Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study

Storey, Dawn J; Waters, Rachael A.; Hibberd, Carina; Rush, Robert; Cargill, Anna; Wall, Lucy; Fallon, Marie; Strong, Vanessa; Walker, Jane; Sharpe, Michael

doi:10.1093/annonc/mdm349

Cited by 59 publications

(36 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The existing fatigue data have been predominantly derived from breast cancer patients during their adjuvant treatment with radiation and/or chemotherapy, with some studies evaluating other patient cohorts after therapy or during treatment or groups of advanced cancer patients referred for specialized care 6 . Although these data focus on the construct of patient-reported fatigue rather than cancer-related fatigue, our findings are consistent with data related to cancer-related fatigue from other researchers who have found that approximately 30%–60% of patients have mild to moderate fatigue, approximately 20% of patients have severe levels of fatigue during or shortly after treatment for cancer, and approximately 10%–15% have fatigue as a chronic effect of treatment 26–31 .…”

Section: Discussionsupporting

confidence: 91%

Predictors of significant worsening of patient‐reported fatigue over a 1‐month timeframe in ambulatory patients with common solid tumors

Fisch

Zhao

O’Mara

et al. 2013

Cancer

View full text Add to dashboard Cite

Purpose Understanding the determinants of fatigue worsening may help distinguish between different fatigue phenotypes and inform clinical trial designs. Patients and Methods Patients with invasive cancer of the breast, prostate, colon/rectum, or lung were enrolled from multiple sites. At enrollment during an outpatient visit and 4–5 weeks later patients rated their symptoms on a 0–10 numerical rating scale. A 2-point change was considered clinically significant for fatigue change. Effects of demographic and clinical factors on patient-reported fatigue were examined using logistic regression models. Results 3123 patients were enrolled at baseline and 3032 were analyzable for fatigue change. At baseline, 23% had no fatigue, 35% mild, 25% moderate, and 17% severe. Key parameters in our model of fatigue worsening includes fatigue at baseline (OR 0.75), disease status (OR 1.99), performance status (OR 1.38), history of depression (OR 1.28), patient perception of bother due to comorbidity (OR 1.26) and treatment exposures including recent cancer treatment (OR 1.77), and use of corticosteroids (1.37). The impact of gender was examined only in colorectal and lung cancer patients, and it was a significant factor with men most likely to experience worsening of fatigue (OR=1.46). Conclusions Predictors of fatigue worsening include multiple factors that are difficult to modify: baseline fatigue level, gender, disease status, performance status, recent cancer treatment, bother due to comorbidity, and history of depression. Future fatigue prevention and treatment trial designs should account for key predictors of worsening fatigue.

show abstract

Section: Discussionsupporting

confidence: 91%

Predictors of significant worsening of patient‐reported fatigue over a 1‐month timeframe in ambulatory patients with common solid tumors

Fisch

Zhao

O’Mara

et al. 2013

Cancer

View full text Add to dashboard Cite

show abstract

“…When fatigue prevalence (26.8%) and intensity (mean=5.8; SD=1.3; median=5.4) in this research were compared to studies involving other cancer patients, it was noted that fatigue was less frequent than in studies on patients in palliative care and receiving adjuvant chemotherapy or radiotherapy (1)(2) , and higher than some cancer survivors' experience, who reported 26% (8) . A slightly higher prevalence of fatigue (33%), using the same cut-off score as this study, was observed among colorrectal cancer patients in the United Kingdom (22) . This higher prevalence might be due to the instrument used for fatigue assessment.…”

