Pro-inflammatory Cytokine Levels and Cancer-related Fatigue in Breast Cancer Survivors: Effects of an Exercise Adherence Program

Kim, Sung Hae; Song, Yoon Kyung; Han, Jeehee; Ko, Yun Hee; Lee, Hyojin; Kang, Myengmo; Park, Hyunki; Kim, Sue

doi:10.4048/jbc.2020.23.e22

Cited by 9 publications

(11 citation statements)

References 27 publications

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“…With respect to the relationship between exercise and fatigue, in a previous meta-analysis involving 25 RCT studies, exercise interventions showed diminished effectiveness for fatigue symptoms at the 6-month follow-up compared to during and immediately after the interventions [ 26 ]. Consistent with those findings, the fatigue levels measured 1 year after the BLESS exercise program did not meaningfully differ from the baseline levels [ 15 , 16 ]. Given these results, the diminishing impacts of long-term adherence to an exercise program on fatigue, as reported in the literature, may be difficult to explain.…”

Section: Discussionsupporting

confidence: 68%

“…Previous studies have shown that exercise intervention is a crucial strategy for reducing CRF, but demonstrating the effectiveness of longer-term adherence to exercise for controlling fatigue has been a challenge. Our previous study found that the experimental and control groups showed no differences in fatigue symptoms immediately after the 12-week active component of the BLESS intervention [ 15 , 16 ]. With respect to the relationship between exercise and fatigue, in a previous meta-analysis involving 25 RCT studies, exercise interventions showed diminished effectiveness for fatigue symptoms at the 6-month follow-up compared to during and immediately after the interventions [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…In one previous study [ 15 ], no significant differences in fatigue were found between intervention and control groups at baseline; anxiety, depression, sleep quality, physical activity, and quality of life also showed no significant differences between the groups. In a second study [ 16 ], fatigue total and subdomain scores at baseline and at three post-exercise program timepoints displayed no significant differences in analyses for group effects and group-time effects, but the data were not used to examine fatigability or the relationship between fatigue and fatigability. While fatigability is an emerging concept in oncology research and various exercise interventions have been developed for breast cancer patients, to our knowledge, no study has explored the relationships between fatigue and fatigability in BCS after a long-term exercise intervention.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial

et al. 2021

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Background Fatigue is one of the most common and burdensome symptoms experienced by cancer patients. In interventions intended to reduce fatigue in such patients, fatigability, or perception of fatigue contextualized to activities of fixed intensity and duration, may also be measured. This study investigated the effects of a 15-month intervention on fatigue and fatigability in breast cancer survivors (BCS); explored the fatigue-fatigability relationship; and evaluated the impacts of fatigue and fatigability on anxiety, depression, sleep disturbance, and endocrine symptoms. Methods A randomized controlled trial design was applied to an exercise program called BLESS (Better Life after cancer, Energy, Strength, and Support). The intervention included this 12-week exercise program and four follow-up contacts intended to promote exercise adherence over the following year. Participants were women aged 20 to 69 who had been diagnosed with stage I, II, or III breast cancer; had completed active treatment; and had moderate or higher fatigue. At the completion of the intervention, the survey responses of 40 BCS were evaluated using the chi-square test and multiple regression analysis. The Korean versions of the Revised Piper Fatigue Scale and Pittsburgh Fatigability Scale were used to measure fatigue and fatigability, respectively. Results There was no significant difference in fatigue or fatigability between the experimental and control groups at intervention completion. However, the control group showed a stronger association than the experimental group between fatigue and physical fatigability. In the control group, fatigue and fatigability were significantly associated with anxiety, depression, sleep disturbance, and endocrine symptoms. In the experimental group, only the cognitive/mood fatigue score and depression were significantly associated. Only endocrine symptoms influenced mental fatigability (B = − 0.185, P < 0.05), and only depression influenced cognitive/mood fatigue (B = 1.469, P < 0.05). Conclusions Fatigue and fatigability showed different correlations with cancer-related symptoms after the exercise intervention. Future assessments of fatigability in intervention studies will allow measurement of the spectrum of patients’ abilities to overcome fatigue at various physical activity levels while capturing different aspects of cancer-related symptoms. Trial registration This study was retrospectively registered on Clinical Research Information Service (KCT0005763; date of registration: 31/12/2020).

