONS FOR PRACTICE Programs that encourage high diet quality and a morning meal and discourage nighttime eating should be tested for efficacy in reducing cancer-related fatigue in survivorship.
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Affiliation(s)
- Amber S Kleckner
- Author Affiliations: Department of Pain and Translational Symptom Science (Drs A. Kleckner, I. Kleckner, and Renn) and Department of Organizational Systems and Adult Health (Dr Zhu), University of Maryland School of Nursing; Department of Hematology and Oncology (Dr Rosenblatt) and Department of Medicine (Dr Ryan), University of Maryland School of Medicine; Baltimore Geriatric Research Education Clinical Center (Dr Ryan); and Greenebaum Comprehensive Cancer Center (Drs A. Kleckner, I. Kleckner, Rosenblatt, and Ryan), Baltimore, Maryland
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Wang H, Deng T, Cao C, Feng D. Distinct dyadic quality of life profiles among patient-caregiver dyads with advanced lung cancer: a latent profile analysis. Support Care Cancer 2023; 31:704. [PMID: 37975958 DOI: 10.1007/s00520-023-08182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE This study aimed to identify the heterogeneity of dyadic quality of life (QoL) profiles, determine whether these profiles differ in terms of demographic and medical factors, neuroticism, resilience, and family functioning, and explore the combined effect of patient and caregiver neuroticism, resilience, and family functioning on dyadic QoL profiles. METHODS A cross-sectional study was conducted with 304 advanced lung cancer patient-caregiver dyads. Self-report questionnaires were administered to patient-caregiver dyads to assess demographic and medical characteristics, neuroticism, resilience, family functioning, and QoL. RESULTS The latent profile analysis identified four subgroups of dyadic QoL: patient-low-caregiver-high profile (38.82%), patient-high-caregiver-high profile (22.37%), patient-high-caregiver-low profile (19.74%), and patient-low-caregiver-low profile (19.08%). Additionally, when both patients and their caregivers had a high level of neuroticism or low level of resilience and low family functioning, compared with only member having them, there was a higher risk of poorer dyadic QoL. CONCLUSIONS Our study identified the four heterogeneities of dyadic QoL profiles among advanced lung cancer patient-caregiver dyads. Future dyadic interventions should consider the heterogeneity of dyadic QoL in this population and prioritize patient-caregiver dyads at risk of poor dyadic QoL. Furthermore, when high neuroticism, low resilience, or family functioning coexist between patients and their caregivers, both parties exhibit much lower dyadic QoL.
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Affiliation(s)
- Hui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China
| | - Tiantian Deng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China
| | - Cong Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China
| | - Danjun Feng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China.
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Ginex PK, Wood SK, Sivakumaran K, Babatunde I, Yu T, Gibbs KD, Morgan RL. Physical activity interventions for cancer-related fatigue: A scoping review of randomized controlled trials from a Nursing Science Precision Health Model perspective. Nurs Outlook 2023; 71:102052. [PMID: 37738805 DOI: 10.1016/j.outlook.2023.102052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND The Nursing Science Precision Health (NSPH) Model has the potential to guide research on the development, testing, and targeting of interventions. PURPOSE This scoping review examines the relationship between physical activity (PA) and cancer-related fatigue (CRF) within the context of the NSPH Model. METHODS The Joanna Briggs Institute scoping review methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this review. We included randomized controlled trials in people with cancer that investigated PA interventions and measured change in CRF as an outcome. DISCUSSION A total of 181 studies met the eligibility criteria. Over 20 different instruments were used to measure CRF. The most common PA interventions were strength training (48%), walking (36%), cycling (26%), and yoga (15%). A limited number of studies reported phenotypic characteristics (32/181, 17%) or biomarkers (31/181, 17%) associated with CRF. CONCLUSION This scoping review identified the body of existing research exploring CRF and PA from a precision health perspective.
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Affiliation(s)
- Pamela K Ginex
- School of Nursing, Stony Brook University School of Nursing, Stony Brook, NY.
| | - Sylvia K Wood
- School of Nursing, Stony Brook University School of Nursing, Stony Brook, NY
| | | | - Ifeoluwa Babatunde
- Evidence Foundation, Cleveland, OH; School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Tiffany Yu
- Evidence Foundation, Cleveland, OH; Faculty of Health Sciences, McMaster University, Hamilton, ON
| | | | - Rebecca L Morgan
- Evidence Foundation, Cleveland, OH; School of Medicine, Case Western Reserve University, Cleveland, OH; Faculty of Health Sciences, McMaster University, Hamilton, ON
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Knefel M, Zeilinger EL, Erfurth A, Lubowitzki S, Lesch O, Wagner T, Unseld M, Bartsch R, Füreder T, Jäger U, Kiesewetter B, Krauth MT, Prager G, Raderer M, Staber PB, Valent P, Gaiger A. Affective temperament, fatigue, and pain in cancer patients. J Affect Disord 2023; 340:80-87. [PMID: 37543112 DOI: 10.1016/j.jad.2023.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Matthias Knefel
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Department of Internal Medicine, Landesklinikum Baden-Mödling, Waltersdorfer Straße 75, 2500 Baden, Austria
| | - Elisabeth L Zeilinger
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
| | - Andreas Erfurth
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Simone Lubowitzki
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Otto Lesch
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Theresa Wagner
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Matthias Unseld
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
| | - Rupert Bartsch
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Thorsten Füreder
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Ulrich Jäger
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesewetter
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Maria T Krauth
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Gerald Prager
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Markus Raderer
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Philipp B Staber
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Alexander Gaiger
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.
