Associations among menopausal symptoms, sleep and fatigue in Taiwanese women with endometrial cancer

Li, Chia-Chun; Tsai, Yun‐Fang; Chang, Ting‐Chang; Chen, Lynn

doi:10.1111/ecc.12559

Cited by 14 publications

(12 citation statements)

References 109 publications

(164 reference statements)

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“…The result of the regression analysis showed that sleep quality, comorbidity and age were important predictors of fatigue. This supported the findings of past research on ovarian or breast cancer populations, which showed that survivors with poorer sleep quality (Li et al, 2017), higher comorbidity index (Jones et al, 2016) and younger age (Bifulco et al, 2012) had higher fatigue level.…”

Section: Discussionsupporting

confidence: 90%

“…Our study subjects had a moderate level of fatigue similar to what was reported in previous studies (Li et al, 2017). The result of the regression analysis showed that sleep quality, comorbidity and age were important predictors of fatigue.…”

Section: Discussionsupporting

confidence: 87%

“…According to the result of a cross-sectional study (n = 95) conducted in Taiwan, most endometrial cancer survivors (55%) had poor sleep quality, and there was a negative correlation between sleep quality and fatigue. The time since diagnosis, sleep quality and menopause together were responsible for 39% of the fatigue variability (Li, Tsai, Chang, & Chen, 2017). Among the remaining studies supporting the link between sleep quality and fatigue, most findings were obtained from patients with other cancers, and studies of endometrial cancer survivors are relatively rare (Tian, Chen, & Zhang, 2015).…”

Section: What Does This Paper Contribute To the Wider Global Clinical Community?mentioning

confidence: 99%

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Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross‐sectional study

Wang

Chang

et al. 2020

Journal of Clinical Nursing

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Aims and objectives The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. Background As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health‐related quality of life. Design This study adopted a cross‐sectional correlational research design. The STROBE checklist for cross‐sectional studies was used as a reference for reporting the study. Methods A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. Results Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = −0.38), comorbidity index (ß = −0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. Conclusions Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. Relevance to clinical practice The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: What Does This Paper Contribute To the Wider Global Clinical Community?mentioning

confidence: 99%

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Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross‐sectional study

Wang

Chang

et al. 2020

Journal of Clinical Nursing

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“…Furthermore, after adjusting for the different treatment modalities and patient characteristics, physical fatigue levels were significantly higher among endometrial compared to breast cancer patients. Although the difference failed statistical significance after adjusting for multiple testing ( P = .17), it might be worth considering that fatigue in endometrial cancer has been found to be associated with menopausal symptoms, which are a common consequence of the surgical procedures for this type of cancer that result in estrogen deficiency 25 . Thus, hormonal pathways may be more relevant in fatigue etiology with this type of cancer than in many other cancer types.…”

Section: Discussionmentioning

confidence: 96%

“…Although the difference failed statistical significance after adjusting for multiple testing (P = .17), it might be worth considering that fatigue in endometrial cancer has been found to be associated with menopausal symptoms, which are a common consequence of the surgical procedures for this type of cancer that result in estrogen deficiency. 25 Thus, hormonal pathways may be more relevant in fatigue etiology with this type of cancer than in many other cancer types. Surprisingly, bladder cancer patients had the highest prevalence of emotional fatigue (49%) although prevalence for physical fatigue (38%) was among the lowest of all considered entities.…”

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confidence: 99%

Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

et al. 2020

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Background Fatigue prevalence and severity have been assessed in a variety of studies, yet, not in a standardized way, and predominantly in breast cancer patients. Systematic, comparative investigations across a broad range of cancer entities are lacking. Methods The FiX study systematically enrolled 2244 cancer patients across 15 entities approximately 2 years after diagnosis. Fatigue was assessed with the multidimensional EORTC QLQ‐FA12 questionnaire. Physical, emotional, cognitive, and total fatigue were compared across entities and with normative values of the general population. Differences in patients' characteristics and cancer therapy between entities were taken into account using analyses of covariance models. Results Across all entities, mean physical fatigue levels were significantly higher than age‐ and sex‐matched means of the general population for all cancer entities (all Bonferroni‐Holm adjusted P < .01). For most entities also emotional and cognitive fatigue levels were significantly higher than normative values. Age‐ and sex‐standardized physical fatigue prevalence ranged from 31.8% among prostate to 51.7% among liver cancer patients. Differences between entities could not be fully explained by sex, age, BMI, or cancer therapy. Adjusted for these factors, mean physical fatigue was higher for stomach (P = .0004), lung (P = .034), kidney (P = .0011), pancreas (P = .081), and endometrium (P = .022) compared to breast cancer patients. Adjusted means of emotional fatigue were also lowest in breast cancer patients and significantly higher in stomach (P = .0047), bladder (P = .0036), and rectal (P = .0020) cancer patients. Conclusions Physical, emotional, and cognitive fatigue is prevalent in all 15 investigated cancer entities even 2 years after diagnosis. Fatigue in breast cancer patients, the so‐far most studied group, is in the lowest range among all entities, suggesting that the extent of fatigue is still insufficiently determined. Entity‐specific problems might need to be considered in the treatment of fatigue.

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Proposal for Managing Cancer‐Related Insomnia: A Systematic Literature Review of Associated Factors and a Narrative Review of Treatment

Saeki,

Sumi,

Ozaki

et al. 2024

Cancer Medicine

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ObjectiveInsomnia is common in patients with cancer. It has a multifactorial etiology that may include the disease process, adverse effects of anticancer therapies, and/or an association with other comorbidities. The purpose of this review was to identify risk factors for insomnia and suggest optimal management strategies.MethodsWe conducted a systematic literature review to elucidate the risk factors for insomnia and sleep disturbances in patients with solid tumors. The effects of sleep medications in this population were also described.ResultsA total of 75 publications were evaluated, including those on breast, lung, gynecologic, brain, head and neck, gastrointestinal, prostate, thyroid, and mixed cancers. We classified the factors related to insomnia or sleep disturbance in cancer into four categories: (1) patient demographic characteristics (e.g., age, marital or socioeconomic status); (2) mental state (e.g., depression or anxiety); (3) physical state (e.g., fatigue, pain, or restless legs syndrome); and (4) anticancer treatment‐related (e.g., use of chemotherapy, opioids, or hormone therapy). Overall, literature on the pharmacologic treatment of insomnia is extremely limited, although some efficacy data for zolpidem and melatonin have been reported.ConclusionsDemographic characteristics, physical and mental distress, and anticancer treatments are all risks for insomnia in patients with cancer. The limited evidence base for pharmacologic therapy in this patient population means that healthcare professionals need to implement a comprehensive and multidisciplinary pathway from screening to management.

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Associations among menopausal symptoms, sleep and fatigue in Taiwanese women with endometrial cancer

Cited by 14 publications

References 109 publications

Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross‐sectional study

Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross‐sectional study

Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

Proposal for Managing Cancer‐Related Insomnia: A Systematic Literature Review of Associated Factors and a Narrative Review of Treatment

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