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Bøhn SKH, Svendsen K, Balto A, Gjelsvik YM, Myklebust TÅ, Børøsund E, Eriksen HR, Meland A, Østby K, Nes LS, Kiserud CE, Reinertsen KV, Ursin G. Health-related quality of life among women diagnosed with in situ or invasive breast cancer and age-matched controls: a population-based study. J Patient Rep Outcomes 2024; 8:105. [PMID: 39298004 DOI: 10.1186/s41687-024-00781-1] [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: 03/06/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
PURPOSE A breast cancer (BC) diagnosis may negatively affect health-related quality of life (HRQoL). However, there are few comparisons of HRQoL at several time points for women with BC, and particular when subdivided into invasive and in situ tumors. The purpose of this study was to investigate various aspects of HRQoL in women recently diagnosed with invasive BC or ductal carcinoma in situ (in situ) compared to age-matched BC free controls in a population-wide sample recruited through the Cancer Registry of Norway. METHODS This cross-sectional study utilized HRQoL data collected in 2020-2022 from a digital survey including 4117 cases (3867 women with invasive BC and 430 with in situ) and 2911 controls. HRQoL was assessed ≥ 21 days after diagnosis, using EORTC QLQ-C30. This includes scores assessing global quality of life (gHRQoL) and HRQoL functions and symptoms. Multivariable regression analyses were used to compare HRQoL between cases and controls and to identify factors associated with gHRQoL and fatigue. Additionally, HRQoL 14 months after diagnosis was analyzed in 1989 of the included cases and in 1212 of the controls. Score differences of ≥ 10 points were considered clinically relevant and thus presented in the results. RESULTS Invasive BC cases had lower gHRQoL, role- and social functioning in addition to more fatigue than controls. In situ cases had lower role-and social functioning than controls. Invasive BC cases scored worse than in situ on all domains, but the differences were not considered clinically relevant. Physical activity was associated with better gHRQoL and less fatigue in invasive BC, in situ and controls. Both invasive BC and in situ cases improved their role- and social functioning scores from diagnosis to 14 months follow-up, however no improvement was seen for fatigue. CONCLUSION Women with invasive BC and in situ reported lower role- and social functioning scores than controls right after diagnosis with improvements 14 months after diagnosis. Physical activity was associated with better gHRQoL and less fatigue and should, whenever possible, play a key role in the care for BC patients.
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Affiliation(s)
- Synne K H Bøhn
- Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Karianne Svendsen
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway.
- The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - A Balto
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Ylva Maria Gjelsvik
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hege R Eriksen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - A Meland
- Department of Social Sciences, Norwegian School of Sport Sciences, Oslo, Norway
| | - K Østby
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - L Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie E Kiserud
- Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Kristin V Reinertsen
- Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - G Ursin
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Auprih M, Zagar T, Kovacevic N, Smrdel ACS, Besic N, Homar V. Impact of early integrated rehabilitation on fatigue in 600 patients with breast cancer - a prospective study. Radiol Oncol 2024; 58:243-257. [PMID: 38452328 PMCID: PMC11165971 DOI: 10.2478/raon-2024-0016] [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: 06/05/2023] [Accepted: 12/09/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Fatigue after breast cancer treatment is a common burden that is challenging to treat. The aim of this study was to explore if such integrated rehabilitation program reduces the prevalence of chronic fatigue compared to simple, non-integrated rehabilitation. PATIENTS AND METHODS The subjects of our prospective study were 600 female breast cancer patients (29-65 [mean 52 years] of age), who participated in the pilot study on the individualized integrated rehabilitation of breast cancer patients in 2019-2021 and were monitored for one year. The control group included 301 patients and the intervention group numbered 299 patients. The patients completed three questionnaires (EORTC QLQ-C30, -BR23 and NCCN): before cancer treatment, and then six and twelve months after the beginning of cancer treatment. The control group obtained the standard rehabilitation program, while the intervention group was part of the early, individualized multidisciplinary and integrated approach of rehabilitation. The rehabilitation coordinator referred patients for additional interventions (e.g., psychologist, gynecologist, pain management team, physiotherapy, clinical nutrition team, kinesiologist-guided online training, vocational rehabilitation, general practitioner). Data on the patients' demographics, disease extent, cancer treatment and complaints reported in questionnaires were collected and analyzed. RESULTS There were no differences between the control and the intervention group of patients in terms of age, education, disease extent, surgical procedures, systemic cancer treatment, or radiotherapy, and also no differences in the fatigue before the beginning of treatment. However, patients from the control group had a greater level of constant fatigue than patients from the intervention group half a year (p = 0.018) and a year (p = 0.001) after the beginning of treatment. Furthermore, a greater proportion of patients from the control group experienced significant interference with their usual activities from fatigue than from the intervention group, half a year (p = 0.042) and a year (p = 0.001) after the beginning of treatment. A multivariate logistic regression showed that one year after the beginning of treatment, the only independent factor correlated to fatigue was inclusion into the intervention group (p = 0.044). Inclusion in the intervention group was beneficial-patients from the control group were 1.5 times more likely to be fatigued. CONCLUSIONS Early individualized integrated rehabilitation is associated with a lower prevalence of chronic fatigue or fatigue interfering with usual activities in breast cancer patients in comparison to the control group of patients.
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Affiliation(s)
- Masa Auprih
- Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Tina Zagar
- Slovenian Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Nina Kovacevic
- Department of Gynaecological Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine Ljubljana, Ljubljana, Slovenia
| | | | - Nikola Besic
- Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia
- Faculty of Medicine Ljubljana, Ljubljana, Slovenia
| | - Vesna Homar
- Faculty of Medicine Ljubljana, Ljubljana, Slovenia
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Iyizoba-Ebozue Z, Nicklin E, Price J, Prestwich R, Brown S, Hall E, Lilley J, Lowe M, Thomson DJ, Slevin F, Murray L, Boele F. "Why am I still suffering?": Experience of long-term fatigue and neurocognitive changes in oropharyngeal cancer survivors following (chemo)radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 30:100241. [PMID: 38510557 PMCID: PMC10951087 DOI: 10.1016/j.tipsro.2024.100241] [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: 11/23/2023] [Revised: 02/02/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
Background Late effects of cancer treatment, such as neurocognitive deficits and fatigue, can be debilitating. Other than head and neck-specific functional deficits such as impairments in swallowing and speech, little is known about survivorship after oropharyngeal cancer. This study examines the lived experience of fatigue and neurocognitive deficits in survivors of oropharyngeal squamous cell cancer and impact on their daily lives. Methods This work is part of the multicentre mixed method ROC-oN study (Radiotherapy for Oropharyngeal Cancer and impact on Neurocognition), evaluating fatigue and neurocognitive function in patients following radiotherapy +/- chemotherapy for oropharyngeal cancer and impact on quality of life. Semi-structured interviews were conducted in adults treated with radiotherapy (+/-chemotherapy) for oropharyngeal squamous cell carcinoma >/=24 months from completing treatment. Reflexive thematic analysis performed. Results 21 interviews (11 men and 10 women; median age 58 years and median time post-treatment 5 years) were conducted and analysed, yielding six themes: (1) unexpected burden of fatigue, (2) noticing changes in neurocognitive function, (3) the new normal, (4) navigating changes, (5)insufficient awareness and (6)required support. Participants described fatigue that persisted beyond the acute post-treatment period and changes in neurocognitive abilities across several domains. Paid and unpaid work, emotions and mood were impacted. Participants described navigating the new normal by adopting self-management strategies and accepting external support. They reported lack of recognition of these late effects, being poorly informed and being unprepared. Follow-up services were thought to be inadequate. Conclusions Fatigue and neurocognitive impairment were frequently experienced by survivors of oropharyngeal cancer, at least two years after treatment. Patients felt ill-prepared for these late sequelae, highlighting opportunities for improvement of patient information and support services.
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Affiliation(s)
| | - Emma Nicklin
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - James Price
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Robin Prestwich
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - Sarah Brown
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research
| | - Emma Hall
- The Institute of Cancer Research, London, UK
| | - John Lilley
- Department of Radiotherapy Physics, Leeds Cancer Centre, Leeds, UK
| | - Matthew Lowe
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - David J Thomson
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Finbar Slevin
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Louise Murray
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Florien Boele
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Pelzer F, Tröger W, Reif M, Schönberg S, Martin DD, Müller C, Utz-Billing I, Kühn T, Baumgartner S, Kiechle M, Paepke D. Fatigue and quality of life during neoadjuvant chemotherapy of early breast cancer: a prospective multicenter cohort study. Breast Cancer 2024; 31:124-134. [PMID: 37966690 PMCID: PMC10764505 DOI: 10.1007/s12282-023-01520-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: 07/03/2023] [Accepted: 10/22/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Few measurements of fatigue and quality of life have been performed during neoadjuvant chemotherapy of early breast cancer. This study evaluates fatigue and quality of life experienced by early breast cancer patients during neoadjuvant chemotherapy and their association with different clinical parameters. METHODS Fifty-four stage I-III patients' responses to the Multidimensional Fatigue Inventory (MFI) and to the Functional Assessment of Cancer Therapy-Breast (FACT-B) were analyzed by a linear covariance pattern model. Chemotherapy regimen, age, baseline fatigue level, body-mass-index and cancer stage were added to the model to estimate their impact on both outcomes. RESULTS All fatigue dimensions worsened in clinically relevant levels. Physical fatigue worsened the most, mental fatigue the least. For quality of life, physical and functional well-being worsened the most. Only emotional well-being improved during chemotherapy. Physical well-being worsened more during standard than during dose-dense chemotherapy, and more during anthracycline than during taxane cycles. Age, body-mass-index and cancer stage had no impact. The higher the fatigue levels at baseline, the less they worsened during chemotherapy. CONCLUSIONS Further actions to reduce fatigue and improve quality of life during neoadjuvant chemotherapy of early breast cancer are needed. Focus should be laid on the physical dimension. Future research should also investigate the impact of different chemotherapy sequences and densities on fatigue and quality of life. STUDY REGISTRATION The study was registered in the German Clinical Trials Register in May 2019 (DRKS00016761).
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Affiliation(s)
- Florian Pelzer
- Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany.
