A Longitudinal Study of Depression, Fatigue, and Sleep Disturbances as a Symptom Cluster in Women With Breast Cancer

Ho, Sheau-Yan; Rohan, Kelly J.; Parent, Justin; Tager, Felice A.; McKinley, Paula S.

doi:10.1016/j.jpainsymman.2014.09.009

Cited by 137 publications

(117 citation statements)

References 39 publications

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“…In addition, in a recent meta-analysis that evaluated the effects of doublet versus single cytotoxic agent treatment for non-small cell lung cancer (47), no between group differences in fatigue occurrence rates were found. Finally, fatigue, feeling drowsy, and sleep disturbance were reported in previous studies to be part of a symptom cluster (48,49). Given that all three symptoms had higher occurrence rates in the patients who received only CTX suggests that when these three symptoms do occur they may interact with each other and result in a higher symptom burden.…”

Section: Symptom Occurrencementioning

confidence: 65%

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

Tantoy

Dhruva

Cataldo

et al. 2017

J. Gastrointest. Oncol.

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Background: Approximately 28% of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93).Methods: Patients completed self-report questionnaires, approximately one week after they received CTX.A modified version of the Memorial Symptom Assessment Scale (MSAS) was used to obtain data on symptom occurrence, severity, and distress. Binary logistic regression analyses were used to test for differences in symptom occurrence rates between the two treatment groups. Ordinal logistic regression analyses were used to test for differences in severity and distress ratings between the two treatment groups.Results: Patients who received CTX with TT were significantly younger (P=0.009); were diagnosed with cancer longer (P=0.004); had a higher number of prior treatments (P=0.024); had metastatic disease, specifically to the liver (P<0.001); had a diagnosis of anal, colon, rectum, or colorectal cancer (CRC) (P<0.001); and were positive for detection of B-Raf proto-oncogene, serine/threonine kinase (BRAF) and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (both P<0.001). In addition, CTX treatment regimens were significantly different between the two groups (P<0.001). After controlling for significant covariates, patients who received TT reported lower occurrence rates for lack of energy, cough, feeling drowsy, and difficulty sleeping (all, P<0.05). Patients who received TT reported lower severity scores for dry mouth (P=0.034) and change in the way food tastes (P=0.035). However, they reported higher severity scores for "I don't look like myself" (P=0.026).No differences in symptom distress scores were found between the two treatment groups.Conclusions: This study is the first to evaluate for differences in the symptom experience of GI cancer patients who received CTX alone or CTX with TT using a multidimensional symptom assessment scale.While between group differences in patients' symptom experiences were identified, both treatment groups warrant ongoing assessments to optimally manage their symptoms.

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Section: Symptom Occurrencementioning

confidence: 65%

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

Tantoy

Dhruva

Cataldo

et al. 2017

J. Gastrointest. Oncol.

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“…In fact, a growing number of recent studies support that fatigue may co-occur with depression and sleep disturbances as part of a symptom cluster in breast cancer patients [30][31][32][33]. Berger et al examined patterns of circadian rhythms and their relationship with fatigue, anxiety, and depression and concluded that disrupted patterns of circadian rhythms were associated with distressing fatigue and depressive symptoms during chemotherapy [30].…”

Section: Discussionmentioning

confidence: 99%

“…Berger et al examined patterns of circadian rhythms and their relationship with fatigue, anxiety, and depression and concluded that disrupted patterns of circadian rhythms were associated with distressing fatigue and depressive symptoms during chemotherapy [30]. Ho et al investigated the co-occurrence of and interrelations between the three symptoms prior to, after and 6 to 8 months following adjuvant chemotherapy, and their findings revealed moderate to large bivariate associations between symptoms, prior to and following treatment [31]. Bower et al examined the impact of fatigue on various components of health-related quality of life in a sample of breast cancer survivors 1 to 5 years after initial cancer diagnosis and concluded that more severe fatigue was associated with significantly higher levels of depression and sleep disturbance [32].…”

Section: Discussionmentioning

confidence: 99%

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The impact of breast cancer treatments on sleep quality 1 year after cancer diagnosis

Fontes

Pereira

Costa

et al. 2017

Support Care Cancer

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Purpose The increasing number of women living longer with potential side effects of breast cancer treatment highlights the need of a comprehensive assessment of its burden. Therefore, we aimed to quantify the relation between different breast cancer treatments and sleep quality 1 year after diagnosis. Methods A cohort of 502 newly diagnosed breast cancer patients was prospectively followed. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI), at baseline and at the 1-year follow-up. Odds ratios (OR) were computed to quantify the association between patient characteristics and poor sleep quality (PSQI score >5) at baseline, and relative risks (RR) were computed for the association between treatments and the occurrence of poor sleep quality at 1 year. Results A total of 60.2% of the patients had poor sleep quality before breast cancer treatments, especially those with anxiety [OR = 2.86, 95% confidence interval (95%CI) 1.92 to 4.27] or depression (OR = 5.25, 95%CI 2.01 to 13.67). Radiotherapy increased the risk of poor sleep quality at 1 year (RR = 3.71, 95%CI 1.15 to 11.96, for a cumulative dose >50 Gy) and there was a tendency for a higher risk in those submitted to chemotherapy, although not statistically significant.Conclusions Our study shows that sleep disturbances are frequent before cancer treatment and confirms their cooccurrence with other medical conditions, such as anxiety and depression. Different breast cancer treatments increase the risk of impaired sleep quality, therefore contributing to the global disability associated with cancer treatments.

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“…Psychological distress is prevalently related to fear of recurrence, uncertainty about the future, the ability to live with loss, changes in body image and sense of abandonment by the medical team (10). Physical symptoms are also a constant concern for breast cancer (BC) survivors including: fatigue (11); pain (12); sleep disorders (13); lymphedema (14); menopause (15)(16)(17), fertility concerns (18) and weight gain (19). Consequently, the ability to effectively intervene on psychosocial aspects associated not only with diagnosis of cancer and its treatment, but also with survival is a major challenge (20).…”

Section: Introductionmentioning

confidence: 99%

The effects of psychosocial interventions in early breast cancer survivors: a systematic review and meta-analysis

Pugliese¹

2014

RIO

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Background: international studies carried out in recent years demonstrate that cancer survivors have persistent levels of emotional distress and physical symptoms related to oncological treatments even 2-10 years after diagnosis. Consequently, the ability to effectively intervene on psychosocial aspects during survivorship is a major challenge. Several clinical trials have investigated the efficacy of psychosocial intervention on different outcome measure but the presence of methodological shortcomings do not allow conclusive evidence. Aims: our aim was to systematically review and quantify existing research investigating the efficacy of psychosocial interventions in early breast cancer survivors and to explore several moderating characteristics that could potentially impact the magnitude of the observed treatment effects. Conclusion: to our knowledge, this is the first systematic review and meta-analysis focusing on psychosocial interventions in early breast cancer survivors. The study indicates that CBT is effective for the short-term management of depression, anxiety and QoL. Besides the strengths of this meta-analysis, the presence of several methodological limitations requires further research to provide more definitive evidence for intervention efficacy in this cancer population.

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A Longitudinal Study of Depression, Fatigue, and Sleep Disturbances as a Symptom Cluster in Women With Breast Cancer

Cited by 137 publications

References 39 publications

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

The impact of breast cancer treatments on sleep quality 1 year after cancer diagnosis

The effects of psychosocial interventions in early breast cancer survivors: a systematic review and meta-analysis

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