Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis

Maqbali, Mohammed Al; Sinani, Mohammed Al; Naamani, Zakariya Al; Badi, Khalid Al; Tanash, Mu’ath

doi:10.1016/j.jpainsymman.2020.07.037

Cited by 149 publications

(115 citation statements)

References 154 publications

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“…More than 500 titles have been screened. In addition, the systematic reviews and meta-analysis mentioned above have been reviewed to find eligible studies [ 1 , 10 , 12 , 19 , 20 , 21 , 25 ]. The inclusion criteria for studies presented in Table 3 were randomized, controlled trials, patients ≥18 years with any type of advanced cancer and/or in a palliative care setting with a pharmacological intervention with a control group and with outcome measure of effect on CRF.…”

Section: Methodsmentioning

confidence: 99%

“…However, in the study by Ma et al, lower performance status was assessed as the most prominent risk factor for CRF [ 25 ]. Similarly, Al Maqbali et al noted the highest frequency of CRF in patients with advanced disease [ 12 ]. In a nationwide Australian study on routinely collected data from more than 116,000 subjects, 80% of cancer patients reported fatigue during the last 60 days of life, and 50% assessed fatigue level to be moderate or severe [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…Various measurements are being used to assess presence, frequency and severity of symptoms in palliative care [ 7 , 11 , 12 ]. The presence of fatigue in patients with cancer with palliative needs is of risk of being overseen by health care personnel due to difficulties in identifying the symptom but also due to a lack of enhanced knowledge of mechanisms causing fatigue.…”

Section: Introductionmentioning

confidence: 99%

“…Two systematic reviews with meta-analyses on the prevalence of fatigue in cancer patients (all stages) have recently been published [ 12 , 23 , 24 , 25 ], with frequency of fatigue in the pooled data reported to be 52 and 49% respectively. A comparison of these two meta-analyses is presented in Table 2 .…”

Section: Introductionmentioning

confidence: 99%

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Fatigue in Cancer Patients in Palliative Care—A Review on Pharmacological Interventions

Klasson

Frankling

Hagelin

et al. 2021

Cancers

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Fatigue is one of the most distressing symptoms experienced by cancer patients. The suggested biological mechanism for cancer related fatigue (CRF) includes immune activation triggered by tumor tissue or by anticancer treatment but other mechanisms have also been proposed. Previous large meta-analysis of interventions on fatigue focuses mostly on patients early in the disease trajectory, with only one tenth of included studies performed in palliative cohorts. The aim of this narrative review is therefore to present a background on CRF with focus on the palliative setting. A summary of recent randomized, controlled trials on pharmacological interventions on CRF in palliative care is presented, including studies on psychostimulants, corticosteroids, testosterone and melatonin. Interestingly, in several of these studies there was a positive and similar effect on fatigue in both the intervention and the placebo arm—indicating an important placebo effect for any pharmacological treatment. In addition, studies on dietary supplements and on pharmacological complementary medicines are discussed. To conclude, the evidence is still weak for using pharmacological treatments on CRF in palliative care patients—although methylphenidate and corticosteroids might be considered.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatigue in Cancer Patients in Palliative Care—A Review on Pharmacological Interventions

Klasson

Frankling

Hagelin

et al. 2021

Cancers

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“…Cancer-related fatigue affects at least 30-90% of patients [1][2][3]. Fatigue can also persist long after the cessation of treatment, as approximately one-third of cancer survivors experience fatigue up to 6 years after cancer treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

The association between cancer-related fatigue and diabetes from pre-chemotherapy to 6-months post-chemotherapy

Kleckner

Culakova

et al. 2021

Preprint

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Purpose To quantify the impact of diabetes on the trajectory of cancer-related fatigue (CRF) from pre-chemotherapy to 6 months post-chemotherapy for patients with breast cancer compared to non-cancer controls.Methods This was a secondary analysis from a nationwide prospective longitudinal study of female patients with breast cancer undergoing chemotherapy and age-matched women without cancer (controls). CRF was measured using the Multidimensional Fatigue Symptom Inventory (MFSI) pre-, post-, and 6-months post-chemotherapy in patients; controls were assessed at equivalent time points. Diabetes status was obtained at baseline. Repeated measures mixed models estimated the association between CRF and diabetes controlling for cancer (y/n), body mass index, exercise and smoking habits, baseline anxiety and depressive symptoms, menopausal status, marital status, race, and education.Results A total of 439 patients and 235 controls (age: 52.8±10.5 years) had available data on diabetes status. Diabetes was twice as prevalent among patients as controls (11.6% vs. 6.8%). Patients had worse fatigue than controls throughout treatment (p<0.001). Diabetes was associated with worse CRF with a clinically meaningful difference of 4.7±1.7 points on the fatigue measure in all participants (p=0.009) and patients alone (p=0.030). For MFSI subdomains, diabetes was associated with worse general (p=0.002), physical (p=0.005), and mental fatigue (p=0.025) but not worse emotional fatigue or vigor (p>0.14) among patients. Conclusions Diabetes was twice as prevalent in women with breast cancer compared to controls, and diabetes was associated with more severe CRF in patients before and after chemotherapy and at 6 months post-chemotherapy. Interventions that address diabetes management may also help address CRF during chemotherapy treatment

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Immune Checkpoint Inhibitor Therapy Toxicities—Reply

Cifu

Bass

Reid

2021

JAMA

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Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis

Cited by 149 publications

References 154 publications

Fatigue in Cancer Patients in Palliative Care—A Review on Pharmacological Interventions

Fatigue in Cancer Patients in Palliative Care—A Review on Pharmacological Interventions

The association between cancer-related fatigue and diabetes from pre-chemotherapy to 6-months post-chemotherapy

Immune Checkpoint Inhibitor Therapy Toxicities—Reply

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