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Pasek M, Biel J, Goździalska A, Jochymek M. Quality of Life of Polish Patients with Lymphoma Treated Systemically. NURSING REPORTS 2023; 13:1421-1431. [PMID: 37873826 PMCID: PMC10594482 DOI: 10.3390/nursrep13040119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/01/2023] [Accepted: 10/07/2023] [Indexed: 10/25/2023] Open
Abstract
Research on the quality of life has become of great importance. It is used by clinical researchers to compare the impact of treatment regimens on patients. The choice of treatment method may significantly depend on the patient's opinion. A cross-sectional study was conducted using the method of a diagnostic questionnaire survey. The research tools were the authors' questionnaire and the standardized WHOQOL-BREF. The study was conducted among patients with lymphoma, treated systemically. More than half of the surveyed patients assessed their overall quality of life as good (50%) and very good (6%), while the expressed satisfaction with health most often ranged from neutral (38%-neither good nor bad) to dissatisfactory (30%) and very dissatisfactory (6%). As regards the detailed domains, the area of physical functioning was rated the lowest, while for the remaining domains-psychological, social, environmental-values above average (60.38-64.30) were observed. Social support, particularly from the immediate family, resulted in a higher assessment of the quality of life. The occurrence of side effects related to anticancer treatment and the disease had a statistically significant impact on the decrease in the quality of life, particularly in the physical domain.
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Affiliation(s)
- Małgorzata Pasek
- Department of Nursing, Faculty of Health, University of Applied Sciences, 33-100 Tarnów, Poland;
| | - Janina Biel
- Faculty of Health and Medical Studies, A. F. Modrzewski Krakow University, 30-705 Krakow, Poland; (J.B.); (M.J.)
| | - Anna Goździalska
- Faculty of Health and Medical Studies, A. F. Modrzewski Krakow University, 30-705 Krakow, Poland; (J.B.); (M.J.)
| | - Małgorzata Jochymek
- Faculty of Health and Medical Studies, A. F. Modrzewski Krakow University, 30-705 Krakow, Poland; (J.B.); (M.J.)
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Sharp L, Watson LJ, Lu L, Harding S, Hurley K, Thomas SJ, Patterson JM. Cancer-Related Fatigue in Head and Neck Cancer Survivors: Longitudinal Findings from the Head and Neck 5000 Prospective Clinical Cohort. Cancers (Basel) 2023; 15:4864. [PMID: 37835558 PMCID: PMC10571913 DOI: 10.3390/cancers15194864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023] Open
Abstract
Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments. For head and neck cancer (HNC), CRF may exacerbate the symptom burden and poor quality-of-life. Using data from the Head and Neck 5000 prospective clinical cohort, we investigated clinically important CRF over a year post-diagnosis, assessing temporal trends, CRF by HNC site and treatment received, and subgroups at higher risk of CRF. Recruitment was undertaken in 2011-2014. Socio-demographic and clinical data, and patient-reported CRF (EORTC QLQ-C30 fatigue subscale score ≥39 of a possible 100) were collected at baseline (pre-treatment) and 4- and 12- months post-baseline. Mixed-effects logistic multivariable regression was used to investigate time trends, compare cancer sites and treatment groups, and identify associations between clinical, socio-demographic and lifestyle variables and CRF. At baseline, 27.8% of 2847 patients scored in the range for clinically important CRF. This was 44.7% at 4 months and 29.6% at 12 months. In the multivariable model, after adjusting for time-point, the odds of having CRF over 12 months were significantly increased in females and current smokers; those with stage 3/4 disease, comorbidities and multimodal treatment; and those who had depression at baseline. The high prevalence of clinically important CRF indicates the need for additional interventions and supports for affected HNC patients. These findings also identified patient subgroups towards whom such interventions could be targeted.