supporting

confidence: 64%

Fatigue in colorectal cancer patients: prevalence and associated factors

Mota

Pimenta

Caponero

2012

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

This study identified the prevalence and predictors of fatigue in colorectal cancer (CRC) patients.Cross-sectional study with 157 adult CRC outpatients (age 60±11.7 years; 54% male; cancer stage IV 44.8%). The Piper Fatigue Scale-revised was used to assess fatigue scores. Socio-demographic, clinical, depression, performance status, pain and sleep disturbance data were assessed. Associations between fatigue and these data were analyzed through logistic regression models. Fatigue was reported by 26.8% patients. Logistic regression identified three predictors: depression (OR: 4.2; 95%CI 1.68-10.39), performance status (OR: 3.2; 95%CI 1.37-7.51) and sleep disturbance (OR: 3.2; 95%CI 1.30-8.09). When all predictors were present, the probability of fatigue occurrence was 80%; when none were present, the probability was 8%. The model's specificity and sensitivity were 81.9% and 58.6%, respectively. Through the assessment of depression, performance status and sleep disturbance, the probability of fatigue occurrence can be estimated, and preventive and treatment strategies can be rapidly implemented in clinical practice. Fatiga en pacientes con cáncer cuello rectal: superioridad y factores asociadosLos objetivos de este estudio fueron la identificación de la superioridad y los predictores de fatiga en pacientes con Cáncer Cuello rectal (CCR). Se trata de estudio seccional con 157 pacientes de ambulatorio con CCR (edad 60±11,7 años; 54% hombres; estadio cáncer IV 44,8%). La Escala de Fatiga de Piper -Revisada fue utilizada para evaluar fatiga. Datos sociodemográficos, clínicos, depresión, funcionalidad, dolor y sueño fueron evaluados. La asociación entre variables fue realizada por regresión logística. Fatiga fue reportada por 26,8% pacientes. Por la regresión logística se identificaron tres predictores: depresión (OR: 4,2; 95%IC 1,68-10,39), funcionalidad (OR: 3,2; 95%IC 1,37-7,51) y perjuicio del sueño (OR: 3,2; 95%IC 1,30-8,09). Cuando todos predictores estaban presentes, la probabilidad de ocurrencia de fatiga fue del 80%; cuando ninguno estaba presente, la probabilidad fue del 8%. La especificidad y sensibilidad del modelo fueron, respectivamente, 81,9 y 58,6%. Conociéndose la probabilidad de fatiga, por medio de la evaluación de depresión, funcionalidad y perjuicio del sueño, se vuelve posible la implementación de estrategias de prevención y tratamiento en la clínica.

show abstract

“…However fatigue and depression should be regarded as separate entities. 43 There are some important negative fi ndings in this study. There were no signifi cant differences in any of the routine laboratory tests.…”

Section: Discussionmentioning

confidence: 74%

A comparison of cognitive function, sleep and activity levels in disease-free breast cancer patients with or without cancer-related fatigue syndrome

Minton

Stone

2012

BMJ Support Palliat Care

View full text Add to dashboard Cite

BackgroundChronic fatigue is a feature in a subset of women successfully treated for breast cancer but is not well characterised. This study examines differences in objective cognitive function, activity levels and sleep in disease-free women who do and do not meet criteria for cancer-related fatigue syndrome (CRFS).MethodsWomen between 3 months and 2 years after completion of any primary therapy were recruited from a cancer centre follow-up clinic. On the basis of a diagnostic semi-structured interview they were classified as being CRFS cases or non-fatigued controls. Participants underwent objective cognitive testing using a computerised battery, wore an activity monitor for 1 week and completed quality of life and fatigue questionnaires.Results114 women were recruited (69 controls and 45 CRFS cases). There were significant differences between groups on fatigue, mood, sleep and quality of life scores, and in objective cognitive testing (tests of sustained attention, reaction time and verbal memory all p<0.03). There was an overall difference in daytime activity (p=0.03) from actigraphy recordings. There were no differences on objective measures of sleep or in routine laboratory measures.ConclusionsOur preliminary results suggest that disease-free women with CRFS after successful breast cancer treatment have significantly lower subjective quality of life and mood. Additionally, objective cognitive impairment in certain domains may play an important role in the subjective manifestation of these symptoms. There is also objective evidence on actigraphy of differing levels of activity. The subjective sleep disturbance and higher prevalence of insomnia do not correlate with objective measures.

show abstract

Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study

Abstract: CRF is common in cancer outpatients and is associated with type of disease and treatment, as well as with emotional distress. The association between CRF and emotional distress is strong but they are not equivalent conditions.

Cited by 59 publications

References 25 publications

Predictors of significant worsening of patient‐reported fatigue over a 1‐month timeframe in ambulatory patients with common solid tumors

Predictors of significant worsening of patient‐reported fatigue over a 1‐month timeframe in ambulatory patients with common solid tumors

Fatigue in colorectal cancer patients: prevalence and associated factors

A comparison of cognitive function, sleep and activity levels in disease-free breast cancer patients with or without cancer-related fatigue syndrome

Contact Info

Product

Resources

About