- Society for Cancer Research, Arlesheim, Switzerland.
| | | | - Marcus Reif
- Gesellschaft Für Klinische Forschung e.V., Berlin, Germany
| | | | - David D Martin
- Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
- Tübingen University Children's Hospital, Tübingen, Germany
| | - Cornelia Müller
- Brandenburgisches Brustzentum, Universitätsklinikum Brandenburg an der Havel, Brandenburg an der Havel, Germany
| | | | - Thorsten Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Germany
- Filderklinik, Filderstadt, Germany
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Stephan Baumgartner
- Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
- Gesellschaft Für Klinische Forschung e.V., Berlin, Germany
| | - Marion Kiechle
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Daniela Paepke
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Spital Zollikerberg, Zurich, Switzerland
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Omari M, Amaadour L, El Asri A, Benbrahim Z, Mellas N, El Rhazi K, Ragala MEA, El Hilaly J, Halim K, Zarrouq B. Psychological distress and coping strategies in breast cancer patients under neoadjuvant therapy: A systematic review. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241276232. [PMID: 39287572 PMCID: PMC11409301 DOI: 10.1177/17455057241276232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND During neoadjuvant therapy (NAT), patients with locally advanced breast cancer (LABC) experience psychological distress (PD) and adopt appropriate coping strategies. OBJECTIVE This systematic review aimed to examine the prevalence and changes in PD and coping strategies in patients with LABC during NAT and to evaluate effective interventions to reduce their PD. DESIGN Quantitative (cross-sectional, longitudinal, and interventional) and qualitative studies reporting PD and coping strategies related to NAT during LABC were included. DATA SOURCES AND METHODS PubMed, Cochrane Library, Scopus, ScienceDirect, Wiley Online Library, and Web of Science databases were consulted to gather relevant literature from the first publications until July 25, 2023. Selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total of 41 articles were included, of which four were qualitative. The main results showed that the prevalence of depression before NAT ranged from 0% to 46% and that of anxiety from 5.5% to 54%. After NAT, the prevalence of depression ranged from 40% to 78.5% and anxiety accounted for 27%. Additionally, PD decreased during NAT. The main determinants of PD were perceived social support, living in joint families, being affected by COVID-19 infection, delays in diagnosis, and starting neoadjuvant treatment. For coping strategies, after NAT, "resigned coping" decreased, whereas "social support" increased, and active coping strategies were correlated with better PD. Some interventions found a reduction in PD, such as a mobile health application, fasting-mimicking diet, relaxation training, and guided imaging. CONCLUSION These findings highlight the importance of considering PD and coping strategies in patients with LABC from diagnosis to the end of NAT. The results suggest that effective psychological interventions should be implemented.
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Affiliation(s)
- Majid Omari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Nursing Training and Research Department, Hassan II University Hospital, Fez, Morocco
| | - Lamiae Amaadour
- Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Achraf El Asri
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Regional Health Directorate Fez-Meknes, El Ghassani Hospital, Fez, Morocco
| | - Zineb Benbrahim
- Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Mohammed El Amine Ragala
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
| | - Jaouad El Hilaly
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRME F), Fez, Morocco
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima Halim
- Laboratory of Natural Substances, Pharmacology, Environment, Modeling, Health & Quality of Life, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Human and Social Sciences-Education Sciences, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi Mohamed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher's Training College (Ecole Normale Supérieure), Sidi Mohamed Ben Abdallah University, Fez, Morocco
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García-González D, Medino-Muñoz J, Romero-Elías M, García-Foncillas J, Ruiz-Casado A. Biological mechanisms of cancer-related fatigue in breast cancer survivors after treatment: a scoping review. J Cancer Surviv 2023:10.1007/s11764-023-01477-z. [PMID: 37930591 DOI: 10.1007/s11764-023-01477-z] [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: 03/21/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is the most common symptom experienced by cancer survivors. It is a multidimensional symptom affecting physical, emotional, and/or cognitive spheres, different from other types of fatigue. Characteristically is not alleviated by sleep or rest. CRF could have specific features in breast cancer survivors (BCS), because of sex, hormones, and distinct treatments. On the other hand, more than 25% of BCS report persistent CRF for 10 years or more after the diagnosis. The present study aims to recapitulate the knowledge about the biological mechanisms that potentially drive CRF in BCS after treatment. METHODS To answer a broad question, a scoping review methodology was used. Data were collated from three bibliographic databases: PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies were selected if they had included more than 20 BCS, after finishing their treatment, fatigue was measured with a quantitative scale and biomarkers were analyzed. RESULTS The final database was composed of 1896 records. Sixty-four studies finally met the eligibility criteria. Inflammation (61%), hypothalamic-pituitary-adrenal (HPA) axis dysregulation (14%), autonomic nervous system (ANS) dysfunction (11%), and diet (9%) were the biological pathways most frequently studied. Unfortunately, results from studies about inflammation and HPA axis show many inconsistencies. CONCLUSION More research about the role of ANS dysfunction and diet on the pathogenesis of CRF would be warranted according to the results of the review. There are some fields such as endocannabinoid systems, mitochondrial dysfunction, gut microbiota, and oxidative stress that have been insufficiently explored. IMPLICATIONS FOR CANCER SURVIVORS To widen the scope of future research in the physiopathology of CRF, it is necessary to identify mechanisms that would be potentially involved and have been insufficiently explored. Because of the high prevalence of CRF in BCS and the tremendous impact that fatigue has in their quality of life, it is essential to improve the efficacy of the treatments through a good knowledge of the biological basis of CRF.
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Affiliation(s)
| | - Juan Medino-Muñoz
- Library, Hospital Universitario de Fuenlabrada, 28942, Madrid, Spain
| | - María Romero-Elías
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, IDIPHISA, 28222, Madrid, Spain
| | - Jesús García-Foncillas
- School of Medicine, Universidad Autónoma de Madrid (UAM), 28029, Madrid, Spain
- Translational Oncology Division, Oncohealth Institute, IIS-Fundación Jiménez Díaz-UAM, 28040, Madrid, Spain
- Department of Medical Oncology, Hospital Universitario Fundación Jiménez Díaz, UAM, 28040, Madrid, Spain
| | - Ana Ruiz-Casado
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, IDIPHISA, 28222, Madrid, Spain.
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, 28222, Madrid, Spain.
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Uslu A, Arslan S. The Effect of Using Virtual Reality Glasses on Anxiety and Fatigue in Women with Breast Cancer Receiving Adjuvant Chemotherapy: A Pretest-Posttest Randomized Controlled Study. Semin Oncol Nurs 2023; 39:151503. [PMID: 37741768 DOI: 10.1016/j.soncn.2023.151503] [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: 05/08/2023] [Revised: 07/20/2023] [Accepted: 08/24/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE To determine the effect of using virtual reality glasses on anxiety and fatigue in women with breast cancer receiving adjuvant chemotherapy. DATA SOURCES A total of 66 women with breast cancer receiving adjuvant chemotherapy. The intervention group watched and listened to beach and nature content with virtual reality glasses for 30 minutes. The control group also received standard care. An Introductory Information Form, the State Anxiety Scale, and the Cancer Fatigue Scale were used for data collection. The scales were administered to the groups before the intervention, followed by practice or standard care, and then the scales were re-administered. All patients were evaluated for each cycle over four cycles. CONCLUSION In the intervention group, the mean post-application anxiety scores decreased compared with the mean pretest scores, and the mean posttest anxiety scores decreased from the first cycle to the last cycle. In addition, the mean post-test anxiety scores of the intervention group were found to be lower in all four cycles than the mean post-test anxiety scores of the control group. In the intervention group, the mean post-test fatigue and subscales scores decreased in all cycles compared with the mean pre-test scores. IMPLICATIONS FOR NURSING PRACTICE This research has shown that the use of virtual reality glasses is effective in reducing anxiety and fatigue scale scores and their subscales in patients with breast cancer. For this reason, it is recommended to introduce the use of virtual reality glasses to patients and to present their use according to patients' preferences.
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Affiliation(s)
- Arzu Uslu
- Harran University, Faculty of Health Sciences, Internal Medicine Nursing, Şanlıurfa 63100, Turkey.
| | - Selda Arslan
- Necmettin Erbakan University, Faculty of Nursing, Internal Medicine Nursing, Konya, Türkiye
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8
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Longcoy LTH, Wu WW, Wei CJ, Doorenbos AZ. Examining the Role of Resilience, Posttraumatic Growth, and Quality of Life in Women with Breast Cancer: A Serial Multiple Mediator Model Approach. Semin Oncol Nurs 2023; 39:151441. [PMID: 37149439 PMCID: PMC10524348 DOI: 10.1016/j.soncn.2023.151441] [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: 10/16/2022] [Revised: 02/21/2023] [Accepted: 04/05/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES It is unclear how resilience and posttraumatic growth help women with breast cancer face cancer-related symptom distress. This study included both resilience and posttraumatic growth as mediators in a serial multiple mediator model to examine changes in the relationship between symptom distress and quality of life among women with breast cancer. DATA SOURCES We conducted the descriptive, cross-sectional study in Taiwan. Data were collected using a survey that assessed symptom distress, resilience, posttraumatic growth, and quality of life. A serial multiple mediator model examined one direct and three specific indirect effects of symptom distress on quality of life through resilience and posttraumatic growth. All 91 participants reported the presence of symptom distress and moderate levels of resilience. Quality of life was significantly associated with symptom distress (b = -1.04), resilience (b = 0.18), and posttraumatic growth (b = 0.09). The indirect effect of symptom distress on quality of life through resilience alone was statistically significant (b = -0.23, 95% CI -0.44 to -0.07) and statistically greater than the specific indirect effect through resilience and posttraumatic growth combined (b = -0.21, 95% CI -0.40 to -0.05). CONCLUSION Resilience plays a unique role in reducing the impact of symptom distress on the quality of life among women with breast cancer. IMPLICATIONS FOR NURSING PRACTICE Given the importance of resilience to quality of life, oncology nurses can assess the resilience of women with breast cancer and help identify available internal, external, and existential resources to strengthen their resilience.
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Affiliation(s)
- Li-Ting H Longcoy
- Postdoctoral Fellow, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Wei-Wen Wu
- Associate Professor; School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Chung-Jen Wei
- Associate Professor; Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ardith Z Doorenbos
- Professor; College of Nursing, University of Illinois Chicago, Chicago, Illinois
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9
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Javan Biparva A, Raoofi S, Rafiei S, Masoumi M, Doustmehraban M, Bagheribayati F, Vaziri Shahrebabak ES, Noorani Mejareh Z, Khani S, Abdollahi B, Abedi Bafrajard Z, Sotoude Beidokhti S, Shojaei SF, Rastegar M, Pashazadeh Kan F, Nosrati Sanjabad E, Ghashghaee A. Global depression in breast cancer patients: Systematic review and meta-analysis. PLoS One 2023; 18:e0287372. [PMID: 37494393 PMCID: PMC10370744 DOI: 10.1371/journal.pone.0287372] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 06/05/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Breast cancer is known as one of the most common diseases among women, the psychological consequences of which are common in women and affect various aspects of their lives, so this study aims to investigate the prevalence of depression among women with breast cancer globally. METHOD The present meta-analysis was performed by searching for keywords related to breast cancer and depression in 4 main databases: PubMed, Embase, Web of Sciences and Scopus in the period of January 2000 to November 2021 and the results of the study using R and CMA software were analyzed. RESULTS A total of 71 studies were selected in English and the results of the analysis showed that the prevalence of depression in women with breast cancer is 30.2%, with Pakistan having the highest (83%) prevalence of depression and Taiwan having the lowest (8.3%). And in the WHO regions, EMRO region had the highest (49.7%) rate and SEARO region had the lowest (23%) prevalence of depression. Also, with increasing age, the prevalence of depression among women with breast cancer increases. CONCLUSION Community and family support for women with breast cancer, holding psychology and psychotherapy courses, lifestyle modifications and training in this area can be effective in preventing the reduction of the prevalence of depression, and given the pivotal role of women in family affairs, this This can be in line with the work of health system policymakers.