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Affiliation(s)
- Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle NE1 7RU, UK;
| | - Laura-Jayne Watson
- Speech & Language Therapy, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK;
| | - Liya Lu
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle NE1 7RU, UK;
| | - Sam Harding
- Speech and Language Therapy Research Unit, Southmead Hospital North Bristol NHS Hospital Trust, Bristol BS10 5NB, UK;
| | - Katrina Hurley
- Head & Neck 5000 Study, Weston NHS Foundation Trust, University of Bristol, Bristol BS8 1TU, UK (S.J.T.)
| | - Steve J. Thomas
- Head & Neck 5000 Study, Weston NHS Foundation Trust, University of Bristol, Bristol BS8 1TU, UK (S.J.T.)
| | - Joanne M. Patterson
- Liverpool Head and Neck Centre, School of Health Science, University of Liverpool, Liverpool L69 3BG, UK;
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DSilva F, Singh P, Javeth A. Determinants of Cancer-Related Fatigue among Cancer Patients: A Systematic Review. J Palliat Care 2023; 38:432-455. [PMID: 36245333 DOI: 10.1177/08258597221131133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: This systematic review aims to assess and explore various determinants of cancer- related fatigue. Methods: A systematic search of various determinants of Cancer-related fatigue (CRF) was performed in different databases like PubMed, Google Scholar, Science Direct and Clinical Key dating from 1990 to September 2020. Results: A total of 6115 studies were screened and 95 articles related to determinants of fatigue were retained. Various modifiable and non-modifiable determinants including socio-demographic, clinical, treatment related, plasma biomarker related, genetic, behavioural, concurrent symptoms related and psychological determinants were identified. Depression was one of the significant factors reported in 28% of studies, followed by pain, (17%), performance status (16%), chemotherapy and anxiety (15%). Conclusion: It is recommended that nurses and clinicians should anticipate, identify and take appropriate interventions to manage those modifiable factors. Ultimately, managing the modifiable factors helps in the comprehensive care of cancer patients.
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Affiliation(s)
- Fatima DSilva
- Nitte Usha Institute of Nursing Sciences, Nitte University, Mangalore, Karnataka, India
| | - Pritanjali Singh
- Department of Radiation Oncology, All India Institute of Medical Science (AIIMS), Patna, Bihar, India
| | - Athar Javeth
- College of Nursing, All India Institute of Medical Science (AIIMS), Patna, Bihar, India
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Alzhrani AA, Alsuhail AI, Rababah AA. Fatigue Prevalence Among Palliative Care Cancer Patients in Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia: A Cross-Sectional Study. J Palliat Care 2023; 38:424-431. [PMID: 37501537 DOI: 10.1177/08258597231191615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Objective: The aims of the current study are to assess the prevalence of cancer-related fatigue, to examine the difference in cancer-related fatigue severity in relation to patients' characteristics (age, gender, type of cancer, and palliative performance status), and to explore the correlation between cancer-related fatigue and pain, dyspnea, insomnia, and depression among palliative care patients. Methods: A cross-sectional descriptive observational study conducted at Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia. The study included cancer patients who received palliative care services from January 2016 to December 2021. Clinical data of study participants were retrospectively collected from Palliative Care department patient registry. Symptoms were assessed and scored using Edmonton Symptom Assessment Scale. Data analysis was performed using SPSS statistical software. Results: A total of 2616 patients were included in the study, 52.3% were females and 47.7% were males. The median age of study participants was 56 years (range: 2-101 years). Among all study population, the highest reported cancer type was gastrointestinal malignancy (33.5%), while the least was unknown primary malignancy (1.4%). With regards to Edmonton Symptom Assessment Scale, pain (86.4%) and fatigue (83%) were the highest reported symptom in comparison to constipation (17.3%) and insomnia (7.1%). Conclusion: Cancer-related fatigue is a prevalent and concerning issue among palliative care patients. It is essential that healthcare providers recognize the prevalence of fatigue among patients with life-limiting illnesses, assess patients for fatigue routinely, incorporate strategies for managing fatigue, work closely with affected individuals and their families in order to guide the establishment of a personalized care plan that addresses the patient's unique needs and preferences.
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Affiliation(s)
- Abdulaziz A Alzhrani
- Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah I Alsuhail
- Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ahmad A Rababah
- Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Ren Z, Cui W, Li YP. Application of traditional Chinese medicine acupoint needle embedding combined with emotional nursing in patients with gynecological malignant tumors. World J Psychiatry 2023; 13:645-653. [PMID: 37771638 PMCID: PMC10523202 DOI: 10.5498/wjp.v13.i9.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Few relevant literature reports on applying acupoint press-needle embedding combined with emotional nursing in patients with a gynecological malignant tumor. AIM To explore the effect of traditional Chinese medicine acupoint needle embedding combined with emotional nursing on chemotherapy-related nausea and vomiting (CINV), cancer-related fatigue (CRF) and psychological state in patients with gynecological malignant tumors. METHODS Retrospective analysis of the clinical information of 84 patients with gynecological malignant tumors treated in our hospital from August 2020 to December 2022 Led to the development of an observation group (n = 42) and a control group (n = 42) based on various nursing approaches. Ondansetron hydrochloride injection was administered to the individuals in the control group. However, the observation group received emotional nursing based on the control group and acupoint press-needle embedding of traditional Chinese medicine. Patients in both groups received the chemotherapy regimen of paclitaxel liposome + carbo-platin/ cisplatin. For four weeks, both groups intervened. The CINV grade, quality of life, CRF, psychological status and sleep quality scores of the two groups before and after intervention were compared. RESULTS After intervention, the degree of CINV in the observation group was significantly better than that in the control group. After intervention, the scores of each dimension and total score of FLIE scale were significantly higher than those in the control group. After intervention, the scores of each dimension and total score of Piper Fatigue Scale were significantly lower than those in the control group (P < 0.05). After intervention, the scores of avoidance and yield dimensions in the observation group were significantly lower than those in the control group, and the scores of confrontation dimension were significantly higher than those in the control group (P < 0.05). After intervention, the sleep quality score of the observation group was significantly lower than that of the control group, and the Karnofsky Performance Status scale score was significantly higher than that of the control group (P < 0.05). CONCLUSION The acupuncture point needle embedding of traditional Chinese medicine combined with emotional nursing can further reduce the incidence of chemotherapy-related nausea and vomiting in patients with gynecological malignant tumors, improve the quality of life and the degree of CRF, alleviate the bad psychological state, adopt a positive way to face the disease and treatment, and improve the quality of sleep and quality of life.
