The long-term course of fatigue following breast cancer diagnosis

Abstract

Purpose Fatigue following breast cancer is a well-known problem, with both high and persistent prevalence. Previous studies suffer from lack of repeated measurements, late recruitment and short periods of follow-up. The course of fatigue from diagnosis and treatment to the long-time outcome status is unknown as well as differences in the level of fatigue between treatment regimens. The purpose of this study was to describe the long-time course of fatigue from the time of clinical suspicion of breast cancer, its dependence of patient characteristics and treatment regimens and the comparison with the course of fatigue among women with the same suspicion, but not diagnosed with breast cancer. Methods Three hundred thirty-two women referred to acute or subacute mammography was followed with questionnaires from before the mammography and up to 1500 days. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-20). The women reported their initial level of fatigue before the mammography and thus without knowledge of whether they had cancer or not. Both women with and without cancer were followed. Women with cancer were identified in the clinical database established by Danish Breast Cancer Cooperative Group (DBCG) to collect information on treatment regimen. Results Compared to fatigue scores before diagnosis, women with breast cancer reported a large increase of fatigue, especially in the first 6 months, followed by a slow decrease over time. Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography. Women without breast cancer, experienced a rapid decrease of fatigue after disproval of diagnosis followed by a steadier period. Conclusions Fatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment. The women with breast cancer were most affected by fatigue in the first 6 months after diagnosis.

Head and Neck Cancer and Social Media: The Patient Experience and Cancer Survivorship

“…Although the most commonly reported patient concerns in our study, acute and chronic fatigue and psychological stress, are often not fully addressed by oncology providers. 24,25 Moreover, head and neck surgeons may be able to address concerns on weight and nutrition with the help of a dietician and speech-language pathology colleagues.…”

Unmet needs among Danish women with breast cancer in the transition from diagnosis into the early treatment phase

“…[30] The items stem from the BDI-I and only the total score is calculated. It is of the grouped into 'none or minimal' (score 0-4), 'mild' (5-7), 'moderate' (8)(9)(10)(11)(12)(13)(14)(15), and 'severe depression' (16+), but with a cut-off point at 9/10 it has been found to include some false positive cases , and with a 13/14 cut-off point to leave some depressive undetected. [31] Cancer-related psychological distress was measured with The Impact of Events Scale-Cancer (IES-C).…”

“…The combined score (avoidance + intrusion) provides a total cancer-related distress score. The IES-C total is considered as subclinical 'scores' (0-8), 'mild' (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), 'moderate' (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43) and 'severe' (44+).…”

“…[6,7] The women might also be further restricted by the physical symptoms, such as fatigue, nausea, vomiting, weight gain, hair loss, that the treatment often extracts. [6] Emotional distress and lower quality of life among people diagnosed with breast cancer is well established in the literature [8,9] and along with higher levels of psychological distress, depression and anxiety. [10,11] Higher levels of distress, depressive symptoms and decreased quality of life is evident several years after completing treatment and has an impact on woman's return to normal life in several ways, [8,9] for example, the need for general rehabilitation, income and returning to the work force.…”

“…[6] Emotional distress and lower quality of life among people diagnosed with breast cancer is well established in the literature [8,9] and along with higher levels of psychological distress, depression and anxiety. [10,11] Higher levels of distress, depressive symptoms and decreased quality of life is evident several years after completing treatment and has an impact on woman's return to normal life in several ways, [8,9] for example, the need for general rehabilitation, income and returning to the work force. [12] Previous research has investigated the transitional experience and health care needs in people undergoing chemotherapy.…”