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Affiliation(s)
- Akbar Javan Biparva
- Student Research Committee, School of Health Management and Medical Informatics, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samira Raoofi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Masoumi
- Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Maryam Doustmehraban
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | | | - Zahra Noorani Mejareh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saghar Khani
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Bahare Abdollahi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Abedi Bafrajard
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shakila Sotoude Beidokhti
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Fahimeh Shojaei
- Firoozgar Clinical Research and Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Rastegar
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashazadeh Kan
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Elmira Nosrati Sanjabad
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghashghaee
- The School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
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10
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Licaj I, Coquan E, Dabakuyo-Yonli TS, Dauchy S, Vaz Luis I, Charles C, Lemogne C, Tredan O, Vanlemmens L, Jouannaud C, Levy C, Rigal O, Fournier M, Petit T, Dalenc F, Rouanet P, Lemonnier J, Everhard S, Cottu P, Joly F. Baseline quality of life and chemotherapy toxicities in patients with early breast cancer. Cancer 2023; 129:1085-1095. [PMID: 36642837 DOI: 10.1002/cncr.34643] [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: 09/27/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND The authors used the French breast cancer Cancer and Toxicities (CANTO) cohort to study the associations between baseline quality of life and chemotherapy dose-reductions (CDRs) or postchemotherapy-toxicities (PCTs). METHODS In total, 3079 patients with breast cancer who received chemotherapy were included in this analysis. The associations between baseline physical functioning (PF) and fatigue measured using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30, and two endpoints-CDRs during adjuvant or neoadjuvant chemotherapy; and selected PCTs were estimated with odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) using logistic regression models. RESULTS Among the 3079 patients from the CANTO cohort who were included, 718 (33.0%) received chemotherapy in the neoadjuvant setting, and 2361 (67.0%) received chemotherapy as adjuvant treatment. The chemotherapy included taxanes in 94.2% of patients and anthracyclines in 90.5% of patients. Overall, 15.5% of patients experienced CDRs and, 31.0% developed PCTs. Women with low baseline PF scores (<83) had higher multivariate odds of developing CDRs compared with those who had PF scores ≥83 (OR, 1.54; 95% CI, 1.13-2.09). The corresponding OR for PCTs was 1.50 (95% CI, 1.13-2.00). Women with high baseline fatigue scores had higher odds of CDRs (OR, 1.43; 95% CI, 1.13-1.76) and PCTs (OR, 1.32; 95% CI, 1.10-1.59). CONCLUSIONS By using the national CANTO cohort, baseline PF and fatigue were independently associated with CDRs and PCTs.
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Affiliation(s)
- Idlir Licaj
- Clinical Research Department, Centre Francois Baclesse, Caen, France.,Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elodie Coquan
- Clinical Research Department, Centre Francois Baclesse, Caen, France.,Medical Oncology, Centre Francois Baclesse, Caen, France
| | | | - Sarah Dauchy
- Supportive Care Department, Gustave Roussy, Villejuif, France
| | | | - Cecile Charles
- Supportive Care Department, Gustave Roussy, Villejuif, France
| | - Cedric Lemogne
- Psychiatry Department, Hopital Europeén Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Paris, France
| | - Olivier Tredan
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | | | | | - Christelle Levy
- Department of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France
| | - Olivier Rigal
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - Marion Fournier
- Department of Surgical Oncology, Institut Bergonié, Bordeaux, France
| | - Thierry Petit
- Department of Medical Oncology, Centre Paul Strauss, Strasbourg, France
| | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | - Philippe Rouanet
- Department of Surgery, Institut du Cancer de Montpellier, Montpellier, France
| | | | | | - Paul Cottu
- Department of Medical Oncology, Institut Curie, Paris, France
| | - Florence Joly
- Clinical Research Department, Centre Francois Baclesse, Caen, France.,ANTICIPE Unit, Institut National de la Sante et de la Recherche Medicale, University of Caen Normandie, Caen, France.,Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, Caen, France
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11
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Morse L, Paul SM, Cooper BA, Oppegaard K, Shin J, Calvo-Schimmel A, Harris C, Hammer M, Conley Y, Wright F, Levine JD, Kober KM, Miaskowski C. Higher Stress in Oncology Patients is Associated With Cognitive and Evening Physical Fatigue Severity. J Pain Symptom Manage 2023; 65:203-215. [PMID: 36423801 PMCID: PMC11189665 DOI: 10.1016/j.jpainsymman.2022.11.017] [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: 09/01/2022] [Revised: 10/15/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022]
Abstract
CONTEXT Cognitive and physical fatigue are common symptoms experienced by oncology patients. Exposure to stressful life events (SLE), cancer-related stressors, coping styles, and levels of resilience may influence the severity of both dimensions of fatigue. OBJECTIVES Evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and coping in oncology patients (n=1332) with distinct cognitive fatigue AND evening physical fatigue profiles. METHODS Latent profile analysis, which combined the two symptom scores, identified three subgroups of patients with distinct cognitive fatigue AND evening physical fatigue profiles (i.e., Low, Moderate, High). Patients completed measures of global, cancer-specific, and cumulative life stress as well measures of resilience and coping. Differences among the latent classes in the various measures were evaluated using parametric and nonparametric tests. RESULTS Compared to Low class, the other two classes reported higher global and cancer-specific stress. In addition, they reported higher occurrence rates for sexual harassment and being forced to touch prior to 16 years of age. Compared to the other two classes, High class reported lower resilience scores and higher use of denial, substance use, and behavioral disengagement. CONCLUSION To decrease both cognitive and evening physical fatigue, clinicians need to assess for relevant stressors and initiate interventions to increase resilience and the use of engagement coping strategies. Additional research is warranted on the relative contribution of various social determinants of health to both cognitive and physical fatigue in oncology patients receiving chemotherapy.
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Affiliation(s)
- Lisa Morse
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Steven M Paul
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Bruce A Cooper
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Kate Oppegaard
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Joosun Shin
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Alejandra Calvo-Schimmel
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Carolyn Harris
- School of Nursing (C.H.,Y.C.,), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Marilyn Hammer
- Dana Farber Cancer Institute (M.H.), Boston, Massachusetts
| | - Yvette Conley
- School of Nursing (C.H.,Y.C.,), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Fay Wright
- Rory Meyers College of Nursing (F.W.), New York University, New York, New York
| | - Jon D Levine
- School of Medicine (J.D.L, C.M.), University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California
| | - Christine Miaskowski
- School of Nursing (L.M.,S.M. P.,B.A.C.,K.O.,J.S.,A.C.S.,K.M.K.,C.M.), University of California, San Francisco, California;; School of Medicine (J.D.L, C.M.), University of California, San Francisco, California, USA.
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12
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Bustamante A, Chavarro PA, Hernández OM. [Exercise tolerance and fatigue in women survivors of non-metastatic breast cancer]. Rev Salud Publica (Bogota) 2023; 21:492-497. [PMID: 36753199 DOI: 10.15446/rsap.v21n5.81849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/29/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer worldwide, and the leading cause of disability and death in young women in Latin America. One of the most common symptoms in this population is fatigue, reported by 70 to 100% of survivors. OBJECTIVE To describe the relationship between exercise tolerance and fatigue in women survivors of non-metastatic breast cancer. MATERIALS AND METHODS Cross-sectional descriptive study in 40 women between 18 and 65 years of age, from a database pertaining to a highly complex healthcare institution in the city of Cali, Colombia. The relationship between fatigue and exercise tolerance was identified using the "Functional Assessment of Cancer Therapy FACT-F" questionnaire and the 6-minute walk test (TC6M). RESULTS 37.5% of the participants presented fatigue related to breast cancer; 33% of women presented dyspnea at the end of the TC6M, 37.5% reported having lower limb fatigue (modified Borg) and 42.5% did not reach 80% of the predicted distance in the TC6M. CONCLUSION A positive correlation (p 0.000) was found between fatigue and exercise tolerance in women survivors of non-metastatic breast cancer.
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Affiliation(s)
- Angelly Bustamante
- Universidad del Valle. Facultad de Salud. Escuela de Rehabilitación Humana. Integrante del Grupo de Investigación Ejercicio y Salud Cardiopulmonar GIESC. Cali, Colombia.
| | - Paola A Chavarro
- PC: Fisioterapeuta. Esp. Fisioterapia Cardiopulmonar. M. Sc. Educación. Universidad del Valle. Facultad de Salud. Escuela de Rehabilitación Humana. Integrante del Grupo de Investigación Ejercicio y Salud Cardiopulmonar GIESC. Cali, Colombia.
| | - Olga M Hernández
- OH: Fisioterapeuta. Esp. Docencia Universitaria. M. Sc. Epidemiología. Universidad del Valle, Escuela de Rehabilitación Humana. Integrante del Grupo de Investigación Ejercicio y Salud Cardiopulmonar GIESC. Cali, Colombia.
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13
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Kristoffersen AE, Wider B, Nilsen JV, Bjelland M, Mora DC, Nordberg JH, Broderstad AR, Nakandi K, Stub T. Prevalence of late and long-term effects of cancer (treatment) and use of complementary and alternative medicine in Norway. BMC Complement Med Ther 2022; 22:322. [PMID: 36471296 PMCID: PMC9721050 DOI: 10.1186/s12906-022-03790-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The increasing number of patients surviving cancer leads to more people experiencing late and long term-effects from the disease and its treatment. Fatigue, sleep disorders, early menopause, pain, and nerve damage are commonly reported. Methods helping people to recover after cancer treatment are therefore essential. The aims of this study were threefold; (1) to determine the level of cancer patients suffering from late and long-term effects of cancer diagnosis and treatment in Norway, (2) explore complementary and alternative medicine (CAM) modalities used for managing these adversities, and (3) describe self-perceived benefits and harms of the CAM interventions. METHODS The study was conducted in cooperation with the Norwegian Cancer Society (NCS) and consisted of an online cross-sectional study among members of the NCS user panel with present or previous cancer (n = 706). The study was carried out in September/October 2021 using a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). A total of 315 women and 153 men agreed to participate, resulting in a response rate of 67%. RESULTS Most of the participants (83%) suffered from late and long-term effects of cancer treatment; mostly fatigue (59.2%), sleep disorder (41.5%), hot flashes (39.2%), nerve damage (polyneuropathy, 38.0%), and pain (36.6%) with a mean number of 5.1 different late and long-term effects. Late and long-term effects were positively associated with younger age and college/university education. Nearly half of the participants experiencing late and long-term effects (43%) reported having used CAM to treat these complaints. Most frequently used were self-help practices (26%) such as relaxation therapy (19%), yoga (14%) and meditation (13%), but also visits to CAM providers were reported by 22%. Herbal- and other natural remedies to treat late and long-term effects were used by 13%. A high percentage of CAM users reported self-perceived improvements of their symptoms (86% for self-help practices, 90% for visits to CAM providers). Few experienced adverse effects of the CAM treatment. CONCLUSION A large proportion of cancer patients suffered from a wide range of late and long-term effects of cancer diagnosis and treatment, and they use CAM to treat these complaints to a rather high degree. Relaxation therapy, yoga, meditation, massage, and acupuncture were the most frequently used therapies regardless of complaint. The therapies used are generally considered to be both safe and beneficial for the respective complaint, indicating that the participants seem to be well informed about the choices they make.