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Affiliation(s)
- Zhen Ren
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, Heilongjiang Province, China
| | - Wen Cui
- Department of Rehabilitation and Health Care, Jinan Vocational College of Nursing, Jinan 250102, Shandong Province, China
| | - Ya-Ping Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
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Roose E, Huysmans E, Lahousse A, Mostaqim K, van Gerven L, Vissers M, Nijs J, Van Wilgen P, Beckwée D, Timmermans A, Bults R, Leysen L. Perceived Injustice in Cancer Survivors: Population-Specific Cut-Off Score and Relations with Personal Factors, Symptoms and Quality of Life-A Cross-Sectional Study. J Clin Med 2023; 12:5780. [PMID: 37762721 PMCID: PMC10531632 DOI: 10.3390/jcm12185780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Fatigue and pain are the most common side effects impacting quality of life (QoL) in cancer survivors. Recent insights have shown that perceived injustice (PI) can play a substantial role in these side effects, but research on cancer survivors is scarce. Furthermore, guidelines for recognizing clinically relevant levels of PI in cancer survivors are missing. The aims of this study are to provide a clinically relevant cut-off for PI and to explore relationships between personal characteristics, symptoms, and QoL with PI. This multicenter, cross-sectional study uses the Injustice Experience Questionnaire (IEQ), Numeric Pain Rating Scale (NPRS), Patient-Specific Complaints (PSC), Multidimensional Fatigue Index (MFI), and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 (EORTC-QLQ-C30). A clinical cut-off for PI was identified based on the 75th percentile of IEQ scores. Univariate and multivariate regressions explored the relationship between PI and personal characteristics (sex, age, cancer type, treatment type), symptoms (pain intensity, fatigue), and QoL (daily activity complaints, cancer-related QoL). Cancer survivors (n = 121) were included, and a cut-off of 20 was identified. Significant indirect associations were found between chemotherapy, NPRS, PSC, MFI, and EORTC-QLQ-C30 with PI. In the multivariate model, only MFI (B = 0.205; 95% CI: 0.125-0.018) and age (B = 0.086; 95% CI: -0.191-0.285) maintained a significant association with PI.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- REVAL, Universiteit Hasselt, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium;
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Research Foundation–Flanders (FWO), Leuvensesteenweg 38, 1000 Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
| | - Lotte van Gerven
- The Berekuyl Academy, Molenweg 4, 3849 Hierden, The Netherlands; (L.v.G.); (M.V.)
| | - Moniek Vissers
- The Berekuyl Academy, Molenweg 4, 3849 Hierden, The Netherlands; (L.v.G.); (M.V.)
