Fatigue prevalence in men treated for prostate cancer: A systematic review and meta-analysis

Abstract

BACKGROUND The side effects of prostate cancer (PCa) treatment are very prominent, with cancer-related fatigue (CRF) being the most common. Fatigue is a distressing symptom that interferes with daily functioning and seriously affects patient quality of life during, and for many years after, treatment. However, compared with other types of cancer, such as breast cancer, little is known about the prevalence of PCa-related fatigue. AIM To determine the prevalence of CRF in patients with PCa. METHODS A systematic search of EMBASE, PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, WANFANG DATA, Technology Journal Database and the Chinese Biological Medical Database was conducted up to July 28, 2020. Included studies measured the incidence of PCa-related fatigue and differentiated fatigue outcomes (incidence) between treatment modalities and fatigue assessment times. In our meta-analysis, both fixed and random-effects models were used to estimate the pooled prevalence of PCa-related fatigue. Subgroup analyses were performed using treatment modalities and fatigue assessment times. Publication and sensitivity bias analyses were performed to test the robustness of the associations. RESULTS Fourteen studies, involving 4736 patients, were eligible for the review. The pooled CRF prevalence was 40% in a total sample of 4736 PCa patients [95% confidence interval (CI): 29-52; P < 0.01; I 2 = 98%]. The results of the subgroup analyses showed the prevalence of CRF after androgen deprivation therapy treatment, radical prostatectomy and radiotherapy to be 42% (95%CI: 20-67, P < 0.01, I 2 = 91%), 21% (95%CI: 16-26, P = 0.87, I 2 = 0%) and 40% (95%CI: 22-58, P < 0.01, I 2 = 90%), respectively. The prevalence of acute and persistent fatigue was 44% (95%CI: 25-64; P < 0.01; I 2 = 93%) and 29% (95%CI: 25-32; P = 0.30; I 2 = 17%), respectively. CONCLUSION Our meta-analysis showed that fatigue is a common symptom in men with PCa, especially those using hormone therapy.

Patients’ Preferences for Androgen Deprivation Therapy in the Treatment of Intermediate-Risk Prostate Cancer

“…16 Its prevalence among patients receiving ADT is estimated to be 42% to 68% and is likely compounded by the receipt of EBRT. 17,18 In the current study, patients reported being willing to trade 3 mo of life expectancy to be able to avoid ADT-related fatigue entirely, underscoring its profound perceived impact on quality of life, both among patients who had accepted and declined it. Lifestyle changes, including physical exercise and dietary modification, are considered to be the best interventions to mitigate ADT-related fatigue.…”

Does hormone therapy impact cognition in patients with prostate cancer? A systematic review and meta‐analysis

“…In particular, it has been reported that the prevalence of fatigue in patients with PC after radiotherapy and radical prostatectomy ranges from 22% to 58% and from 16% to 26%, respectively. 60 During follow-up, seven of the 20 studies included in the systematic review showed a decline in objective cognition or demonstrated a between-group difference with greater impairment in the HT group.…”

“…Many patients considered in this synthesis had already received treatment likely to affect cognition directly and indirectly according to the aforementioned factors. In particular, it has been reported that the prevalence of fatigue in patients with PC after radiotherapy and radical prostatectomy ranges from 22% to 58% and from 16% to 26%, respectively 60 …”

Fatigue in Prostate Cancer: A Roundtable Discussion and Thematic Literature Review

“…Indeed, fatigue is well documented to significantly affect the lives of prostate cancer patients and their ability to cope with everyday activities ( Supplementary material [S11,12]) [13] . In previous studies investigating the prevalence of cancer-related fatigue for prostate cancer patients, rates have varied between 13% and 82% ( Supplementary material [S13]) [13] , [14] , [15] . A more recent meta-analysis, however, suggests prevalence in the region of 40% [13] .…”

“…In previous studies investigating the prevalence of cancer-related fatigue for prostate cancer patients, rates have varied between 13% and 82% ( Supplementary material [S13]) [13] , [14] , [15] . A more recent meta-analysis, however, suggests prevalence in the region of 40% [13] . This still represents a sizeable proportion of men with prostate cancer who experience debilitating fatigue.…”