Cancer-related fatigue: Links with inflammation in cancer patients and survivors

Bower, Julienne E.

doi:10.1016/j.bbi.2007.03.013

Cited by 222 publications

(171 citation statements)

References 49 publications

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“…Earlier research has suggested that increased proinflammatory cytokine activity and increased cytokine production in response to lipopolysaccharides are associated with chronic fatigue. 9,13,15,24 Our findings support this hypothesis to some extent, because many of the core genes are involved in cytokine and stress responses, and the gene sets identified are part of the immune system. Our results indicate that a B-cell-mediated inflammatory process might underlie fatigue.…”

Section: Discussionsupporting

confidence: 73%

“…5,7,8 Some studies have investigated the role of the immune system and, in particular, the role of cytokines in relation to fatigue in breast cancer survivors. [9][10][11][12][13][14][15] Fatigued breast cancer survivors have been shown to have significantly higher levels of proinflammatory cytokines and circulating T lymphocytes compared with non-fatigued survivors. 9,10,15 Bower et al 11,12 showed that fatigued breast cancer survivors had an altered diurnal cortisol rhythm, and, compared to non-fatigued survivors, a blunted cortisol response to experimental stressors.…”

Section: Introductionmentioning

confidence: 99%

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Alterations of gene expression in blood cells associated with chronic fatigue in breast cancer survivors

et al. 2009

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Fatigue is one of the most frequent complaints among breast cancer survivors. However, mechanisms underlying persisting fatigue after end of treatment are poorly understood. To explore whether biological processes underlying persistent fatigue can affect gene expression of blood cells, genome-wide expression analyses were performed on whole blood samples from breast cancer survivors classified as chronic fatigued 2-6 years after diagnosis. Non-fatigued survivors served as controls. Several gene sets involved in plasma-and B-cell pathways differed between the chronic fatigued and the non-fatigued, suggesting that a dysregulation in these pathways is associated with chronic fatigue and that a B-cell-mediated inflammatory process might underlie fatigue. The chronic fatigued also had a higher level of leucocytes, lymphocytes and neutrophiles compared with the non-fatigued, thus further indicating that an activation of the immune system plays a role in the biology of chronic fatigue in breast cancer survivors.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Alterations of gene expression in blood cells associated with chronic fatigue in breast cancer survivors

et al. 2009

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“…6 Monk et al observed in advanced cancer patients that the use of Etanercept (Enbrel), which works by reducing the effects of TNF, safely and effectively reduced their reported levels of fatigue. 94…”

Section: Pharmacotherapymentioning

confidence: 99%

Breast Cancer and Fatigue

Bardwell

Ancoli‐Israel

2008

Sleep Medicine Clinics

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SynopsisFatigue is a common and disabling symptom in breast cancer patients and survivors. A rather nebulous concept, fatigue overlaps with sleepiness and depressed mood. In this chapter, we cover methods for assessing fatigue; describe the occurrence of fatigue before, during and after initial treatment; present possible underlying mechanisms of fatigue; and, enumerate approaches to its treatment. KeywordsFatigue; breast cancer; sleep; mood; fatigue assessment Fatigue is a common and frequently disabling symptom in cancer patients and cancer survivors. 1,2 Fatigue is also often a presenting symptom at cancer diagnosis. 3-5 Cancer fatigue differs from other manifestations of fatigue in that it is generally not alleviated by sleep or rest, is typically of greater duration and severity, is often associated with high levels of distress, and is disproportionate to the level of exertion. 6-11 Cancer-related fatigue often co-occurs with other troublesome symptoms such as pain, sleep disturbance, and depression. 12-14 Thus, the impact of cancer fatigue on health-related quality of life can be substantial, reducing the patient's engagement in work, personal and social activity. 2,15-17 Some studies have reported that fatigue in cancer patients has a greater negative impact on quality of life than all other symptoms, including nausea, pain and depression. 2,18 Treatment of cancer-related fatigue has been recently identified as a priority by the National Institutes of Health. 19 Specific to breast cancer, fatigue is reported by a substantial majority of patients during their initial treatment (surgery, radiation, and/or chemotherapy). In addition, although estimates vary widely, approximately 33% of individuals with breast cancer report persistent fatigue up to ten years into survivorship. 6,20,21 Fatigue is a rather nebulous symptom; hence, numerous definitions of this construct are found in the literature. 6,22 Complicating this situation is the fact that breast cancer patients and survivors commonly complain of both sleepiness and fatigue. 23 These terms are often used interchangeably, and both have been linked to decrements in various aspects of health-related Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. As is the case with pain, fatigue is a complaint that is almost always evaluated using self-report scales. 6,24 Therefore, by default, fatigue is ultimately defined by the instruments employed for its measurement. In the next section we provide an overview of several types of scales for assessing fatigue. NIH Public Access Assessment of FatigueThere are numerous self-r...

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“…[19][20][21][22] Not only is fatigue highly prevalent, but it is also reported to be the most distressing symptom, affecting the patient's quality of life and daily activities negatively. [19][20][21] Given this wide prevalence among cancer patients, and even cancer survivors several years after complete remission, 23,24 it is clear that the underlying mechanisms may deeply involve various components of human physiology. Thus, possible causes of fatigue can involve the periphery (eg, neuromuscular junctions and proprioceptive fibers), the central nervous system (eg, neuromediators imbalance, inflammatory cytokines, hormonal dysfunction, autonomic dereg ulation, and circadian disruption), and comorbid conditions, such as anemia, cachexia, and depression.…”

Section: Fatigue In Cancer Patientsmentioning

confidence: 99%

Circadian Disruption, Fatigue, and Anorexia Clustering in Advanced Cancer Patients: Implications for Innovative Therapeutic Approaches

et al. 2009

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A disruption of the circadian timing system, as identified by monitoring of marker biorhythms, is common in cancer patients. The recording of the rest-activity rhythm with a wrist actigraph has been commonly used. This noninvasive monitoring allows a robust estimation of circadian disruption. The authors have previously found that altered patterns of circadian rest-activity rhythms are significantly and independently associated with the severity of fatigue and anorexia in patients with metastatic colorectal cancer. Elevated proinflammatory cytokines could partly account for this circadian disruption and its associated constitutional symptoms. Here, the authors present and discuss the data supporting the hypothesis that circadian disruption is often associated with fatigue and anorexia, which in turn further alter and dampen circadian synchronization, thus, creating a vicious cycle. This body of evidence paves the path for innovative therapeutic approaches targeting the circadian timing system in an effort to diminish constitutional symptoms induced by cancer and some anticancer treatments.

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Cancer-related fatigue: Links with inflammation in cancer patients and survivors

Cited by 222 publications

References 49 publications

Alterations of gene expression in blood cells associated with chronic fatigue in breast cancer survivors

Alterations of gene expression in blood cells associated with chronic fatigue in breast cancer survivors

Breast Cancer and Fatigue

Circadian Disruption, Fatigue, and Anorexia Clustering in Advanced Cancer Patients: Implications for Innovative Therapeutic Approaches

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