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Affiliation(s)
- Agnete E Kristoffersen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Barbara Wider
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | | | - Dana C Mora
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johanna Hök Nordberg
- Regional Cancer Center Stockholm Gotland, Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences & Society, Division of Nursing & Department of Physiology & Pharmacology, Stockholm, Sweden
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kiwumulo Nakandi
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trine Stub
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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14
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Ohlsson Nevo E, Arvidsson-Lindvall M, Hellerstedt Börjeson S, Hagberg L, Hultgren Hörnqvist E, Valachis A, Wickberg Å, Duberg A. Digitally distributed Yoga Intervention in Breast Cancer Rehabilitation (DigiYoga CaRe): protocol for a randomised controlled trial. BMJ Open 2022; 12:e065939. [PMID: 36319059 PMCID: PMC10098266 DOI: 10.1136/bmjopen-2022-065939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Breast cancer is the most prevalent cancer among women. The treatment is extensive; in addition to surgery, various combinations of radiation therapy, chemotherapy and antibody and endocrine treatment can be applied. Cancer-related fatigue (CRF) is high in patients with breast cancer, peaking during chemotherapy, but may persist for several years. Physical activity has proven to be effective in reducing CRF in breast cancer rehabilitation, but many patients tend to be less active after the diagnosis. Yoga has a previously demonstrated effect on energy levels and digitally distributed yoga intervention can potentially increase accessibility in pandemic times and facilitate participation for patients susceptible to infection and those living far from organised rehabilitation opportunities. The purpose of this study, Digital Yoga Intervention in Cancer Rehabilitation (DigiYoga CaRe) is to investigate whether a 12-week digitally distributed yoga intervention can reduce CRF and stress, improve health-related quality of life (HRQL) and affect pro-inflammatory and metabolic markers in patients with breast cancer. METHODS AND ANALYSIS This multicentre study will adopt a randomised controlled design including 240 persons after their breast cancer surgery. They will be randomised to a 12-week digitally distributed yoga intervention or to a control group. The intervention group practice yoga two times a week, one yoga class live-streamed to the patient's computer or mobile device and one prerecorded video class for self-training. The controls receive standardised care, gift cards for flowers and access to yoga video links after the data collection has ended. The primary analysis will be performed following the principle of intention to treat. Data will be collected by questionnaires, blood samples, accelerometers and interviews. ETHICS AND DISSEMINATION The DigiYoga CaRe study was approved by the Regional Ethical Review Board in Lund. The final results of this study will be disseminated to conference, patient and public involvements and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04812652.
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Affiliation(s)
- Emma Ohlsson Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - MiaLinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - Susanne Hellerstedt Börjeson
- Department of Public Health and Caring Sciences, Center for Clinical Research, Uppsala University, Uppsala, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | | | - Antonios Valachis
- Department of Oncology, Faculty of Medicin and Health,Örebro University, Örebro, Sweden
| | - Åsa Wickberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
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15
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Tan JY(B, Wang T, Zhao I, Polotan MJ, Eliseeva S. An Evidence-Based Somatic Acupressure Intervention Protocol for Managing the Breast Cancer Fatigue-Sleep Disturbance-Depression Symptom Cluster: Development and Validation following the Medical Research Council Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11934. [PMID: 36231235 PMCID: PMC9565572 DOI: 10.3390/ijerph191911934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Somatic acupoint stimulation (SAS) has been frequently utilised as a promising intervention for individual cancer-related symptom management, such as fatigue, sleep disturbance and depression. However, research evidence regarding the role of SAS in mitigating the fatigue-sleep disturbance-depression symptom cluster (FSDSC) has been scant. This study was conducted to develop an evidence-based SAS intervention protocol that can be further implemented in a Phase II randomized controlled trial (RCT) to manage the FSDSC in breast cancer survivors. METHODS The Medical Research Council Framework for Developing and Evaluating Complex Intervention (MRC framework) was employed to guide the development procedures of the SAS intervention protocol, including the identification of an existing evidence base, the identification of theories and practice standards, and the validation of the SAS intervention protocol. A content validity study was performed through an expert panel to assess the scientific and practical appropriateness of the SAS intervention protocol. The content validity index (CVI), including item-level CVI and protocol-level CVI, were calculated to evaluate the consensus level of the expert panel. RESULTS Key components of the SAS protocol, including the acupoint formula, the SAS modality, technique, intensity and frequency were identified for both a true and placebo SAS intervention based on the best available research evidence retrieved from systematic reviews, clinical trials, and relevant theories, particularly regarding the inflammatory process, yin-yang theory, zang-fu organs and meridians theory, and acupressure practical standards. The true SAS intervention was determined as daily self-administered acupressure on specific acupoints for seven weeks. The placebo SAS was designed as light acupressure on non-acupoints with the same frequency and duration as the true SAS. Excellent content validity was achieved after one round of expert panel assessment, with all the key components of the true and placebo SAS protocols rated as content valid (CVI ranged from 0.86 to 1.00). CONCLUSIONS A research-informed, theory-driven and practically feasible SAS intervention protocol for the FSDSC management in breast cancer survivors was developed following the MRC framework. The feasibility and acceptability of the SAS intervention will be further tested in breast cancer survivors through a Phase II RCT.
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Affiliation(s)
- Jing-Yu (Benjamin) Tan
- College of Nursing and Midwifery, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Brisbane Centre, 410 Ann Street, Brisbane, QLD 4000, Australia
| | - Isabella Zhao
- College of Nursing and Midwifery, Charles Darwin University, Brisbane Centre, 410 Ann Street, Brisbane, QLD 4000, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Brisbane, QLD 4000, Australia
| | - Mary Janice Polotan
- College of Nursing and Midwifery, Charles Darwin University, Brisbane Centre, 410 Ann Street, Brisbane, QLD 4000, Australia
- Thornlands General Practice, Thornlands, QLD 4164, Australia
| | - Sabina Eliseeva
- College of Nursing and Midwifery, Charles Darwin University, Brisbane Centre, 410 Ann Street, Brisbane, QLD 4000, Australia
- Thornlands General Practice, Thornlands, QLD 4164, Australia
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16
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Reverte-Pagola G, Sánchez-Trigo H, Saxton J, Sañudo B. Supervised and Non-Supervised Exercise Programs for the Management of Cancer-Related Fatigue in Women with Breast Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:3428. [PMID: 35884489 PMCID: PMC9319207 DOI: 10.3390/cancers14143428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023] Open
Abstract
Physical exercise is considered to be a non-pharmacological strategy for reducing symptoms of cancer-related fatigue (CRF) in women with breast cancer (BC). This systematic review and meta-analysis aims to assess the effects of non-supervised exercise programs in comparison with the effects of supervised exercise interventions for CRF in BC patients. Randomized controlled trials that investigated the effect of exercise on CRF in women were searched for until 29 June 2022. Inclusion criteria comprised women diagnosed with BC; exercise-based interventions; trials comparing at least one exercise group vs. a control group; trials that assessed exercise effects on CRF. Thirty-one studies met the inclusion criteria (n = 2964). Both non-supervised and supervised exercise programs significantly reduced CRF (standard mean difference (SMD) = −0.46, confidence interval (CI) = (−0.64, −0.28), p < 0.0001 and SMD = −0.74, CI = (−0.99, −0.48), p < 0.0001, respectively), without statistical difference (p = 0.09). However, a short-term training program subgroup analyses showed significant differences between supervised and non-supervised training programs (p = 0.01), showing that supervised training programs have a greater effect (SMD = −1.33, CI = (−1.92, −0.73), p < 0.0001) than non-supervised ones (SMD = −0.44, CI = (−0.78, −0.11), p = 0.009). Both supervised and non-supervised exercise programs may reduce CRF in BC patients; however, in the short-term, supervised exercise may have a greater effect on CRF in BC patients.
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Affiliation(s)
- Gonzalo Reverte-Pagola
- Department of Physical Education and Sport, Universidad de Sevilla, 41012 Sevilla, Spain; (H.S.-T.); (B.S.)
| | - Horacio Sánchez-Trigo
- Department of Physical Education and Sport, Universidad de Sevilla, 41012 Sevilla, Spain; (H.S.-T.); (B.S.)
| | - John Saxton
- Department of Sport, Health and Exercise Science, Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK;
| | - Borja Sañudo
- Department of Physical Education and Sport, Universidad de Sevilla, 41012 Sevilla, Spain; (H.S.-T.); (B.S.)