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Huvudbyggnad Vasaparken, Universitetsplatsen 1, 41345 Gothenburg, Sweden
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Transcare Pain Transdisciplinary Pain Treatment Center, 9711 Groningen, The Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Annick Timmermans
- REVAL, Universiteit Hasselt, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium;
| | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
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Grignaschi S, Kim M, Zanframundo G, Ravichandran N, Lilleker JB, Sen P, Joshi M, Agarwal V, Kardes S, Day J, Makol A, Milchert M, Gheita T, Salim B, Velikova T, Gracia-Ramos AE, Parodis I, Nikiphorou E, Chatterjee T, Tan AL, Saavedra MA, Shinjo SK, Ziade N, Knitza J, Kuwana M, Nune A, Distler O, Chinoy H, Cavagna L, Agarwal V, Aggarwal R, Gupta L. High fatigue scores in patients with idiopathic inflammatory myopathies: a multigroup comparative study from the COVAD e-survey. Rheumatol Int 2023; 43:1637-1649. [PMID: 37314497 PMCID: PMC10265550 DOI: 10.1007/s00296-023-05344-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/06/2023] [Indexed: 06/15/2023]
Abstract
Idiopathic inflammatory myopathies (IIMs) confer a significant risk of disability and poor quality of life, though fatigue, an important contributing factor, remains under-reported in these individuals. We aimed to compare and analyze differences in visual analog scale (VAS) scores (0-10 cm) for fatigue (VAS-F) in patients with IIMs, non-IIM systemic autoimmune diseases (SAIDs), and healthy controls (HCs). We performed a cross-sectional analysis of the data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) international patient self-reported e-survey. The COVAD survey was circulated from December 2020 to August 2021, and details including demographics, COVID-19 history, vaccination details, SAID details, global health, and functional status were collected from adult patients having received at least one COVID-19 vaccine dose. Fatigue experienced 1 week prior to survey completion was assessed using a single-item 10 cm VAS. Determinants of fatigue were analyzed in regression models. Six thousand nine hundred and eighty-eight respondents (mean age 43.8 years, 72% female; 55% White) were included in the analysis. The overall VAS-F score was 3 (IQR 1-6). Patients with IIMs had similar fatigue scores (5, IQR 3-7) to non-IIM SAIDs [5 (IQR 2-7)], but higher compared to HCs (2, IQR 1-5; P < 0.001), regardless of disease activity. In adjusted analysis, higher VAS-F scores were seen in females (reference female; coefficient -0.17; 95%CI -0.21 to -13; P < 0.001) and Caucasians (reference Caucasians; coefficient -0.22; 95%CI -0.30 to -0.14; P < 0.001 for Asians and coefficient -0.08; 95%CI -0.13 to 0.30; P = 0.003 for Hispanics) in our cohort. Our study found that patients with IIMs exhibit considerable fatigue, similar to other SAIDs and higher than healthy individuals. Women and Caucasians experience greater fatigue scores, allowing identification of stratified groups for optimized multidisciplinary care and improve outcomes such as quality of life.
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Affiliation(s)
- Silvia Grignaschi
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Lombardia, Italy
- Rheumatology Division, IRCCS Policlinico San Matteo Foundation, Pavia, Lombardia, Italy
| | - Minchul Kim
- Center for Outcomes Research, Department of Internal Medicine, University of Illinois College of Medicine Peoria, Peoria, IL, USA
| | - Giovanni Zanframundo
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Lombardia, Italy
- Rheumatology Division, IRCCS Policlinico San Matteo Foundation, Pavia, Lombardia, Italy
| | - Naveen Ravichandran
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - James B Lilleker
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Neurology, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Parikshit Sen
- Maulana Azad Medical College, 2-Bahadurshah Zafar Marg, New Delhi, 110002, India
| | - Mrudula Joshi
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India
| | - Vishwesh Agarwal
- Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India
| | - Sinan Kardes
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey
| | - Jessica Day
- Department of Rheumatology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Ashima Makol
- Division of Rheumatology, Mayo Clinic, Rochester, MN, USA
| | - Marcin Milchert
- Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, Ul Unii Lubelskiej 1, 71-252, Szczecin, Poland
| | - Tamer Gheita
- Rheumatology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Babur Salim
- Rheumatology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407, Sofia, Bulgaria
| | - Abraham Edgar Gracia-Ramos
- Department of Internal Medicine, General Hospital, National Medical Center "La Raza", Instituto Mexicano del Seguro Social, Av. Jacaranda S/N, Col. La Raza, Del. Azcapotzalco, C.P. 02990, Mexico City, Mexico
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College Hospital, London, UK
- Rheumatology Department, King's College Hospital, London, UK
| | - Tulika Chatterjee
- Center for Outcomes Research, Department of Internal Medicine, University of Illinois College of Medicine Peoria, Peoria, IL, USA
| | - Ai Lyn Tan
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Miguel A Saavedra
- Departamento de Reumatología Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, IMSS, Mexico City, Mexico
| | - Samuel Katsuyuki Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Nelly Ziade
- Rheumatology Department, Saint-Joseph University, Beirut, Lebanon
- Rheumatology Department, Hotel-Dieu de France Hospital, Beirut, Lebanon
| | - Johannes Knitza
- Medizinische Klinik 3-Rheumatologie Und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan
| | - Arvind Nune
- Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN, UK
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hector Chinoy
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Lombardia, Italy
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Lorenzo Cavagna
- Rheumatology Division, IRCCS Policlinico San Matteo Foundation, Pavia, Lombardia, Italy
- Rheumatology Unit, Dipartimento Di Medicine Interna E Terapia Medica, Università Degli Studi Di Pavia, Pavia, Lombardy, Italy
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Latika Gupta
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, WV10 0QP, UK.