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial

et al. 2021

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“…Nevertheless, authors concluded that the prescription of exercise is far from becoming a part of standard care and further intervention studies are necessary to endorse clinical implementation. It is of interest to note that a recent randomized controlled intervention trial in breast cancer patients demonstrated that an exercise intervention lead to reduced CRF leves, but inflammatory biomarkers (Il-6 and TNF-α) did not differ between experimental and control group [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Tired of feeling tired – The role of circulating inflammatory biomarkers and long-term cancer related fatigue in breast cancer survivors

et al. 2021

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Background Low-grade inflammation has been associated with cancer related fatigue (CRF). However, most studies focused on CRF during or shortly after treatment. Longitudinal studies are rare with inconsistent results. We assessed the association of inflammatory biomarkers with total CRF and all subdomains (physical, cognitive, affective) in long-term breast cancer survivors. Method Patients recruited between 2002 and 2005 provided information on CRF at first follow-up (FU1) (N = 1292) and second follow-up (FU2) (N = 1205), after a median of 6.2 years and 11.7 years, respectively. Associations of 11 inflammatory biomarkers with CRF at FU1 and at FU2 were assessed using linear regression models. Logistic regression models were used to compare patients fatigued at both time-points and those never fatigued (N = 932). Results C-reactive protein (CRP) was significantly associated with total CRF at FU1 (β = 1.47, 95%CI = 0.62–2.31, p = 0.0007), at FU2 (β = 1.98, 95 %CI = 0.96–2.99, p = 0.0001) and with persistent CRF (OR = 1.29, 95%CI = 1.13–1.47, p < 0.0001). IL-6 levels were associated with total CRF at FU1 (β = 1.01, 95%CI = 0.43–1.59, p = 0.0006), but not with CRF at FU2 or persistent CRF. No association remained significant after adjustment for relevant covariates. Discussion CRP and Il-6 were associated with risk of CRF in long-term breast cancer survivors, but were not independent of other known risk factors, suggesting that currently studied inflammatory markers are not suitable to identify patients at risk of long-term CRF.

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“…Generally, CRF is generally evaluated by self-reporting using several validated questionnaires referring to severity, duration, dimensions and other aspects of fatigue performance, which were designed for different contexts (23,25). As instruments in (20,29,30). Based on the above reasons, we applied its Chinese version in the present study.…”

Section: Discussionmentioning

confidence: 99%

Effect of the solution-focused brief therapy on cancer-related fatigue in breast cancer patients under adjuvant chemotherapy: a randomized trial

Liu¹,

Geng²,

Ma³

et al. 2020

Transl Cancer Res TCR

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Background: Cancer-related fatigue (CRF) is a severe symptom in breast cancer survivors. We aimed to explore the effects of the solution-focused brief therapy (SFBT) on CRF in breast cancer patients after lumpectomy or mastectomy under adjuvant chemotherapy.Methods: First, 196 patients with primarily diagnosed breast cancer were recruited, screened, and the qualified 160 patients were randomly assigned into the control (routine nursing interventions), and intervention (routine nursing interventions and SFBT) groups. CRF was evaluated using the Chinese version of revised Piper Fatigue Scale. Data were collected at baseline (T1), post-intervention (T2), and post-followup (T3).Results: Mild to severe fatigue existed in all qualified participants at T1 and the fatigue symptom went worse with the chemotherapy in control group. In intervention group, the fatigue level decreased at T2 (P<0.05), and went to the similar level at T3 as that at T1. The levels of behavioral, affective, and sensory fatigues in the control group significantly increased at T3 (P<0.05), while no difference was found in the intervention group. This study showed that SFBT effectively decreased CRF in breast cancer survivors after surgery under adjuvant chemotherapy.Conclusions: Hence, SFBT might be a beneficial non-pharmacological intervention alone or in combination with other interventions to improve patients' quality of life.

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Pro-inflammatory Cytokine Levels and Cancer-related Fatigue in Breast Cancer Survivors: Effects of an Exercise Adherence Program

Cited by 9 publications

References 27 publications

Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial

Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial

Tired of feeling tired – The role of circulating inflammatory biomarkers and long-term cancer related fatigue in breast cancer survivors

Effect of the solution-focused brief therapy on cancer-related fatigue in breast cancer patients under adjuvant chemotherapy: a randomized trial

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