Identifying the subtypes of cancer-related fatigue: results from the population-based PROFILES registry

Thong, Melissa S. Y.; Mols, Floortje; Poll‐Franse, Lonneke V. van de; Sprangers, Mirjam A. G.; Rijt, Carin C.D. van der; Knoop, Hans; Husson, Olga

doi:10.1007/s11764-017-0641-0

Cited by 35 publications

(26 citation statements)

References 49 publications

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“…Women reported higher rates of lack of energy/tiredness, difficulty sleeping, and decreased sexual interest in the multivariate analysis. These associations have been found in previous studies of cancer survivors that showed women were more likely to report cancer-related fatigue [18, 19] and sexual problems [20] in various cancer diagnoses. Non-whites were at elevated risk for sore muscles and high symptom burden, which is consistent with existing research showing disparities in pain control between white and non-white survivors and reports showing that cancer survivors in minority groups are less likely to seek medical care for management of physical symptoms [21].…”

Section: Discussionsupporting

confidence: 77%

Physical symptoms in long-term survivors of rare cancer

et al. 2018

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Purpose: Advances in cancer detection and treatment have resulted in a growing population of long-term survivors, but even years after treatment has concluded many survivors report physical symptoms that interfere with daily living. While there are studies of late effects following common cancers, less is known about these complications in rare cancers. This study focuses on the physical symptoms reported by long-term survivors enrolled in the NIH-sponsored Rare Cancer Genetics Registry. Methods: The Rotterdam Symptom Checklist-Modified was administered to evaluate the severity of physical symptoms commonly reported by long-term cancer survivors. Logistic regression was used to assess association between symptoms and demographic and clinical factors. Results: In 309 subjects with a median time of 7.6 years from a diagnosis of one or more rare cancers the median number of symptoms present per participant was 7. The most prevalent symptom reported was tiredness/lack of energy, which was present/very bothersome in 70%/25% of registrants. Women, non-whites, current smokers, and upper GI cancer survivors are particularly affected. Overall, symptom prevalence was similar across rare cancer types, time since diagnosis, and type of treatment. Conclusions: Rare cancer survivors continue to experience troublesome symptoms many years after diagnosis, regardless of cancer type or treatment modality. Impact for Cancer Survivors: There is a need for continued emphasis on smoking cessation in cancer survivors as well as enhanced monitoring of long-term complications in female, non-white, and upper GI cancer survivors.

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Section: Discussionsupporting

confidence: 77%

Physical symptoms in long-term survivors of rare cancer

et al. 2018

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“…CRF and anhedonia have a similar phenomenology and tend to co‐occur . In our previous study, we identified subtypes of fatigue using the Multidimensional Fatigue Inventory . Our findings suggest that male and female CRC survivors could experience CRF and symptoms of anhedonia differently as female survivors were more likely to be classified in either the “low fatigue, moderate distress” or “high fatigue, moderate distress” subgroups.…”

Section: Discussionmentioning

confidence: 67%

The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

et al. 2019

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Purpose Cancer‐related fatigue (CRF) is one of the most prevalent symptoms experienced by cancer survivors. However, researchers are only beginning to elucidate the risk factors, underlying mechanism(s), and its association with other outcomes. Research on the association between CRF and mortality is limited. Methods The study sample comprised 2059 short‐term (<5 years postdiagnosis) cancer survivors from four PROFILES registry studies. Survivors diagnosed with stage I‐III colorectal cancer (CRC) or stage I‐III endometrial cancer (EC), with no evidence of disease, were identified and followed‐up by the Netherlands Cancer Registry. Fatigue was assessed with the Fatigue Assessment Scale. Cox proportional hazards models adjusted for demographic, clinical, and lifestyle characteristics were performed to assess the association of CRF with all‐cause mortality. Date of censoring was February 1, 2017. Results Prevalence of CRF varied between 35.8% (male CRC) and 43.6% (female CRC). After a median follow‐up period of 9.0 years, a total of 408 survivors (20%) had died. CRF was associated with increased all‐cause mortality in male CRC survivors (HRadj = 1.75, 95% CI [1.31‐2.33]). This association remained statistically significant after excluding survivors experiencing anhedonia. For female CRC (HRadj = 1.32, 95% CI [0.90‐1.97]) and EC (HRadj = 1.27, 95% CI [0.84‐1.90]) survivors, there was no significant association with all‐cause mortality for the fatigued group in multivariable analyses. Conclusion Our study found that CRF is significantly associated with all‐cause mortality in male CRC survivors, irrespective of potential confounders. This result suggests that clinicians should increase their attention towards the recognition and treatment of CRF.