- City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
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Martinez-Calderon J, García-Muñoz C, Cano-García FJ, Heredia-Rizo AM. Psychological and spiritual interventions to enhance meaning in adults diagnosed with cancer: a systematic review with meta-analysis and meta-regression. Support Care Cancer 2023; 31:523. [PMID: 37584817 DOI: 10.1007/s00520-023-07986-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE To summarize the evidence on the effectiveness that psychological and/or spiritual interventions may have to change the levels of meaning, measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), in adults diagnosed with cancer. METHODS Systematic review with meta-analysis and meta-regression. CINAHL (via EBSCOhost), Embase, PubMed, PsycINFO (via ProQuest), and the Cochrane Library were searched from inception to 21st October 2022. Manual searches were conducted. Only randomized clinical trials (RCTs) were included. The risk of bias was assessed with the Cochrane Risk of Bias tool 2. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to judge the certainty of the evidence. RESULTS Eight RCTs were included (N = 1682). Although some individual studies showed positive effects to enhance meaning using mindfulness or dignity therapy, the overall and individual meta-analyses showed a lack of effect of psychological and spiritual interventions in comparison to comparator interventions (MD (95%CI) = -0.19 (-0.45 to 0.06), p = 0.11, Tau2 = 0.0015, I2 = 2%). Publication bias was undetected (Egger's test = 0.35). Furthermore, no RCTs were judged to have a low risk of bias and the overall certainty of the evidence was judged as low. Meta-regression and subgroups meta-analyses also found possible sources of heterogeneity such as some cancer characteristics, the educational stage, or the religious affiliation. CONCLUSIONS Despite some RCTs may show promising results following mindfulness or dignity therapy, no effects were observed in the meta-analysis. Moreover, important methodological and clinical concerns precluded us to make sound clinical recommendations with the available evidence. OPEN SCIENCE FRAMEWORK DOI REGISTRATION: https://doi.org/10.17605/OSF.IO/4YMTK .
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, c/Avicena s/n, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain.
- Universidad Loyola de Andalucía, Avda. de las Universidades s/n, 41704 Sevilla, Sevilla, Spain.
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) Research Group, Andalusia, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain
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Cai T, Chen J, Ni F, Zhu R, Wu F, Huang Q, Zhou T, Yang Y, Yuan C. Psychometric properties of the Chinese version of the functional assessment of chronic illness therapy-fatigue (FACIT-F) among patients with breast cancer. Health Qual Life Outcomes 2023; 21:91. [PMID: 37582752 PMCID: PMC10428540 DOI: 10.1186/s12955-023-02164-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Fatigue is the most frequent and distressing symptom affecting the physical, cognitive, and affective domains of breast cancer patients. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) has been widely used in patients with chronic diseases and has shown satisfactory reliability and validity. This study aimed to examine the psychometric properties of the FACIT-F among Chinese patients with breast cancer. METHODS Using a convenience sampling method, a cross-sectional survey (January 2020 and September 2022) was used with patients recruited from two tertiary hospitals in Shanghai, Mainland China, and a total of 597 patients completed a demographic information questionnaire, the FACIT-F and the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B). Convergent validity was estimated by calculating the Pearson correlation coefficient of the FACIT-F with the FACT-B. Measurement invariance across age was performed by examining differential item functioning (DIF) across age groups (≤ 60 and > 60 years). The internal consistency and split-half reliability were performed for reliability analysis. Unidimensionality of the scale was evaluated by the principal component analysis by Rasch analysis. Additionally, Rasch analysis was performed for item difficulty levels, and an item-person map was used. RESULTS No floor/ceiling effects were observed for the FACIT-F. Moderate correlations were found between FACIT-F and FACT-B (r = - 0.342, p < 0.01). Most items showed an absence of DIF regarding age, except for one item. In addition, the FACIT-F showed acceptable internal consistency. Principal component analysis of Rasch residuals showed that the proportion of variance explained by the FACIT-F was 53.3%, and the outfit mean square statistics for the items ranged from 0.68 to 1.90 and the infit MNSQ from 0.63 to 1.73. Additionally, an acceptable response between items and persons was found. CONCLUSIONS The findings indicate that the Chinese version of the FACIT-F is a valid tool for the measurement of fatigue in breast cancer patients.
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Affiliation(s)
- Tingting Cai
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Jialin Chen
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Feixia Ni
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
- Nursing Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Zhu
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Fulei Wu
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Qingmei Huang
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Tingting Zhou
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Yang Yang
- Department of Nursing, Department of Oncology Shanghai Medical College, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, 200032, China.
- Department of Oncology Shanghai Medical College, Fudan University, Shanghai, China.
| | - Changrong Yuan
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China.
