Factors Associated With Fatigue in Patients with Breast Cancer Undergoing External Beam Radiation Therapy

Radiotherapy-induced fatigue in Palestinian breast cancer survivors

Background

No study has investigated the cancer-related fatigue (CRF) among Palestinian breast cancer survivors. Our purpose is to assess, compare, and correlate CRF in breast cancer survivors undergoing radiotherapy (RT) with study variables.

Methods

CRF in breast cancer survivors was assessed using Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F) (version 4). The sample consisted of 148 breast cancer survivors undergoing RT. Data was collected between 1 May 2021 and 1 September 2021. The means and standard deviations of the questionnaire using one-way ANOVA, and Pearson correlation coefficient were reported.

Results

Respondents ages ranged from 20 to >65 years old and was divided into four groups: (20-35, 36-50, 51-65, and >65 years, respectively). The total fatigue mean was 2.88 and the SD was 0.84, indicating an intermediate fatigue level among breast cancer survivors. Study survivors with higher education were more likely to be fatigued (F =7.68, P-value =0.001). Divorced survivors were more prone to fatigue compared to married survivors (F =5.83, P-value= 0.001). Finally, survivors who do not have children were more vulnerable to exhaustion compared to those with children (F =7.35, P-value =0.001). Also, younger survivors were more prone to fatigue, compared to older survivors (F =5.29, P-value = 0.002). Results also showed a positive relationship between each of the variables; the number of children (R =0.221, P-value =0.007), age (R =0.311, P-value =0.000), and duration of treatment (R =0.290, P-value =0.000), which means that the greater the number of children, the younger the age, or the longer the duration of treatment, the more fatigue is reported in breast cancer survivors.

Conclusions

Fatigue is frequently observed in breast cancer survivors undergoing RT. It can limit RT treatment continuity. Therefore, early detection of fatigue can help survivors adhere to RT treatment and achieve better clinical results.

Clock in radiation oncology clinics: cost-free modality to alleviate treatment-related toxicity

A large number of studies have reported that tumor cells are often out of sync with the surrounding healthy tissue. Exploiting this misalignment may be a way to obtain a substantial gain in the therapeutic window. Specifically, based on reports to date, we will assess whether radiotherapy outcomes differ depending on the administration time. Collectively, 24 studies met the inclusion criteria, out of which 12 at least reported that radiation therapy is less toxic when administered at a particular time, probably because there is less collateral damage to healthy cells. However, discrepancies exist across studies and urge further investigation. Mechanistic studies elucidating the relationship between radiotherapy, circadian rhythms, and cell cycle, combined with either our “digital” or “biological” chronodata, would help oncologists successfully chronotype individual patients and strategize treatment plans accordingly.

The Effects of Ionising and Non-Ionising Electromagnetic Radiation on Extracellular Matrix Proteins

Exposure to sub-lethal doses of ionising and non-ionising electromagnetic radiation can impact human health and well-being as a consequence of, for example, the side effects of radiotherapy (therapeutic X-ray exposure) and accelerated skin ageing (chronic exposure to ultraviolet radiation: UVR). Whilst attention has focused primarily on the interaction of electromagnetic radiation with cells and cellular components, radiation-induced damage to long-lived extracellular matrix (ECM) proteins has the potential to profoundly affect tissue structure, composition and function. This review focuses on the current understanding of the biological effects of ionising and non-ionising radiation on the ECM of breast stroma and skin dermis, respectively. Although there is some experimental evidence for radiation-induced damage to ECM proteins, compared with the well-characterised impact of radiation exposure on cell biology, the structural, functional, and ultimately clinical consequences of ECM irradiation remain poorly defined.

Qigong for women with breast cancer: An updated systematic review and meta-analysis

OBJECTIVE

The purpose of this review was to evaluate the effectiveness of Qigong in improving the quality of life and relieving fatigue, sleep disturbance, and cancer-related emotional disturbances (distress, depression, and anxiety) in women with breast cancer.

METHODS

The PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Sinomed, Wanfang, VIP, and China National Knowledge Infrastructure databases were searched from their inceptions to March 2020 for controlled clinical trials. Two reviewers selected relevant trials that assessed the benefit of Qigong for breast cancer patients independently. A methodological quality assessment was conducted according to the criteria of the 12 Cochrane Back Review Group for risk of bias independently. A meta-analysis was performed by Review Manager 5.3.

RESULTS

This review consisted of 17 trials, in which 1236 cases were enrolled. The quality of the included trials was generally low, as only five of them were rated high quality. The results showed significant effectiveness of Qigong on quality of life (n = 950, standardized mean difference (SMD), 0.65, 95 % confidence interval (CI) 0.23-1.08, P =  0.002). Depression (n = 540, SMD = -0.32, 95 % CI -0.59 to -0.04, P =  0.02) and anxiety (n = 439, SMD = -0.71, 95 % CI -1.32 to -0.10, P =  0.02) were also significantly relieved in the Qigong group. There was no significant benefit on fatigue (n = 401, SMD = -0.32, 95 % CI  0.71 to 0.07, P = 0.11) or sleep disturbance relief compared to that observed in the control group (n = 298, SMD = -0.11, 95 % CI  0.74 to 0.52, P = 0.73).

CONCLUSION

This review shows that Qigong is beneficial for improving quality of lifeand relieving depression and anxiety; thus, Qigong should be encouraged in women with breast cancer.