Journal of Pain and Symptom Management
Volume 39, Issue 2 , Pages 197-210 , February 2010

Fatigue in Gynecological Cancer Patients During and After Anticancer Treatment

  • Gillian Prue, PhD

      Affiliations

    • Institute of Nursing Research, University of Ulster, Newtownabbey, United Kingdom
    • Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, United Kingdom
    • Corresponding Author InformationAddress correspondence to: Gillian Prue, PhD, Institute of Nursing Research, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, United Kingdom.
    • ,
  • James Allen, PhD

      Affiliations

    • Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, United Kingdom
    • ,
  • Jacqueline Gracey, PhD

      Affiliations

    • Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, United Kingdom
    • ,
  • Jane Rankin, MSc

      Affiliations

    • Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom
    • ,
  • Fiona Cramp, PhD

      Affiliations

    • Department of Allied Health Professions, Faculty of Health and Life Sciences, University of the West of England, Bristol, United Kingdom

,Accepted 13 July 2009.

References 

  1. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cancer-related fatigue v.1. 2006 [online]. Available from http://www.nccn.org/professionals/physician_gls/PDF/fatigue.pdf/. Accessed October 10, 2006.
  2. Flechtner H, Bottomley A. Fatigue assessment in cancer clinical trials. Expert Rev Pharmacoecon Outcomes Res. 2002;2:67–76
  3. Morrow GR, Andrews PLR, Hickok JT, Roscoe JA, Matteson S. Fatigue associated with cancer and its treatment. Support Care Cancer. 2002;10:389–398
  4. Payne JK. The trajectory of fatigue in adult patients with breast and ovarian cancer receiving chemotherapy. Oncol Nurs Forum. 2002;29:1334–1340
  5. Stone P, Richardson A, Ream E, et al. Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Ann Oncol. 2000;11:971–975
  6. Prue G, Rankin J, Cramp F, Allen J, Gracey J. Fatigue in gynaecological cancer patients: a pilot study. Support Care Cancer. 2006;14:78–83
  7. Sadler IJ, Jacobsen PB. Progress in understanding fatigue associated with breast cancer treatment. Cancer Invest. 2001;19:723–731
  8. Jacobsen PB, Thors CL. Fatigue in the radiation therapy patient: current management and investigations. Semin Radiat Oncol. 2003;13:372–380
  9. Stone P, Richards M, A'Hern R, Hardy J. Fatigue in patients with cancers of the breast and prostate undergoing radical radiotherapy. J Pain Symptom Manage. 2001;22:1007–1015
  10. Winningham ML, Nail LM, Barton-Burke M, et al. Fatigue and the cancer experience: the state of the knowledge. Oncol Nurs Forum. 1994;21:23–36
  11. Nail LM, Winningham ML. Fatigue. In:  Groenwald SL,  Hansen Frogge M,  Goodman M,  Yarbo CH editor. Cancer nursing: Principles and practice. 3rd ed. London, United Kingdom: Jones and Bartlett; 1993;p. 609–617
  12. Winningham ML. How exercise mitigates fatigue: implications for people receiving cancer therapy. In:  Johnson RM editors. The biotherapy of cancer V. Pittsburgh, PA: Oncology Nursing Press; 1992;p. 16–20
  13. Endacott R, Botti M. Clinical research 3: sample selection. Intensive Crit Care Nurs. 2005;21:51–55
  14. Stein KD, Jacobsen PB, Blanchard CM, Thors C. Further validation of the multidimensional fatigue symptom inventory-short form. J Pain Symptom Manage. 2004;27:14–23
  15. De Haes JCJM, Olschewski M, Fayers P, et al. Measuring the quality of life of cancer patients with the Rotterdam Symptom Check List: A manual. Groningen, The Netherlands: Northern Center for Healthcare Research, University of Groningen; 1996;
  16. Hann DM, Garovoy N, Finkelstein B, et al. Fatigue and quality of life in breast cancer patients undergoing autologous stem cell transplantation: a longitudinal comparative study. J Pain Symptom Manage. 1999;17:311–319
  17. Jacobsen PB, Hann DM, Azzarello LM, et al. Fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates. J Pain Symptom Manage. 1999;18:233–242
  18. Tchen N, Juffs HG, Downie FP, et al. Cognitive function, fatigue, and menopausal symptoms in women receiving adjuvant chemotherapy for breast cancer. J Clin Oncol. 2003;22:4175–4183
  19. Mar Fan HG, Houede-Tchen N, Yi Q, et al. Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer: 1- and 2- year follow-up of a prospective controlled study. J Clin Oncol. 2005;23:8025–8032