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17
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Keaver L, O'Callaghan N, Douglas P. Nutrition Support & Intervention Preferences of Cancer Survivors. J Hum Nutr Diet 2022; 36:526-539. [PMID: 35778782 DOI: 10.1111/jhn.13058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/03/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Ascertaining cancer survivors' specific needs and preferences regarding nutrition information delivery is important in developing and designing future health interventions in oncology. This study aimed to explore the nutrition information needs of cancer survivors and their preferences regarding intervention delivery. METHODS The present study is a mixed-methods study comprising a cross-sectional survey and focus groups. Participants were eligible for inclusion if they were 18+years, living in Ireland with a cancer diagnosis and had completed treatment at least six months previous. Cancer support centres promoted the online survey on social media. Focus groups were conducted with twenty individuals. RESULTS The cohort (n=56) were predominantly female (n=50, 89.3%), breast cancer survivors (n=42, 75%). Seven (12.5%) had received nutrition advice from a dietitian. Most are interested in receiving nutrition advice (n=52, 92.9%), with variability in delivery mode. There was interest in improving sleep quality (n=35, 62.5%), making positive lifestyle changes (n=28, 50%) and accessing cancer-specific physical activity classes (n=27, 48.2%). The best time to deliver information was throughout the cancer journey (n=31, 55.4%). Time and motivation (n=15, 26.8%) were the main barriers. Facilitators were keeping healthy (n=42, 75%), and weight maintenance (n=31, 55.4%). Four themes emerged from thematic analysis; lack of nutrition guidance, an abundance of misinformation, one size does not fit all and dietitians as the preferred source of advice. CONCLUSION There is a desire for evidence-based nutrition advice and for dietitians to be integrated into cancer clinics and cancer survivorship care. This research guides future interventional work on the efficacy of nutrition interventions to improve cancer survivorship outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Laura Keaver
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo Campus, Ash Lane, Sligo, F91 YW50
| | - Niamh O'Callaghan
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo Campus, Ash Lane, Sligo, F91 YW50
| | - Pauline Douglas
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, UK
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18
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Immediate increase in perceived energy after exercise during the course of chemotherapy treatment for breast cancer. Eur J Oncol Nurs 2022; 58:102149. [DOI: 10.1016/j.ejon.2022.102149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 04/10/2022] [Accepted: 05/08/2022] [Indexed: 11/23/2022]
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Bu X, Ng PH, Xu W, Cheng Q, Chen PQ, Cheng AS, Liu X. The Effectiveness of Virtual Reality-Based Interventions in Rehabilitation Management of Breast Cancer Survivors: Systematic Review and Meta-analysis. JMIR Serious Games 2022; 10:e31395. [PMID: 35225817 PMCID: PMC8922144 DOI: 10.2196/31395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/14/2021] [Accepted: 10/23/2021] [Indexed: 12/25/2022] Open
Abstract
Background Breast cancer survivors (BCSs) can present with various physical and psychological symptoms and functional deficits that impact their quality of life. Virtual reality (VR) technology is being used in breast cancer rehabilitation management to improve the emotional, cognitive, and physical well-being of BCSs. Objective This systematic review aimed to examine the effectiveness of VR-based interventions on health-related outcomes in BCSs. A meta-analysis was conducted to evaluate the effectiveness of VR-based interventions in the rehabilitation management of BCSs. Methods A systematic search was conducted on PubMed, Web of Science, EMBASE, CINAHL with Full Text, the Cochrane Central Register of Controlled Trials, CNKI, WanFang, VIP, and CBM, from inception to May 25, 2021. The inclusion criteria of the selected studies were as follows: (1) adults diagnosed with breast cancer; (2) any type of VR-based interventions (immersive and nonimmersive virtual environment); (3) comparison of traditional rehabilitation methods; (4) outcomes including pain, depression, anxiety, fatigue, cognitive function, shoulder range of motion (ROM), hand grip strength, lymphedema, cybersickness symptoms, fear of movement, bleeding, effusion, and flap necrosis, both during and after treatment; and (5) randomized controlled trials (RCTs), case-controlled trials, and quasi-experimental studies. The Cochrane Collaboration Tool was used to evaluate the risk of bias. Review Manager version 5.3 (Cochrane Collaboration) was used to conduct the meta-analysis. The mean difference (MD) and SDs with 95% CIs were used to calculate continuous variables. Results Twelve articles were included in this systematic review, of which 10 contributed information to the meta-analysis. A total of 604 participants were analyzed. The statistical analysis showed significant results for flexion (standard mean difference [SMD] 1.79; 95% CI 0.55 to 3.03; P=.005), extension (SMD 1.54; 95% CI 0.83 to 2.25; P<.001), abduction (MD 17.53; 95% CI 14.33 to 20.72; P<.001), adduction (MD 15.98; 95% CI 14.02 to 17.94; P<.001), internal rotation (MD 7.12; 95% CI 5.54 to 8.70; P<.001), external rotation (SMD 0.96; 95% CI 0.62 to 1.29; P<.001), anxiety (MD −6.47; 95% CI −7.21 to −5.73; P<.001), depression (MD −4.27; 95% CI −4.64 to −3.91; P<.001), pain (MD −1.32; 95% CI −2.56 to −0.09; P=.04), and cognitive function (MD 8.80; 95% CI 8.24 to 9.36; P<.001). The meta-analysis indicated little to no difference in hand grip strength (MD 1.96; 95% CI –0.93 to 4.85; P=.18). Conclusions Findings of this review noted a weak but consistent positive association between VR-based interventions and outcomes. However, these results must be interpreted with caution due to the limited number of controlled trials analyzed, small sample sizes, and poor methodological quality. Well‐designed, large, high‐quality trials may have a significant impact on our confidence in the results. Future studies should identify specific aspects that improve the clinical impact of VR-based interventions on major outcomes in BCSs in the clinical setting. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42021250727; https://tinyurl.com/2p89rmnk
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Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Peter Hf Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wenjing Xu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Qinqin Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Peter Q Chen
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Mendes-Santos C, Nunes F, Weiderpass E, Santana R, Andersson G. Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study. JMIR Cancer 2022; 8:e33550. [PMID: 35166682 PMCID: PMC8889471 DOI: 10.2196/33550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Despite the efficacy of psychosocial interventions in minimizing psychosocial morbidity in breast cancer survivors (BCSs), intervention delivery across survivorship is limited by physical, organizational, and attitudinal barriers, which contribute to a mental health care treatment gap in cancer settings. OBJECTIVE The aim of this study is to develop iNNOV Breast Cancer (iNNOVBC), a guided, internet-delivered, individually tailored, acceptance and commitment therapy-influenced cognitive behavioral intervention program aiming to treat mild to moderate anxiety and depression in BCSs as well as to improve fatigue, insomnia, sexual dysfunction, and health-related quality of life in this group. This study also aims to evaluate the usefulness, usability, and preliminary feasibility of iNNOVBC. METHODS iNNOVBC was developed using a user-centered design approach involving its primary and secondary end users, that is, BCSs (11/24, 46%) and mental health professionals (13/24, 54%). We used mixed methods, namely in-depth semistructured interviews, laboratory-based usability tests, short-term field trials, and surveys, to assess iNNOVBC's usefulness, usability, and preliminary feasibility among these target users. Descriptive statistics were used to characterize the study sample, evaluate performance data, and assess survey responses. Qualitative data were recorded, transcribed verbatim, and thematically analyzed. RESULTS Overall, participants considered iNNOVBC highly useful, with most participants reporting on the pertinence of its scope, the digital format, the relevant content, and the appropriate features. However, various usability issues were identified, and participants suggested that the program should be refined by simplifying navigation paths, using a more dynamic color scheme, including more icons and images, displaying information in different formats and versions, and developing smartphone and tablet versions. In addition, participants suggested that tables should be converted into plain textboxes and data visualization dashboards should be included to facilitate the tracking of progress. The possibility of using iNNOVBC in a flexible manner, tailoring it according to BCSs' changing needs and along the cancer care continuum, was another suggestion that was identified. CONCLUSIONS The study results suggest that iNNOVBC is considered useful by both BCSs and mental health professionals, configuring a promising point-of-need solution to bridge the psychological supportive care gap experienced by BCSs across the survivorship trajectory. We believe that our results may be applicable to other similar programs. However, to fulfill their full supportive role, such programs should be comprehensive, highly usable, and tailorable and must adopt a flexible yet integrated structure capable of evolving in accordance with survivors' changing needs and the cancer continuum.
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Society, Linköping University, Linköping, Sweden
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
- Public Health Research Centre, NOVA National School of Public Health, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Portugal
| | | | | | - Rui Santana
- Public Health Research Centre, NOVA National School of Public Health, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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Poikonen-Saksela P, Kolokotroni E, Vehmanen L, Mattson J, Stamatakos G, Huovinen R, Kellokumpu-Lehtinen PL, Blomqvist C, Saarto T. A graphical LASSO analysis of global quality of life, sub scales of the EORTC QLQ-C30 instrument and depression in early breast cancer. Sci Rep 2022; 12:2112. [PMID: 35136160 PMCID: PMC8826362 DOI: 10.1038/s41598-022-06138-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022] Open
Abstract
We aimed to (a) investigate the interplay between depression, symptoms and level of functioning, and (b) understand the paths through which they influence health related quality of life (QOL) during the first year of rehabilitation period of early breast cancer. A network analysis method was used. The population consisted of 487 women aged 35-68 years, who had recently completed adjuvant chemotherapy or started endocrine therapy for early breast cancer. At baseline and at the first year from randomization QOL, symptomatology and functioning by the EORTC QLQ-C30 and BR-23 questionnaires, and depression by the Finnish version of Beck's 13-item depression scale, were collected. The multivariate interplay between the related scales was analysed via regularized partial correlation networks (graphical LASSO). The median global quality of life (gQoL) at baseline was 69.9 ± 19.0 (16.7-100) and improved to 74.9 ± 19.0 (0-100) after 1 year. Scales related to mental health (emotional functioning, cognitive functioning, depression, insomnia, body image, future perspective) were clustered together at both time points. Fatigue was mediated through a different route, having the strongest connection with physical functioning and no direct connection with depression. Multiple paths existed connecting symptoms and functioning types with gQoL. Factors with the strongest connections to gQoL included: social functioning, depression and fatigue at baseline; emotional functioning and fatigue at month 12. Overall, the most important nodes were depression, gQoL and fatigue. The graphical LASSO network analysis revealed that scales related to fatigue and emotional health had the strongest associations to the EORTC QLQ-C30 gQoL score. When we plan interventions for patients with impaired QOL it is important to consider both psychological support and interventions that improve fatigue and physical function like exercise.Trial registration: http://www.clinicaltrials.gov/ (identifier number NCT00639210).
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Affiliation(s)
- Paula Poikonen-Saksela
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Eleni Kolokotroni
- In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Leena Vehmanen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Mattson
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Georgios Stamatakos
- In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Riikka Huovinen
- Department of Oncology, Turku University Hospital and Faculty of Medicine, University of Turku, Turku, Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Faculty of Medicine and Health Technology, Tampere University and Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Carl Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tiina Saarto
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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22
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Wang T, Tan JYB, Liu XL, Zheng SL, Zhao I, Eliseeva S, Polotan MJ, Cheng HL, Huang HQ. Implementing an evidence-based somatic acupressure intervention in breast cancer survivors with the symptom cluster of fatigue, sleep disturbance and depression: study protocol of a phase II randomised controlled trial. BMJ Open 2022; 12:e054597. [PMID: 35058263 PMCID: PMC8783815 DOI: 10.1136/bmjopen-2021-054597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The fatigue-sleep disturbance-depression (FSD) symptom cluster, as one of the most common symptom clusters in breast cancer (BC) survivors, can significantly decrease patients' quality of life. Since the management of the FSD symptom cluster has been unsatisfactory with the use of pharmacological treatments alone, non-pharmacological approaches have, therefore, been recommended. Somatic acupressure (SA) is a promising approach given its potential benefits of cancer-related symptom alleviation and the convenience of self-practice. However, research evidence on using acupressure to manage the FSD symptom cluster has been limited. The proposed trial aims to examine the feasibility and preliminary effects of an evidence-based SA intervention for FSD symptom cluster management in BC survivors. METHODS AND ANALYSIS This study will be a phase II randomised controlled trial with three study arms and 1:1:1 allocation. Fifty-one early-stage BC survivors who are experiencing the FSD symptom cluster will be randomly assigned to a true SA group, a sham SA group or a usual care group. All participants will receive an education booklet regarding FSD symptom cluster management advice as the usual care package. The participants in the true SA group will additionally receive a 7-week self-administered SA intervention. The participants in the sham SA group will additionally receive self-administered light acupressure at non-acupoints with the same frequency, session and duration as the true SA group. The primary outcomes will be feasibility outcomes related to subject recruitment and completion of study questionnaires and interventions. The secondary outcomes will be the effects of SA on fatigue, sleep disturbance, depression and quality of life. Descriptive statistics will be used to present all the outcomes. The secondary outcomes will be analysed using an intent-to-treat approach. ETHICS AND DISSEMINATION Ethical approvals of this trial have been granted by the Human Research Ethics Committee at Charles Darwin University (H19017) and the Clinical Trial Ethics Committee at The Affiliated Hospital of Southwest Medical University (KY2019039). Findings from this trial will be published in peer-reviewed journals and presented at professional conferences. TRIAL REGISTRATION NUMBER This trial was registered at ClinicalTrials.gov and the registration number is NCT04118140, with the stage at Recruiting.