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Kang YE, Yoon JH, Park NH, Ahn YC, Lee EJ, Son CG. Prevalence of cancer-related fatigue based on severity: a systematic review and meta-analysis. Sci Rep 2023; 13:12815. [PMID: 37550326 PMCID: PMC10406927 DOI: 10.1038/s41598-023-39046-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
Cancer-related fatigue (CRF) affects therapeutic compliance and clinical outcomes including recurrence and mortality. This study aimed to comprehensively and comparatively assess the severity-based prevalence of CRF. From two public databases (PubMed and Cochrane Library), we extracted data containing information on both prevalence and severity of fatigue in cancer patients through December 2021. We conducted a meta-analysis to produce point estimates using random effects models. Subgroup analyses were used to assess the prevalence and severity by the organ/system tumor development, treatment phase, therapeutic type, sex and assessment method. A total of 151 data (57 studies, 34,310 participants, 11,805 males and 22,505 females) were selected, which indicated 43.0% (95% CI 39.2-47.2) of fatigue prevalence. The total CRF prevalence including 'mild' level of fatigue was 70.7% (95% CI 60.6-83.3 from 37 data). The prevalence of 'severe' fatigue significantly varied by organ/system types of cancer origin (highest in brain tumors 39.7% vs. lowest in gynecologic tumors 3.9%) and treatment phase likely 15.9% (95% CI 8.1-31.3) before treatment, 33.8% (95% CI 27.7-41.2) ongoing treatment, and 24.1% (95% CI 18.6-31.2) after treatment. Chemotherapy (33.1%) induced approximately 1.5-fold higher prevalence for 'severe' CRF than surgery (22.0%) and radiotherapy (24.2%). The self-reported data for 'severe' CRF was 20-fold higher than those assessed by physicians (23.6% vs. 1.6%). Female patients exhibited a 1.4-fold higher prevalence of 'severe' fatigue compared to males. The present data showed quantitative feature of the prevalence and severity of CRF based on the cancer- or treatment-related factors, sex, and perspective of patient versus physician. In the context of the medical impact of CRF, our results provide a comparative reference to oncologists or health care providers making patient-specific decision.
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Affiliation(s)
- Ye-Eun Kang
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Ji-Hae Yoon
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Na-Hyun Park
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Yo-Chan Ahn
- Department of Health Service Management, Daejeon University, Daejeon, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Gue Son
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, Daejeon, Republic of Korea.
- East-West Cancer Center of Daejeon Hospital, Daejeon University, Daejeon, Republic of Korea.
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Trigueros-Murillo A, Martinez-Calderon J, Casuso-Holgado MJ, González-García P, Heredia-Rizo AM. Effects of music-based interventions on cancer-related pain, fatigue, and distress: an overview of systematic reviews. Support Care Cancer 2023; 31:488. [PMID: 37486578 PMCID: PMC10366242 DOI: 10.1007/s00520-023-07938-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To summarize the available evidence from systematic reviews with meta-analysis on the effects of music-based interventions in adults diagnosed with cancer. METHODS An overview of systematic reviews was conducted. CINHAL, Embase, PEDro, PubMed, Scopus, the Cochrane Library and Web of Science were searched from inception until November 2022. Systematic reviews with meta-analysis in individuals with cancer (any type), any comparator, and outcomes of cancer-related pain, fatigue, and psychosocial symptoms were eligible. The methodological quality of systematic reviews and the amount of spin of information in the abstract were assessed. The Graphical Representation of Overlap for OVErviews tool (GROOVE) was used to explore the overlap of primary studies among systematic reviews. RESULTS Thirteen systematic reviews, with over 9000 participants, containing 119 randomized trials and 34 meta-analyses of interest, were included. Music-based interventions involved passive music listening or patients' active engagement. Most systematic reviews lacked a comprehensive search strategy, did not assess the certainty in the evidence and discussed their findings without considering the risk of bias of primary studies. The degree of overlap was moderate (5.81%). Overall, combining music-based interventions and standard care seems to be more effective than standard care to reduce cancer-related pain, fatigue, and distress. Mixed findings were found for other psychosocial measures. CONCLUSION Music-based interventions could be an interesting approach to modulate cancer-related pain, fatigue, and distress in adults with cancer. The variability among interventions, together with important methodological biases, detract from the clinical relevance of these findings.
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Affiliation(s)
- Ana Trigueros-Murillo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain
| | - Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) research group, Andalusia, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) research group, Andalusia, Spain
| | - Paula González-García
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain.
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Seville, Spain.
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Seville, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMMS) research group, Andalusia, Spain
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Yenson VM, Amgarth-Duff I, Brown L, Caperchione CM, Clark K, Cross A, Good P, Landers A, Luckett T, Philip J, Steer C, Vardy JL, Wong AK, Agar MR. Defining research priorities and needs in cancer symptoms for adults diagnosed with cancer: an Australian/New Zealand modified Delphi study. Support Care Cancer 2023; 31:436. [PMID: 37395859 DOI: 10.1007/s00520-023-07889-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE This study asked consumers (patients, carers) and healthcare professionals (HCPs) to identify the most important symptoms for adults with cancer and potential treatment interventions. METHODS A modified Delphi study was conducted involving two rounds of electronic surveys based on prevalent cancer symptoms identified from the literature. Round 1 gathered information on participant demographics, opinions and/or experience on cancer symptom frequency and impact, and suggestions for interventions and/or service delivery models for further research to improve management of cancer symptoms. In Round 2, respondents ranked the importance of the top ten interventions identified in Round 1. In Round 3, separate expert panels of consumers and healthcare professionals (HCPs) attempted to reach consensus on the symptoms and interventions previously identified. RESULTS Consensus was reached for six symptoms across both groups: fatigue, constipation, diarrhoea, incontinence, and difficulty with urination. Notably, fatigue was the only symptom to reach consensus across both groups in Round 1. Similarly, consensus was reached for six interventions across both groups. These were the following: medicinal cannabis, physical activity, psychological therapies, non-opioid interventions for pain, opioids for breathlessness and cough, and other pharmacological interventions. CONCLUSIONS Consumers and HCPs prioritise differently; however, the symptoms and interventions that reached consensus provide a basis for future research. Fatigue should be considered a high priority given its prevalence and its influence on other symptoms. The lack of consumer consensus indicates the uniqueness of their experience and the need for a patient-centred approach. Understanding individual consumer experience is important when planning research into better symptom management.