  20. Brown DJ, McMillan DC, Milroy R. The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer. Cancer. 2005;103:377–382
  21. Payne JK, Piper BF, Rabinowitz I, Zimmerman MB. Biomarkers, fatigue, sleep, and depressive symptoms in women with breast cancer: a pilot study. Oncol Nurs Forum. 2006;33:775–783
  22. Statistical Package for the Social Sciences (SPSS). Available from: http://www.spss.com/. Accessed June 2009.
  23. Krueger C, Tian L. A comparison of the general linear model and repeated measures ANOVA using a dataset with multiple missing data points. Biol Res Nurs. 2004;6:151–157
  24. Fleer J, Sleijfer DT, Hoekstra HJ, Tuinman MA, Hoekstra-Weebers JE. Prevalence, changes in and correlates of fatigue in the first year after diagnosis of testicular cancer. Anticancer Res. 2005;25:4647–4653
  25. Stone PC, Abdul-Wahab A, Gibson JS, Wright RJ, Andrews PL. Fatigue in cancer patients is not related to changes in oxyhaemoglobin dissociation. Support Care Cancer. 2005;13:854–858
  26. Servaes P, Verhagen C, Bleijenberg G. Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study. Ann Oncol. 2002;13:589–593
  27. Fossa SD, Dahl AA, Loge JH. Fatigue, anxiety, and depression in long-term survivors of testicular cancer. J Clin Oncol. 2003;21:1249–1254
  28. Hjermstad MJ, Fossa SD, Oldervoll L, et al. Fatigue in long-term Hodgkin's disease survivors: a follow-up study. J Clin Oncol. 2005;23:6587–6595
  29. Ng AK, Li S, Recklitis C, et al. A comparison between long-term survivors of Hodgkin's disease and their siblings on fatigue level and factors predicting for increased fatigue. Ann Oncol. 2005;16:1949–1955
  30. Hjermstad MJ, Oldervoll L, Fossa SD, et al. Quality of life in long-term Hodgkin's disease survivors with chronic fatigue. Eur J Cancer. 2006;42:327–333
  31. Banthia R, Malcarne VL, Roesch SC, et al. Correspondence between daily and weekly fatigue reports in breast cancer survivors. J Behav Med. 2006;29:269–279
  32. Poirier P. The relationship of sick leave benefits, employment patterns, and individual characteristics to radiation therapy-related fatigue. Oncol Nurs Forum. 2006;33:593–601
  33. Ahlberg K, Ekman T, Gaston-Johansson F. The experience of fatigue, other symptoms and global quality of life during radiotherapy for uterine cancer. Int J Nurs Stud. 2005;42:377–386
  34. Liu L, Marler MR, Parker BA, et al. The relationship between fatigue and light exposure during chemotherapy. Support Care Cancer. 2005;13:1010–1017
  35. Mills PJ, Parker B, Dimsdale JE, Sadler GR, Ancoli-Israel S. The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer. Biol Psychol. 2005;69:85–96
  36. Monga U, Kerrigan AJ, Thornby J, Monga TN, Zimmermann KP. Longitudinal study of quality of life in patients with localized prostate cancer undergoing radiotherapy. J Rehabil Res Dev. 2005;42:391–400
  37. Shun S-C, Lai Y-H, Jing T-T, et al. Fatigue patterns and correlates in male liver cancer patients receiving transcatheter hepatic arterial chemoembolization. Support Care Cancer. 2005;13:311–317
  38. Byar KL, Berger AM, Bakken SL, Cetak MA. Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms and quality of life. Oncol Nurs Forum. 2006;33:E18–E26
  39. Lavdaniti M, Patiraki E, Dafani U, et al. Prospective assessment of fatigue and health status in Greek patients with breast cancer undergoing adjuvant radiotherapy. Oncol Nurs Forum. 2006;33:603–610
  40. Geinitz H, Zimmermann FB, Stoll P, et al. Fatigue, serum cytokine levels and blood cell counts during radiotherapy of patients with breast cancer. Int J Radiat Oncol Biol Phys. 2001;51:691–698
  41. Jacobsen PB, Garland LL, Booth-Jones M, et al. Relationship of hemoglobin levels to fatigue and cognitive functioning among cancer patients receiving chemotherapy. J Pain Symptom Manage. 2004;28:7–18
  42. De Jong N, Candel MJJM, Schouten HC, Abu-Saad HH, Courtens AM. Course of mental fatigue and motivation in breast cancer patients receiving adjuvant chemotherapy. Ann Oncol. 2005;16:372–382
  43. Smets EMA, Visser MRM, Willems-Groot AFMN, et al. Fatigue and radiotherapy: (A) experience in patients undergoing treatment. Br J Cancer. 1998;78:899–906