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Affiliation(s)
- Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queesland, Australia
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Xian-Liang Liu
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queesland, Australia
| | - Si-Lin Zheng
- Department of Nursing, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Isabella Zhao
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queesland, Australia
- Cancer and Palliative Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sabina Eliseeva
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queesland, Australia
- Thornlands General Practice, Brisbane, Queensland, Australia
| | - Mary Janice Polotan
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queesland, Australia
- Thornlands General Practice, Brisbane, Queensland, Australia
| | - Hui-Lin Cheng
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Queesland, Australia
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Hou-Qiang Huang
- Department of Nursing, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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23
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Zhao H, Li X, Zhou C, Wu Y, Li W, Chen L. Psychological distress among Chinese patients with breast cancer undergoing chemotherapy: Concordance between patient and family caregiver reports. J Adv Nurs 2021; 78:750-764. [PMID: 34363625 DOI: 10.1111/jan.15004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/01/2021] [Accepted: 07/24/2021] [Indexed: 02/06/2023]
Abstract
AIMS To examine patient-caregiver concordances about psychological distress among Chinese patients with breast cancer undergoing chemotherapy and identify factors related to concordance among patients and family caregivers. DESIGN Cross-sectional study. METHODS From October 2019 to June 2020, 137 patient-caregiver dyads were enrolled. Sociodemographic information, the distress thermometer (including the problem list), the Distress Disclosure Index and the Family Adaptability and Cohesion Evaluation Scale were used to collect data. Data were analysed using intraclass correlation coefficients (ICC), kappa statistics, two related samples test, chi-square tests and/or Fisher's exact tests and binary logistic regression. RESULTS Overall, fair agreement was identified between patients' and caregivers' reports (intraclass correlation coefficients [ICC] = .528). Patients reported significantly higher psychological distress scores than paired caregiver reports. Lower psychological distress concordance was found among patients with comorbidities (odds ratio [OR], 0.352; 95% confidence interval [CI], 0.155-0.798) and lower levels of self-disclosure (OR, 0.402; 95% CI, 0.186-0.868). CONCLUSION There was relatively low concordance between patients' reports and caregivers' perceptions of psychological distress. Family caregivers tended to underestimate patients' psychological distress. A comorbid condition and lower levels of self-disclosure contributed to this bias. IMPACT Having an awareness of the incongruence between patient and caregiver may help healthcare providers better interpret caregiver assessments. Healthcare providers should reinforce patient-caregiver dyadic psychosocial education to improve concordance. More psychological care and substantial emotional support should be provided for Chinese breast cancer patients undergoing chemotherapy by family caregivers and healthcare providers.
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Affiliation(s)
- Huihui Zhao
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Xiaojin Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Wenji Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Liling Chen
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
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24
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Byrne M, Leiser J, Mitchell SA, Kent EE, Siembida EJ, Somers T, Arem H. Trajectories of fatigue in a population-based sample of older adult breast, prostate, and colorectal cancer survivors: an analysis using the SEER-MHOS data resource. Support Care Cancer 2021; 29:7393-7402. [PMID: 34052930 DOI: 10.1007/s00520-021-06267-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/30/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Fatigue is one of the most common and distressing symptoms experienced by cancer survivors. Understanding fatigue trajectories from pre- to post-diagnosis could inform fatigue prevention and management strategies. METHODS We used the Surveillance, Epidemiology and End Results Medicare Health Outcomes Survey (SEER-MHOS) linked data resource to characterize fatigue trajectories and their predictors 1214 older adult survivors of breast, colorectal, or prostate cancer. Fatigue was measured prior to the cancer diagnosis (T0) and at two timepoints after diagnosis (T1: mean = 20 months and T2: mean = 39 months post-diagnosis). Latent growth curve modeling and mixed effects models for repeated measurements were used to investigate fatigue experiences before and after a cancer diagnosis. RESULTS Overall, mean fatigue T-scores declined (T0 = 50, T1 = 46, and T2 = 45) indicating worsening fatigue over time. Four latent trajectory subgroups were identified: severe fatigue worsening over time (8.2% of sample), severe fatigue persisting over time (14.4%), no fatigue pre-diagnosis and mild fatigue post-diagnosis (44.4%), and not fatigued (33%). Age, cancer stage, comorbidities, and depressed mood predicted membership in the two trajectory groups experiencing severe fatigue that persisted or that worsened post-diagnosis. Older age, advanced cancer stage at diagnosis, and depressed mood were significantly associated with worsening fatigue from T1 to T2 (all p < 0.0001). CONCLUSIONS Evaluating cancer patients for depressive symptoms and considering prior fatigue levels, age, comorbid conditions, and cancer stage may help providers anticipate fatigue trajectories and implement pre-emptive strategies to lessen fatigue impact.
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Affiliation(s)
- Morgan Byrne
- Biostatistics and Epidemiology Consulting Service, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Jaclyn Leiser
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Sandra A Mitchell
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Erin E Kent
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth J Siembida
- Center for Health Innovations and Outcomes Research, The Feinstein Institutes for Medical Research, Northwell Health, NY, Manhasset, USA
| | - Tamara Somers
- Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC, USA
| | - Hannah Arem
- Healthcare Delivery Research, Medstar Health Research Institute, Washington, DC, USA.
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Maurer T, Jaskulski S, Behrens S, Jung AY, Obi N, Johnson T, Becher H, Chang-Claude J. Tired of feeling tired - The role of circulating inflammatory biomarkers and long-term cancer related fatigue in breast cancer survivors. Breast 2021; 56:103-109. [PMID: 33668004 PMCID: PMC7937559 DOI: 10.1016/j.breast.2021.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/26/2021] [Accepted: 02/15/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Low-grade inflammation has been associated with cancer related fatigue (CRF). However, most studies focused on CRF during or shortly after treatment. Longitudinal studies are rare with inconsistent results. We assessed the association of inflammatory biomarkers with total CRF and all subdomains (physical, cognitive, affective) in long-term breast cancer survivors. METHOD Patients recruited between 2002 and 2005 provided information on CRF at first follow-up (FU1) (N = 1292) and second follow-up (FU2) (N = 1205), after a median of 6.2 years and 11.7 years, respectively. Associations of 11 inflammatory biomarkers with CRF at FU1 and at FU2 were assessed using linear regression models. Logistic regression models were used to compare patients fatigued at both time-points and those never fatigued (N = 932). RESULTS C-reactive protein (CRP) was significantly associated with total CRF at FU1 (β = 1.47, 95%CI = 0.62-2.31, p = 0.0007), at FU2 (β = 1.98, 95 %CI = 0.96-2.99, p = 0.0001) and with persistent CRF (OR = 1.29, 95%CI = 1.13-1.47, p < 0.0001). IL-6 levels were associated with total CRF at FU1 (β = 1.01, 95%CI = 0.43-1.59, p = 0.0006), but not with CRF at FU2 or persistent CRF. No association remained significant after adjustment for relevant covariates. DISCUSSION CRP and Il-6 were associated with risk of CRF in long-term breast cancer survivors, but were not independent of other known risk factors, suggesting that currently studied inflammatory markers are not suitable to identify patients at risk of long-term CRF.
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Affiliation(s)
- T Maurer
- Cancer Epidemiology, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - S Jaskulski
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University Medical Center, University of Freiburg, Freiburg, Germany
| | - S Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - N Obi
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Chang-Claude
- Cancer Epidemiology, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg (UCCH), Hamburg, Germany; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Al Maqbali M, Al Sinani M, Al Naamani Z, Al Badi K, Tanash MI. Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2021; 61:167-189.e14. [PMID: 32768552 DOI: 10.1016/j.jpainsymman.2020.07.037] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer. OBJECTIVES The objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer. METHODS The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. RESULTS A total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45-53) with significant heterogeneity between studies (P < 0.000; τ2 = 0.0000; I2 = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue. CONCLUSION This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.
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Affiliation(s)
| | - Mohammed Al Sinani
- Reproductive and Developmental Biology Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Zakariya Al Naamani
- School of Nursing and Midwifery, Queen's University Medical Biology Centre, Belfast, Northern Ireland
| | - Khalid Al Badi
- Al Khawarizmi International College, Abu Dhabi, United Arab Emirates
| | - Mu'ath Ibrahim Tanash
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Barbosa-Lima R, Kameo SY, Amorim BF, Ramos MJO, Costa JDS, Marinho PML, Sawada NO, Moura Silva G. Occurrence of oral mucositis in women during oncological treatment of breast cancer in the Brazilian Northeast. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i4.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To describe the occurrence of oral mucositis (OM) in women undergoing cancer treatment for breast cancer (BC). Methods: This is a retrospective, quantitative, and analytical study in medical records of women diagnosed with BC in an oncology service. Clinical data were collected regarding the occurrence and severity of OM according to the World Health Organization criteria and the cancer treatment experienced by the participants. Results: 196 women were included. Of these, 97 (49.5%) developed OM, 43.4% of which were grade 1 or 2 (low or moderate). The occurrence was higher in white women (OR 1.93; 95% CI 1.04 - 3.57; p = 0.035), with metastatic breast cancer (OR 5.46; 95% CI 1.79 - 16.64; p = 0.002) and who experienced taxane agents at some point during chemotherapy (OR 2.26; 95% CI 1.12 - 4.56; p = 0.02). The mean severity of OM in the entire sample was 0.8 ± 1.0, and in the affected women was 1.7 ± 0.7. The difference in the severity of OM by the variables was observed only among women with grade 2 and grade 3 fatigue (p = 0.03). Conclusions: OM is a common mucocutaneous toxicity in women with BC. Despite the low severity observed, care for women with BC undergoing cancer treatment must consider the possible risks and complications associated with OM, adopting strategies to prevent, monitor, and treat them.
