Nausea and disturbed sleep as predictors of cancer-related fatigue in breast cancer patients: a multicenter NCORP study

Abstract

Purpose Cancer-related fatigue (CRF) is a prevalent and distressing side effect of cancer and its treatment that remains inadequately understood and poorly managed. A better understanding of the factors contributing to CRF could result in more effective strategies for the prevention and treatment of CRF. The objectives of this study were to examine the prevalence, severity and potential predictors for the early onset of CRF after chemotherapy cycle 1 in breast cancer patients. Methods We report on a secondary data analysis of 548 female breast cancer patients from a phase III multi-center randomized controlled trial examining antiemetic efficacy. CRF was assessed by the Brief Fatigue Inventory at pre- and post-chemotherapy cycle 1 as well as by the four-day diary. Results The prevalence of clinically relevant post-CRF was 75%. Linear regression showed that pre-treatment CRF, greater nausea, disturbed sleep, and younger age were significant risk factors for post-CRF (adjusted R2=0.39; P<0.0001). Path modeling showed that nausea severity influenced post-CRF both directly and indirectly by influencing disturbed sleep. Similarly, pre-treatment CRF influenced post-CRF directly as well as indirectly through both nausea severity and disturbed sleep. Pearson correlations showed that changes in CRF over time were significantly correlated with concurrent changes in nausea severity (r=0.41; P<0.0001) and in disturbed sleep (r=0.20; P<0.0001). Conclusion This study showed a high prevalence (75%) of clinically relevant CRF in breast cancer patients following their initial chemotherapy, and that nausea severity, disturbed sleep, pre-treatment CRF, and age were significant predictors of symptom.

Factors of the evolution of fatigue dimensions in patients with breast cancer during the 2 years after surgery

“…Most demographical characteristics-marital status, cohabitation, employment, physical activity and daily help-were not significantly related to CRF. Young age was associated with increased levels of fatigue in some research, 23 but we found the contrary in the reduced motivation dimension. Another study supported our findings, showing that older adults, whatever the type of cancer they had, reported more fatigue than did younger adults.…”

Distinct evening fatigue profiles in oncology outpatients receiving chemotherapy

“…Additional studies of patients with cancers that occur across both genders (e.g., GI, lung) will allow for an evaluation of the independent contributions of gender and cancer diagnosis to evening fatigue severity. In prior reports,[5,9,46] the association between years of education and higher mean fatigue scores is inconsistent. Whether education is a proxy for some other demographic characteristic (e.g., socioeconomic status) warrants investigation in further studies.…”

Efficacy and Safety of the Traditional Herbal Medicine, Gamiguibi-tang, in Patients With Cancer-Related Sleep Disturbance: A Prospective, Randomized, Wait-List-Controlled, Pilot Study

“…Patients with cancer usually experience a cluster of symptoms, including sleep disturbance, fatigue, depression, and anxiety. 2 Sleep disturbance is closely correlated with cancer-related fatigue, 29 but pharmacological intervention in conventional medicine has clinical limitations in improving fatigue in patients with cancer or survivors of cancer with insomnia. 30 In our study, fatigue was alleviated in addition to sleep improvement.…”