  44. Stone P, Hardy J, Huddart R, A'Hern R, Richards M. Fatigue in patients with prostate cancer receiving hormone therapy. Eur J Cancer. 2000;36:1134–1141
  45. Ahsberg E, Furst CJ. Dimensions of fatigue during radiotherapy: an application of the Swedish Occupational Fatigue Inventory (SOFI) on cancer patients. Acta Oncol. 2001;40:37–43
  46. Kallich JD, Tchekmedyian NS, Damiano AM, et al. Psychological outcomes associated with anaemia-related fatigue in cancer patients. Oncology. 2002;16:117–124
  47. Roscoe JA, Morrow GR, Hickok JT, et al. Temporal interrelationships among fatigue, circadian rhythm and depression in breast cancer patients undergoing chemotherapy treatment. Support Care Cancer. 2002;10:329–336
  48. Haghighat S, Akbari ME, Holakouei K, Rahimi A, Montazeri A. Factors predicting fatigue in breast cancer patients. Support Care Cancer. 2003;11:533–538
  49. Hwang SS, Chang VT, Rue M, Kasimis B. Multidimensional independent predictors of cancer-related fatigue. J Pain Symptom Manage. 2003;26:604–614
  50. Respini D, Jacobsen PB, Thors C, Tralongo P, Balducci L. The prevalence and correlates of fatigue in older cancer patients. Crit Rev Oncol Hematol. 2003;47:273–279
  51. Ahlberg K, Ekman T, Wallgren A, Gaston-Johansson F. Fatigue, psychological distress, coping and quality of life in patients with uterine cancer. J Adv Nurs. 2004;45:205–213
  52. Geinitz H, Zimmermann FB, Thamm R, et al. Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up. J Cancer Res Clin Oncol. 2004;130:327–333
  53. Ahlberg K, Ekman T, Gaston-Johansson F. Levels of fatigue compared to levels of cytokines and haemoglobin during pelvic radiotherapy: a pilot study. Biol Res Nurs. 2004;5:203–210
  54. Porock D, Beshears B, Hinton P, Anderson C. Nutritional, functional and emotional characteristics related to fatigue in patients during and after biochemotherapy. Oncol Nurs Forum. 2005;32:661–667
  55. Munch TN, Stromgren AS, Pedersen L, et al. Multidimensional measurement of fatigue in advanced cancer patients in palliative care: an application of the multidimensional fatigue inventory. J Pain Symptom Manage. 2006;31:533–541
  56. Donovan KA, Jacobsen PB, Andrykowski MA, et al. Course of fatigue in women receiving chemotherapy and/or radiotherapy for early stage breast cancer. J Pain Symptom Manage. 2004;28:373–380
  57. Jacobsen PB, Andrykowski MA, Thors CL. Relationship of catastrophizing to fatigue among women receiving treatment for breast cancer. J Consult Clin Psychol. 2004;72:355–361
  58. Wratten C, Kilmurray J, Nash S, et al. Fatigue during breast radiotherapy and its relationship to biological factors. Int J Radiat Oncol Biol Phys. 2004;59:160–167
  59. Can G, Durna Z, Aydiner A. Assessment of fatigue in and care needs of Turkish women with breast cancer. Cancer Nurs. 2004;27:153–161
  60. Hann DM, Jacobsen PB, Martin SC, et al. Fatigue in women treated with bone marrow transplantation for breast cancer: a comparison with women with no history of cancer. Support Care Cancer. 1997;5:44–52
  61. Andrykowski MA, Curran SL, Lightner R. Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med. 1998;21:1–18
  62. Broeckel JA, Jacobsen PB, Horton J, Balducci L, Lyman GH. Characteristics and correlates of fatigue after adjuvant chemotherapy for breast cancer. J Clin Oncol. 1998;16:1689–1696
  63. Hann DM, Jacobsen PB, Martin S, Azzarello L, Greenberg H. Fatigue and quality of life following radiotherapy for breast cancer: a comparative study. J Clin Psychol Med Settings. 1998;5:19–33
  64. Smets EMA, Visser MRM, Willems-Groot AFMN, et al. Fatigue and radiotherapy: (B) experience in patients 9 months following treatment. Br J Cancer. 1998;78:907–912
  65. Loge JH, Abrahamsen AF, Ekeberg O, Kaasa S. Hodgkin's disease survivors more fatigued than the general population. J Clin Oncol. 1999;17:253–261
  66. Howell SJ, Radford JA, Smets EMA, Shalet SM. Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction. Br J Cancer. 2000;82:789–793
  67. Loge JH, Abrahamsen AF, Ekeberg O, Kaasa S. Fatigue and psychiatric morbidity among Hodgkin's disease survivors. J Pain Symptom Manage. 2000;19:91–99
  68. Okuyama T, Akechi T, Kugaya A, et al. Factors correlated with fatigue in disease-free breast cancer patients: an application of the Cancer Fatigue Scale. Support Care Cancer. 2000;8:215–222