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Sørensen HL, Schjølberg TK, Småstuen MC, Utne I. Social support in early-stage breast cancer patients with fatigue. BMC WOMENS HEALTH 2020; 20:243. [PMID: 33121476 PMCID: PMC7599095 DOI: 10.1186/s12905-020-01106-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 10/20/2020] [Indexed: 12/11/2022]
Abstract
Background A large number of women with breast cancer suffer from fatigue, and social support is described as having a positive impact on health in stressful life situations. The aim of this study is to evaluate social support in a sample of early-stage breast cancer outpatients with fatigue during treatment, and to evaluate the association between cancer-related fatigue and social support and between social support and demographic and treatment characteristics. Method This cross-sectional study includes 160 outpatients with early-stage breast cancer and cancer-related fatigue. The patients were recruited from clinics at a university-based cancer centre in Norway. The research instruments included The Social Provisions Scale (SPS), which measures ‛attachment’, ‛social integration’, ‛reassurance of worth’, and ‛nurturance’, and a fatigue questionnaire (FQ), which measures total, physical and mental fatigue. Data were analysed using descriptive statistics and linear regression analysis. Results Median total score for SPS was 59 (min/max = 39/64). Significant associations were found between mental fatigue and the provisions ‛reassurance of worth’ (B = − 0.34, 95% CI = [− 0.60; − 0.08]) and ‛nurturance’ (B = 0.20, 95% CI = [0.08; 0.31]). In addition, an association was found between social support and living with someone (B = 6.09, 95% CI = [4.07; 8.11]). No associations were found between physical fatigue and social support or between social support and treatment variables. Conclusions To a large extent, breast cancer patients with fatigue in this study experienced social support from their surroundings. The fact that there were significant associations between mental fatigue and two of the provisions of SPS suggests that social support is more closely related to mental fatigue than to physical fatigue. Findings from this study suggest that living with someone is important for the experience of social support during treatment for breast cancer. Clinicians need to evaluate demographic characteristics in relation to social support in early-stage breast cancer patients with fatigue.
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Affiliation(s)
- Hege Lilleskare Sørensen
- Department of Otorhinolaryngology, Head and Neck Surgery, Division for Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Tore Kr Schjølberg
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, Postbox 4, 0131, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, Postbox 4, 0131, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, Postbox 4, 0131, Oslo, Norway.
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Park H, Kim K. Impact of Psycho-Social Factors on Fatigue among Breast Cancer Patients Who Are Currently Undergoing Radiotherapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176092. [PMID: 32825682 PMCID: PMC7503387 DOI: 10.3390/ijerph17176092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/16/2022]
Abstract
Fatigue in breast cancer patients undergoing radiotherapy has been studied less comprehensively than fatigue from chemotherapy. The aim of this study was to test the impact of psycho-social factors on the fatigue among breast cancer patients undergoing radiotherapy. This was a cross-sectional correlational study and participants were 210 breast cancer patients currently undergoing radiotherapy in an outpatient setting in Korea. Data collection was carried out from 22 July to 30 September 2019. The results of this study showed that symptom assessment, anxiety and depression, uncertainty, and perceived stress had a direct effect on the fatigue of breast cancer patients receiving radiotherapy, while social support had an indirect effect. These factors explained 67.2% of the fatigue among the participants. This study confirmed that various interventions for symptom assessment, anxiety and depression, uncertainty, and stress reduction need to be developed to reduce fatigue of breast cancer patients receiving radiotherapy. The present results form the basis for developing such interventions.
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Affiliation(s)
| | - Kisook Kim
- Correspondence: ; Tel.: +82-2820-5723; Fax: +82-2824-7961
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Cancer-related fatigue and its determinants in a cohort of women with breast cancer: the DAMA Cohort. Support Care Cancer 2020; 28:5213-5221. [DOI: 10.1007/s00520-020-05337-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/02/2020] [Indexed: 12/12/2022]
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Thong MSY, van Noorden CJF, Steindorf K, Arndt V. Cancer-Related Fatigue: Causes and Current Treatment Options. Curr Treat Options Oncol 2020; 21:17. [PMID: 32025928 PMCID: PMC8660748 DOI: 10.1007/s11864-020-0707-5] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cancer-related fatigue (CRF) is a problem for a significant proportion of cancer survivors during and after active cancer treatment. However, CRF is underdiagnosed and undertreated. Interventions are available for CRF although there is no gold standard. Based on current level of evidence, exercise seems to be most effective in preventing or ameliorating CRF during the active- and posttreatment phases.
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Affiliation(s)
- Melissa S Y Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009, Heidelberg, Germany.
| | - Cornelis J F van Noorden
- Department of Medical Biology, Amsterdam University Medical Centers, AMC, Amsterdam, Netherlands.,Department of Genetic Toxicology and Tumor Biology, National Institute of Biology, Ljubljana, Slovenia
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), P.O. Box 101949, 69009, Heidelberg, Germany
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Abu-Taha OM, Al Qadire MI, Maharmeh M, Alyami MS. Assessment of cancer-related fatigue among Jordanian patients: a cross-sectional survey. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:111-117. [PMID: 31972112 DOI: 10.12968/bjon.2020.29.2.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is considered to be one of the most common symptoms reported by cancer patients. However, little information is available regarding the variables associated with CRF among Jordanian patients. AIMS To assess the prevalence of CRF and explore its predictors among Jordanian patients. METHODS A cross-sectional survey design was used. FINDINGS Of the 240 patients surveyed, 210 (87.5%) had fatigue at the time of the survey. The total mean fatigue score was 6.2 (SD=1.7) out of a maximum possible score of 10. The results also showed that being unemployed, with longer hospitalisation, low haemoglobin, and having lung cancer seem to predict higher levels of CRF. CONCLUSION Several variables and factors associated with CRF were identified. In response to these results, healthcare providers should pay more attention to CRF, which needs to be assessed on a regular basis and to be managed with the available pharmacological and non-pharmacological interventions.
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Affiliation(s)
| | | | - Mahmoud Maharmeh
- Associate Professor, Faculty of Nursing, Head of Clinical Nursing Department, University of Jordan, Amman, Jordan
| | - Mansour Saleh Alyami
- General Director, General Directorate of Academic Affairs and Training, Ministry of Health, Saudi Arabia
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Wright F, Kober KM, Cooper BA, Paul SM, Conley YP, Hammer M, Levine JD, Miaskowski C. Higher levels of stress and different coping strategies are associated with greater morning and evening fatigue severity in oncology patients receiving chemotherapy. Support Care Cancer 2020; 28:4697-4706. [PMID: 31956947 PMCID: PMC7223171 DOI: 10.1007/s00520-020-05303-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE A cancer diagnosis and associated treatments are stressful experiences for most patients. Patients' perceptions of stress and their use of coping strategies may influence fatigue severity. This study extends our previous work describing distinct profiles of morning (i.e., Very Low, Low, High, and Very High) and evening (i.e., Low, Moderate, High, and Very High) fatigue in oncology patients by evaluating for differences in stress and coping strategies among these fatigue classes. METHODS This longitudinal study evaluated for changes in morning and evening fatigue in oncology patients (n = 1332) over two cycles of chemotherapy (CTX). Patients completed measures of cumulative exposure to stressful life events (SLEs) (i.e., the Life Stressor Checklist-Revised), general stress (i.e., Perceived Stress Scale [PSS]), cancer-specific stress (i.e., Impact of Event Scale-Revised [IES-R]), and coping strategies (i.e., Brief Cope). Differences among the latent classes were evaluated using analyses of variance, Kruskal-Wallis, or chi-square tests. RESULTS Patients in both the Very High morning and evening fatigue classes reported higher numbers of and a higher impact from previous SLEs and higher PSS scores than the other fatigue classes. The IES-R scores for the Very High morning fatigue class met the criterion for subsyndromal PTSD. Patients in the Very High evening fatigue class used a higher number of engagement coping strategies compared with the Very High morning fatigue class. CONCLUSIONS Our findings suggest that interventions to reduce stress and enhance coping warrant investigation to decrease fatigue in patients undergoing CTX.
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Affiliation(s)
- Fay Wright
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, CA, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, CA, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA, USA. .,School of Medicine, University of California, San Francisco, CA, USA. .,Department of Physiological Nursing, University of California, 2 Koret Way - N631F, San Francisco, CA, 94143-0610, USA.
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Fosså A, Smeland KH, Fluge Ø, Tronstad KJ, Loge JH, Midttun Ø, Ueland PM, Kiserud CE. Metabolic analysis of amino acids and vitamin B6 pathways in lymphoma survivors with cancer related chronic fatigue. PLoS One 2020; 15:e0227384. [PMID: 31923274 PMCID: PMC6953873 DOI: 10.1371/journal.pone.0227384] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 12/17/2019] [Indexed: 12/31/2022] Open
Abstract
Chronic cancer-related fatigue (CF) is a common and distressing condition in a subset of cancer survivors and common also after successful treatment of malignant lymphoma. The etiology and pathogenesis of CF is unknown, and lack of biomarkers hampers development of diagnostic tests and successful therapy. Recent studies on the changes of amino acid levels and other metabolites in patients with chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) have pointed to possible central defects in energy metabolism. Here we report a comprehensive analysis of serum concentrations of amino acids, including metabolites of tryptophan, the kynurenine pathway and vitamin B6 in a well characterized national Norwegian cohort of lymphoma survivors after high-dose therapy and autologous stem cell transplantation. Among the 20 standard amino acids in humans, only tryptophan levels were significantly lower in both males and females with CF compared to non-fatigued survivors, a strikingly different pattern than seen in CFS/ME. Markers of tryptophan degradation by the kynurenine pathway (kynurenine/tryptophan ratio) and activation of vitamin B6 catabolism (pyridoxic acid/(pyridoxal + pyridoxal 5'-phosphate), PAr index) differed in survivors with or without CF and correlated with known markers of immune activation and inflammation, such as neopterin, C-reactive protein and Interleukin-6. Among personal traits and clinical findings assessed simultaneously in participating survivors, higher neuroticism score, obesity and higher PAr index were significantly associated with increased risk of CF. Collectively, these data point to low grade immune activation and inflammation as a basis for CF in lymphoma survivors.
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Affiliation(s)
- Alexander Fosså
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- KG Jebsen Center for B-cell malignancies, Oslo University, Oslo, Norway
- * E-mail:
| | - Knut Halvor Smeland
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Øystein Fluge
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | | | - Jon Håvard Loge
- Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway
| | | | - Per Magne Ueland
- Bevital AS, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Cecilie Essholt Kiserud
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
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Nome ME, Euceda LR, Jabeen S, Debik J, Bathen TF, Giskeødegård GF, Taskén KA, Maelandsmo GM, Halvorsen B, Yndestad A, Borgen E, Garred Ø, Aukrust P, Ueland T, Engebraaten O, Kristensen VN, Tekpli X. Serum levels of inflammation-related markers and metabolites predict response to neoadjuvant chemotherapy with and without bevacizumab in breast cancers. Int J Cancer 2019; 146:223-235. [PMID: 31444972 DOI: 10.1002/ijc.32638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/25/2019] [Accepted: 07/25/2019] [Indexed: 01/23/2023]
Abstract
Angiogenesis is necessary for tumor growth and has been targeted in breast cancer; however, it is unclear which patients will respond and benefit from antiangiogenic therapy. We report noninvasive monitoring of patient response to neoadjuvant chemotherapy given alone or in combination with anti-vascular endothelial growth factor (bevacizumab) in a randomized clinical trial. At four time points during neoadjuvant chemotherapy ± bevacizumab of receptor tyrosine-protein kinase erbB-2-negative breast cancers, we measured metabolites and inflammation-related markers in patient's serum. We report significant changes in the levels of several molecules induced by bevacizumab, the most prominent being an increase in pentraxin 3 (PTX3) and von Willebrand factor (VWF). Serum levels of AXL, VWF and pulmonary and activation-regulated cytokine (PARC/CCL18) reflected response to chemotherapy alone or in combination with bevacizumab. We further analyzed serum cytokines in relation to tumor characteristics such as gene expression, tumor metabolites and tumor infiltrating leukocytes. We found that VWF and growth-differentiation factor 15 tumor mRNA levels correlated with their respective serum protein levels suggesting that these cytokines may be produced by tumors and outflow to the bloodstream while influencing the tumor microenvironment locally. Finally, we used binomial logistic regression which allowed to predict patient's response using only 10 noninvasive biomarkers. Our study highlights the potential of monitoring circulating levels of cytokines and metabolites during breast cancer therapy.