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Affiliation(s)
- Vanessa M Yenson
- University of Technology Sydney, Sydney, NSW, Australia.
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia.
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia.
| | - Ingrid Amgarth-Duff
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Linda Brown
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Cristina M Caperchione
- University of Technology Sydney, Sydney, NSW, Australia
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Katherine Clark
- University of Technology Sydney, Sydney, NSW, Australia
- Northern Sydney Local Health District Supportive and Palliative Care Network, St Leonards, Sydney, NSW, Australia
- Northern Clinical School, The University of Sydney, St Leonards, Sydney, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Andrea Cross
- Consumer Advocate, Cancer Symptom Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Phillip Good
- University of Technology Sydney, Sydney, NSW, Australia
- Palliative and Supportive Care, Mater Misericordiae, South Brisbane, QLD, Australia
- Department of Palliative Care, St Vincent's Private Hospital, Brisbane, QLD, Australia
- Mater Research - University of Queensland, South Brisbane, QLD, Australia
| | - Amanda Landers
- University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Tim Luckett
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Jennifer Philip
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of Melbourne, Palliative Medicine, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Palliative Care, Melbourne, VIC, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Christopher Steer
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of New South Wales Rural Clinical Campus, Albury-Wodonga, NSW, Australia
- Border Medical Oncology, Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, NSW, Australia
| | - Janette L Vardy
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Aaron K Wong
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of Melbourne, Palliative Medicine, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Palliative Care, Melbourne, VIC, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Meera R Agar
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
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Nowakowska MK, Ortega RM, Wehner MR, Nead KT. Association of Second-generation Antiandrogens With Cognitive and Functional Toxic Effects in Randomized Clinical Trials: A Systematic Review and Meta-analysis. JAMA Oncol 2023; 9:930-937. [PMID: 37227736 PMCID: PMC10214180 DOI: 10.1001/jamaoncol.2023.0998] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/13/2023] [Indexed: 05/26/2023]
Abstract
Importance The use of second-generation antiandrogens (AAs) in the treatment of prostate cancer is increasing. Retrospective evidence suggests an association between second-generation AAs and adverse cognitive and functional outcomes, but further data from prospective trials are needed. Objective To examine whether evidence from randomized clinical trials (RCTs) in prostate cancer supports an association between second-generation AAs and cognitive or functional toxic effects. Data Sources PubMed, EMBASE, and Scopus (inception to September 12, 2022). Study Selection Randomized clinical trials of second-generation AAs (abiraterone, apalutamide, darolutamide, or enzalutamide) among individuals with prostate cancer that reported cognitive toxic effects, asthenic toxic effects (eg, fatigue, weakness), or falls were evaluated. Data Extraction and Synthesis Study screening, data abstraction, and bias assessment were completed independently by 2 reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-analyses and Enhancing the Quality and Transparency of Health Research reporting guidelines. Tabular counts for all-grade toxic effects were determined to test the hypothesis formulated before data collection. Main Outcomes and Measures Risk ratios (RRs) and SEs were calculated for cognitive toxic effects, asthenic toxic effects, and falls. Because fatigue was the asthenic toxic effect extracted from all studies, data on fatigue are specified in the results. Meta-analysis and meta-regression were used to generate summary statistics. Results The systematic review included 12 studies comprising 13 524 participants. Included studies had a low risk of bias. An increased risk of cognitive toxic effects (RR, 2.10; 95% CI, 1.30-3.38; P = .002) and fatigue (RR, 1.34; 95% CI, 1.16-1.54; P < .001) was noted among individuals treated with second-generation AAs vs those in the control arms. The findings were consistent in studies that included traditional hormone therapy in both treatment arms for cognitive toxic effects (RR, 1.77; 95% CI, 1.12-2.79; P = .01) and fatigue (RR, 1.32; 95% CI, 1.10-1.58; P = .003). Meta-regression supported that, across studies, increased age was associated with a greater risk of fatigue with second-generation AAs (coefficient, 0.75; 95% CI, 0.04-0.12; P < .001). In addition, the use of second-generation AAs was associated with an increased risk of falls (RR, 1.87; 95% CI, 1.27-2.75; P = .001). Conclusions and Relevance The findings of this systematic review and meta-analysis suggest that second-generation AAs carry an increased risk of cognitive and functional toxic effects, including when added to traditional forms of hormone therapy.
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Affiliation(s)
| | | | - Mackenzie R. Wehner
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston
| | - Kevin T. Nead
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
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