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“…Also in other diagnostic groups (i.e. Parkinson's Disease, Colorectal Cancer), patient profiling did not result in clear differentiation based on the most affected fatigue domains 34,35 . An explanation for the absence of distinct profiles for type of fatigue might be related to the inability of patients to make further distinctions when fatigue becomes very severe.…”

Section: Discussionmentioning

confidence: 80%

Fatigue Profiles in Patients with Multiple Sclerosis are Based on Severity of Fatigue and not on Dimensions of Fatigue

Beckerman

Eijssen

Meeteren

et al. 2020

Sci Rep

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Fatigue related to Multiple Sclerosis (MS) is considered a multidimensional symptom, manifesting in several dimensions such as physical, cognitive, and psychosocial fatigue. This study investigated in 264 patients with severe primary MS-related fatigue (median MS duration 6.8 years, mean age 48.1 years, 75% women) whether subgroups can be distinguished based on these dimensions. Subsequently, we tested whether MS-related fatigue consists of a single common unidimensional factor. Subscale scores on four self-reported fatigue questionnaires, including the Checklist of Individual Strength, the Modified Fatigue Impact Scale, the Fatigue Severity Scale and the SF36 vitality, were used in a cluster analysis to identify patients with similar fatigue characteristics. Next, all 54 items were included in exploratory factor analysis to test unidimensionality. Study results show that in patients with a treatment indication for primary MS-related fatigue, fatigue profiles are based on severity and not on the various dimensions of fatigue. The three profiles found, suggested one underlying fatigue dimension, but this could not be confirmed. Factor analysis of all 54 items resulted in 8 factors, confirming the multidimensional construct of the included fatigue questionnaires. Multiple sclerosis-related fatigue is a disabling symptom that affects most patients during the neuroprogressive course of the disease 1-4. MS-related fatigue is a puzzling interplay between multiple genotypic and phenotypic factors 5,6. Fatigue can be caused either directly by the MS disease process in the central nervous system (i.e. primary fatigue), initiated by inflammatory processes associated with immune activation, demyelination, axonal loss or neuroendocrine disturbance, or indirectly by other problems (i.e. secondary fatigue) such as insomnia, sleep disturbance due to urge incontinence or spasticity, acute infections, thyroid disorders, physical inactivity and deconditioning, or depression. In all cases, a correct differential diagnosis is required for proper clinical decision making. There are many definitions of fatigue (see Supplementary Information 1 for references regarding Fatigue Definitions) and over 250 ways to measure fatigue 7. Examples of frequently used definitions of MS-related fatigue include: the reduction in performance following either prolonged or unusual exertion, together with feelings of sensory, motor, cognitive or subjective fatigue 8 ; a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual and desired activities 9 ; the perception of decreased mental or physical energy that may restrict routines of daily activities 10 ; the failure to initiate and/or sustain attentional tasks (mental or cognitive fatigue) and physical activities (physical fatigue) 5. Dittner et al. 11 recognized the wide range of fatigue definitions as a so-called Catch-22 situation: "Before a concept can be measured, it must be defined, and before a definition can be agreed, there must ...

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Identifying the subtypes of cancer-related fatigue: results from the population-based PROFILES registry

Cited by 35 publications

References 49 publications

Physical symptoms in long-term survivors of rare cancer

Physical symptoms in long-term survivors of rare cancer

The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

Fatigue Profiles in Patients with Multiple Sclerosis are Based on Severity of Fatigue and not on Dimensions of Fatigue

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