  69. Servaes P, van der Werf S, Prins J, Verhagen S, Bleijenberg G. Fatigue in disease-free cancer patients compared with fatigue in chronic fatigue syndrome. Support Care Cancer. 2000;9:11–17
  70. Bower JE, Ganz PA, Aziz N, Fahey JL. Fatigue and proinflammatory cytokine activity in breast cancer survivors. Psychosom Med. 2002;64:604–611
  71. Barstch HH, Weis J, Moser MT. Cancer-related fatigue in patients attending oncological rehabilitation programs: prevalence, patterns and predictors. Onkologie. 2003;26:51–57
  72. Dimeo F, Schmittel A, Fietz T. Physical performance, depression, immune status and fatigue in patients with haematological malignancies after treatment. Ann Oncol. 2004;15:1237–1242
  73. Gelinas C, Fillion L. Factors related to persistent fatigue following completion of breast cancer treatment. Oncol Nurs Forum. 2004;31:269–278
  74. Young KE, White CA. The prevalence and moderators of fatigue in people who have been successfully treated for cancer. J Psychosom Res. 2006;60:29–38
  75. Servaes P, Verhagen C, Schreuder B, Veth RPH, Bleijenberg G. Fatigue after treatment for malignant and benign bone and soft tissue tumors. J Pain Symptom Manage. 2003;26:1113–1122
  76. Knobel H, Loge JH, Nordoy T, et al. High level of fatigue in lymphoma patients treated with high dose therapy. J Pain Symptom Manage. 2000;19:446–456
  77. Okuyama T, Tanaka K, Akechi T, et al. Fatigue in ambulatory patients with advanced lung cancer: prevalence, correlated factors, and screening. J Pain Symptom Manage. 2001;22:554–564
  78. Sugawara Y, Akechi T, Okuyama T, et al. Occurrence of fatigue and associated factors in disease-free breast cancer patients without depression. Support Care Cancer. 2005;13:628–636
  79. Knobel H, Loge JH, Lund MB, et al. Late medical complications and fatigue in Hodgkin's disease survivors. J Clin Oncol. 2001;19:3226–3233
  80. Jacobsen PB, Donovan KA, Weitzner MA. Distinguishing fatigue and depression in patients with cancer. Semin Clin Neuropsychiatry. 2003;8:229–240
  81. Reuter K, Harter M. The concepts of fatigue and depression in cancer. Eur J Cancer Care. 2004;13:127–134
  82. Visser MRM, Smets EMA. Fatigue, depression and quality of life in cancer patients: how are they related?. Support Care Cancer. 1998;6:101–108
  83. Wisniewski SR, Leon AC, Otto MW, Trivedi MH. Prevention of missing data in clinical research studies. Biol Psychiatry. 2006;59:997–1000
  84. Cella D, Hahn EA, Dineen K. Meaningful change in cancer-specific quality of life scores: difference between improvement and worsening. Qual Life Res. 2002;11:201–221
  85. Ahlberg K, Ekman T, Gaston-Johansson F. Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer. Oncol Nurs Forum. 2005;32:633–640
  86. Ahlberg K, Ekman T, Gaston-Johansson F, Mock V. Assessment and management of cancer-related fatigue in adults. Lancet. 2003;362:640–650
  87. National Institute for Health and Clinical Excellence. Guidance on cancer services: Improving supportive and palliative care for adults with cancer: The manual. London, United Kingdom: National Institute for Clinical Excellence; 2004;
  88. Stasi R, Abriani L, Beccaglia P, Terzoli E, Amadori S. Cancer-related fatigue: evolving concepts in evaluation and treatment. Cancer. 2003;98:1786–1801
  89. Mock V. Evidence-based treatment for cancer-related fatigue. J Natl Cancer Inst Monogr. 2004;32:112–118
  90. Manzullo E, Liu W, Escalante C. Treatment for cancer-related fatigue: an update. Expert Rev Anticancer Ther. 2003;3:99–106
  91. Lawrence DP, Kupelnick B, Miller K, Devine D, Lau J. Evidence report on the occurrence, assessment, and treatment of fatigue in cancer patients. J Natl Cancer Inst Monogr. 2004;32:40–50
  92. Ream E, Richardson A, Alexander-Dann C. Supportive intervention for fatigue in patients undergoing chemotherapy: a randomised controlled trial. J Pain Symptom Manage. 2006;31:148–161
  93. Goedendorp MM, Gielissen MFM, Verhagen CAHHVM, Bleijenberg G. Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev. 2009;(Issue 1):

 Financial support was provided by the Northern Ireland Cancer Recognized Research Group.

PII: S0885-3924(09)00844-6

doi: 10.1016/j.jpainsymman.2009.06.011

Journal of Pain and Symptom Management
Volume 39, Issue 2 , Pages 197-210 , February 2010

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