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Affiliation(s)
- Marianne E Nome
- Department of Clinical Molecular Biology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Leslie R Euceda
- Department of Circulation and Medical Imaging, NTNU - The Norwegian University of Science and Technology, Trondheim, Norway
| | - Shakila Jabeen
- Department of Clinical Molecular Biology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Julia Debik
- Department of Circulation and Medical Imaging, NTNU - The Norwegian University of Science and Technology, Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, NTNU - The Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro F Giskeødegård
- Department of Circulation and Medical Imaging, NTNU - The Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristin A Taskén
- Department of Tumour Biology, Institute for Cancer Research, Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gunhild M Maelandsmo
- Department of Tumour Biology, Institute for Cancer Research, Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Medical Biology, Faculty of Health Sciences, Artic University of Norway - University of Tromsø, Tromsø, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Arne Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elin Borgen
- Department of Pathology, Division of Laboratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Øystein Garred
- Department of Pathology, Division of Laboratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.,K.G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,K.G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Olav Engebraaten
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Vessela N Kristensen
- Department of Clinical Molecular Biology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Xavier Tekpli
- Department of Clinical Molecular Biology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
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Johannessen B, Syvertsen S, Kersten C, Berntsen S. Cancer-related fatigue: Patients' experiences of an intervention at a green care rehabilitation farm. Complement Ther Clin Pract 2019; 37:133-139. [PMID: 31582199 DOI: 10.1016/j.ctcp.2019.101062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Siri Syvertsen
- University of Agder, Faculty of Health and Sport Sciences, Norway
| | - Christian Kersten
- Center for Cancer Treatment, Sorlandet Hospital HF, Kristiansand, Norway
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Mendes-Santos C, Weiderpass E, Santana R, Andersson G. A guided internet-delivered individually-tailored ACT-influenced cognitive behavioural intervention to improve psychosocial outcomes in breast cancer survivors (iNNOVBC): Study protocol. Internet Interv 2019; 17:100236. [PMID: 30949435 PMCID: PMC6430035 DOI: 10.1016/j.invent.2019.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Internet-delivered interventions can provide remarkable opportunities in addressing breast cancer survivors' unmet support care needs, as they present an effective strategy to improve care coordination and provide access to efficacious, cost-efficient and convenient survivorship care. Nevertheless, research focusing on improving survivors' psychosocial needs using internet-based tools is scarce and its practical implementation is limited. OBJECTIVES To study the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, a 10 weeks guided internet-delivered individually-tailored Acceptance and Commitment Therapy (ACT)-influenced cognitive behavioural (CBT) intervention developed to improve mild to moderate anxiety and depression in Breast cancer survivors when compared to treatment as usual (TAU) in a waiting list control group (WLC). METHODS A two-arm, parallel, open label, multicentre, waiting list randomized controlled trial will be conducted to investigate the efficacy and cost-effectiveness of INNOVBC. The primary outcomes in this research will be anxiety and depression. Secondary outcomes will include psychological flexibility, fatigue, insomnia, sexual dysfunction and Health Related Quality of Life (HRQoL). ETHICAL APPROVAL This study has been reviewed and approved by Comissão Nacional de Proteção de Dados; Instituto Português de Oncologia do Porto Francisco Gentil; Unidade Local de Saúde de Matosinhos, EPE; Centro Hospitalar de São João and Ordem dos Psicólogos ethical committees. EXPECTED RESULTS It is anticipated that iNNOVBC will show to be an efficacious and cost-effective program in improving the outcomes of interest in this study, as opposed to a WLC under TAU. The results of this research will be published in accordance with CONSORT-EHEALTH guidelines. CONCLUSIONS This study will inform on the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, in improving psychosocial outcomes in breast cancer survivors when compared to TAU in a WLC. Its conclusions will contribute to understand the idiosyncrasies of designing and implementing internet-delivered interventions in breast cancer survivors.Trial Registration code: INNOVBC (NCT03275727).
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Communication (IKK), Linköping University, Linköping, Sweden
- Public Health Research Center (CISP), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Rui Santana
- Public Health Research Center (CISP), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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Dong X, Yi X, Gao D, Gao Z, Huang S, Chao M, Chen W, Ding M. The effects of the combined exercise intervention based on internet and social media software (CEIBISMS) on quality of life, muscle strength and cardiorespiratory capacity in Chinese postoperative breast cancer patients:a randomized controlled trial. Health Qual Life Outcomes 2019; 17:109. [PMID: 31242926 PMCID: PMC6595606 DOI: 10.1186/s12955-019-1183-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 06/18/2019] [Indexed: 12/11/2022] Open
Abstract
Background Breast cancer (BC) patients who undergo surgery followed by radiotherapy and chemotherapy have limitations on physical activity which will lead to a decreased quality of life and poor physical fitness level. The purpose of this study was to investigate the effects of the combined exercise intervention based on internet and social media software (CEIBISMS) on postoperative breast cancer patients by evaluating their quality of life, muscle strength and cardiorespiratory capacity. Methods This study was a randomized control trial with an intervention period of 12 weeks. Sixty participants (30 in each group, 42–60 years old, female) were recruited through an outpatient department. Procedure of exercise in the intervention group included: via phone step-recording app, ask the individuals to complete the target number of steps within a specified period of exercise, four times per week; face-to-face remote video instruction of individuals on muscle training, three times per week; via social media apps daily push common knowledge of physical exercise BC rehabilitation. The control group received traditional treatment and rehabilitation according to daily specifications of the hospital. The primary outcome was quality of life and the secondary outcomes were muscle strength and cardiorespiratory capacity. Results Experiments using a Short Form 36 showed that the CEIBISMS yielded significantly better results than traditional methods, in vitality (p = 0.009), mental health (p = 0.001) and reported health transition (p = 0.048) by week 12. The CEIBISMS resulted in significant improvement in the stand-up and sit-down chair test (p < 0.0001), arm lifting test (p = 0.017). Conclusion The CEIBISMS offered rehabilitative effects in quality of life (QOL) and muscle strength of postoperative patients with breast cancer (BC) in China. Trial registration ChiCTR-IPR-17012368. Trial registered on 14 August, 2017.
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Affiliation(s)
- Xiaosheng Dong
- College of Physical Education, Shandong Normal University, 88 Wenhuaxi Road, Jinan, 250014, China
| | - Xiangren Yi
- College of Physical Education, Shandong University, Jinan, 250011, China
| | - Dezong Gao
- The Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Zan Gao
- School of Kinesiology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Shuyuan Huang
- College of Physical Education, Shandong University, Jinan, 250011, China
| | - Mengyao Chao
- College of Physical Education, Shandong Normal University, 88 Wenhuaxi Road, Jinan, 250014, China
| | - Wenxin Chen
- College of Physical Education, Shandong University, Jinan, 250011, China
| | - Meng Ding
- College of Physical Education, Shandong Normal University, 88 Wenhuaxi Road, Jinan, 250014, China.
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Gullett JM, Cohen RA, Yang GS, Menzies VS, Fieo RA, Kelly DL, Starkweather AR, Jackson-Cook CK, Lyon DE. Relationship of fatigue with cognitive performance in women with early-stage breast cancer over 2 years. Psychooncology 2019; 28:997-1003. [PMID: 30761683 DOI: 10.1002/pon.5028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/06/2019] [Accepted: 02/12/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Fatigue and cognitive dysfunction are major concerns for women with early-stage breast cancer during treatment and into survivorship. However, interrelationships of these phenomena and their temporal patterns over time are not well documented, thus limiting the strategies for symptom management interventions. In this study, changes in fatigue across treatment phases and the relationship among fatigue severity and its functional impact with objective cognitive performance were examined. METHODS Participants (N = 75) were assessed at five time points beginning prior to chemotherapy to 24 months after initial chemotherapy. Fatigue severity and impact were measured on the Brief Fatigue Inventory. Central nervous system (CNS) Vital Signs was used to measure performance based cognitive testing. Temporal changes in fatigue were examined, as well as the relationship between fatigue and cognitive performance, at each time point using linear mixed effect models. RESULTS Severity of fatigue varied as a function of phase of treatment. Fatigue severity and its functional impact were moderate at baseline, increased significantly during chemotherapy, and returned to near baseline levels by 2 years. At each time point, fatigue severity and impact were significantly associated with diminished processing speed and complex attention performance. CONCLUSIONS A strong association between fatigue and objective cognitive performance suggests that they are likely functionally related. That cognitive deficits were evident at baseline, whereas fatigue was more chemotherapy dependent, implicates that two symptoms share some common bases but may differ in underlying mechanisms and severity over time. This knowledge provides a basis for introducing strategies for tailored symptom management that vary over time.
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Affiliation(s)
- Joseph M Gullett
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, Florida.,Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Ronald A Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, Florida.,Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Gee Su Yang
- College of Nursing, University of Florida, Gainesville, Florida
| | | | - Robert A Fieo
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, Florida.,Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Debra L Kelly
- College of Nursing, University of Florida, Gainesville, Florida
| | | | - Colleen K Jackson-Cook
- Department of Pathology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Debra E Lyon
- College of Nursing, University of Florida, Gainesville, Florida
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Abrahams H, Gielissen M, Verhagen C, Knoop H. The relationship of fatigue in breast cancer survivors with quality of life and factors to address in psychological interventions: A systematic review. Clin Psychol Rev 2018; 63:1-11. [DOI: 10.1016/j.cpr.2018.05.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 05/15/2018] [Accepted: 05/15/2018] [Indexed: 12/24/2022]
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42
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O’ Regan P, Hegarty J. The importance of self-care for fatigue amongst patients undergoing chemotherapy for primary cancer. Eur J Oncol Nurs 2017; 28:47-55. [DOI: 10.1016/j.ejon.2017.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 02/03/2017] [Accepted: 02/20/2017] [Indexed: 02/03/2023]
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