Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis

Abstract

The fatigue and goal disturbance experienced from diagnosis to 18 months post-diagnosis differ considerably for subgroups of patients with cancer. Fatigue and concrete goal disturbance are persistent burdens in the majority of patients. Investigating symptom burden beyond average trends can guide clinicians to identify patients most in need for treatment. Targeting goal disturbance might benefit the psychological well-being in patients suffering from persistent symptoms. Statement of contribution What is already known on this subject? Fatigue is a common and distressing symptom at all stages of the cancer experience. Earlier studies suggest that many patients recover from fatigue after treatment completion. Patients with cancer experience disturbance in their personal goals, which is related to poor psychological well-being. What does this study add? Developments of fatigue and goal disturbance differ between subgroups of patients with cancer but co-occur within these subgroups. About 30% of the patients experience severe fatigue after diagnosis, of which only few patients recover within 18 months post-diagnosis. Targeting goal disturbance might benefit patients with severe and ongoing symptoms.

Trajectories of fatigue in cancer patients during psychological care

“…First, judged by the size of the effect the decrease in fatigue was smaller in the high fatigue class during psychological care, although we did not test the differences. The finding that the decrease in fatigue was smaller in the high fatigue class during psychological care seems more in line with longitudinal studies that investigated fatigue trajectories in cancer patients that do not receive psychological care (Beesley et al, 2020;Goedendorp et al, 2013;Müller et al, 2017;Person et al, 2020). Second, the decreases in the moderate and high fatigue classes do not seem to be clinically relevant.…”

“…Longitudinal studies on fatigue in cancer survivors that were treated for various malignancies showed that about a quarter of the survivors suffered from persistent fatigue (lasting for at least six months). Notably, in subgroups of cancer survivors with high levels of fatigue, fatigue decreased minimally over time (Beesley et al, 2020;Goedendorp et al, 2013;Müller et al, 2017;Person et al, 2020). Even though these studies are not a representation of all types of cancer and treatments, fatigue has considerable impact on cancer patients' daily activities and their quality of life (Donovan et al, 2013;Medysky et al, 2020;Schmidt et al, 2012), and therefore appropriate care is crucial.…”

“…As stated above, several studies showed that many cancer patients treated for various malignancies suffer from severe fatigue and that in subgroups of patients with high levels of fatigue it deceases minimally over time (Beesley et al, 2020;Goedendorp et al, 2013;Müller et al, 2017;Person et al, 2020). To tailor psychological care for cancer patients with fatigue it is not only important to identify various fatigue trajectories, but also what factors are related to these trajectories, and which factors predict fatigue during psychological care.…”

Longitudinal Associations Between Fatigue and Perceived Work Ability in Cancer Survivors

“…Spaghetti plots showed large inter-individual variability of trajectories of morning and evening fatigue of breast cancer patients who underwent radiotherapy [26]. Also, clinically distinct fatigue trajectories were found in persons diagnosed with and treated for colorectal cancer [27].…”

Cancer pain and lower functional status predict poor trajectories of symptom and fatigue distress in patients with lung cancer

“…Although it seems clear that patients with LC suffer symptom and fatigue distress, the long‐term effects on the link between symptoms and demographic or clinical factors are still not clear yet, and the changes in symptoms over time or the characteristics associated with these changes have rarely been evaluated in LC. One longitudinal study indicated that fatigue and symptom disturbance experienced from diagnosis to post‐diagnosis differed considerably for distinct trajectories of patients with cancer (Muller et al, 2017), and Brant et al (2011) also indicated that effective approaches to symptom management are dependent on an understanding of inter‐individual differences in the trajectories of patients’ symptoms. Nevertheless, these studies included patients with a variety of different cancers.…”