Severe fatigue after treatment for childhood cancer

Abstract

BackgroundTreatment strategies for childhood cancer are improving, resulting in higher survival rates. However, the consequences of childhood cancer do not end with the successful completion of cancer treatment. Most patients will develop late e ects a er cessation of treatment. Severe fatigue is seen as a common and debilitating late e ect in cancer survivors. Although most research on fatigue has been performed in patients a er adult-onset cancer, our review focuses on fatigue a er childhood cancer. ObjectivesTo estimate the prevalence of severe fatigue a er treatment for childhood cancer. Secondary objectives are to describe the course of severe fatigue following cancer treatment and to examine risk factors for fatigue, or factors associated with it.Severe fatigue a er treatment for childhood cancer (Review)

Self-Reported Executive Dysfunction, Fatigue, and Psychological and Emotional Symptoms in Physically Well-Functioning Long-Term Survivors of Pediatric Brain Tumor

“…ESs for fatigue in the young adult group may be due to longer time since treatment completion, with initial symptoms of fatigue having subsided with time. This is consistent with previous findings showing that although there is a subgroup for whom symptoms may persist several years upon treatment completion, in many PBT survivors fatigue reduces posttreatment (Boonstra et al, 2017;Brand et al, 2016;Clanton et al, 2011;Mulrooney et al, 2008;van Deuren et al, 2020).…”

“…One of most frequent and debilitating late effects following PBT treatment is excessive fatigue (van Deuren et al, 2020). Fatigue refers to the persistent, subjective experience of physical, emotional, and/or cognitive tiredness and lack of energy, not proportional to recent activity, and interfering with usual functioning (Bower, 2014;Zeller et al, 2014).…”

“…While fatigue reduces upon treatment completion in many PBT survivors, for some the symptoms may persist several years, and the etiology of persistent post-treatment fatigue remains somewhat unclear (Boonstra et al, 2017;Brand et al, 2016;Clanton et al, 2011;Mulrooney et al, 2008). However, fatigue after childhood cancer has been linked to several predisposing, triggering, maintaining and modulating factors, such as demographic factors (e.g., age, sex, unmarried status, low income), genetic disposition (i.e., genetic components that affect proinflammatory cytokine activity), biological and treatment-related mechanisms (e.g., inflammatory processes, cytokine dysregulation, anemia, hypothalamic-pituitaryadrenal (HPA) axis dysregulation, 5-hydroxytryptophan neurotransmitter dysregulation, and alterations in ATP and muscle metabolism), medical factors (e.g., medical comorbidities, medications, nutritional issues), and psychological and biobehavioral factors (e.g., depression, coping and appraisal of the diagnosis and/or treatment, emotional support, sleep disturbance, physical inactivity and body mass) (Bower, 2014;van Deuren et al, 2020).…”

A vulnerable age group: the impact of cancer on the psychosocial well-being of young adult childhood cancer survivors

“…While some studies indicate that fatigue is a problem among (YA)CCS [18,20], other studies show that fatigue levels among CCS do not differ from reference groups or that clinical significance is questionable [24,25]. A recent review concluded that the prevalence of severe fatigue among CCS remains unclear, due in part to the heterogeneity of studies regarding inclusion criteria and samples as well as the questionnaires used to assess fatigue [26]. As fatigue has previously been linked to poor (HR)QOL [5,18,27], it is crucial to investigate the incidence of fatigue in the Dutch population of YACCS and explore underlying mechanisms.…”

Lifetime Costs of Surviving Cancer—A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study

“…Childhood cancer patients face additional health risks due to exposure to radiation and chemotherapy during early life growth and development. Recent literature reviews reported the following late adverse effects childhood cancer: increased risk of subsequent primary malignancies, hypothyroidism, severe fatigue, hearing loss organ dysfunctions (ovarian, liver, lungs, heart, kidney and bladder), obesity as well as musculoskeletal, dental and psychosocial effects [15][16][17][18][19][20][21]. The Australian healthcare system consists of both public and private providers.…”