Do all patients with cancer experience fatigue? A longitudinal study of fatigue trajectories in women with breast cancer.

Breast Neoplasms / complications Depression / psychology Disease Progression Fatigue / classification Female Humans Longitudinal Studies Middle Aged Neoplasm Staging Psychological Distress Socioeconomic Factors Survivorship
biobehavioral breast cancer fatigue growth mixture modeling survivorship

Journal

Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236

Informations de publication

Date de publication:
15 04 2021
Historique:
revised: 08 10 2020
received: 26 06 2020
accepted: 13 10 2020
pubmed: 20 2 2021
medline: 12 11 2021
entrez: 19 2 2021
Statut: ppublish

Résumé

Fatigue is a common and expected side effect of cancer treatment. However, the majority of studies to date have focused on average levels of fatigue, which may obscure important individual differences in the severity and course of fatigue over time. The current study was designed to identify distinct trajectories of fatigue from diagnosis into survivorship in a longitudinal study of women with early-stage breast cancer. Women with stage 0 to stage IIIA breast cancer (270 women) were recruited before (neo)adjuvant therapy with radiotherapy, chemotherapy, and/or endocrine therapy and completed assessments at baseline; posttreatment; and at 6 months, 12 months, and 18 months of follow-up. Growth mixture modeling was used to identify trajectories of fatigue, and differences among the trajectory groups with regard to demographic, medical, and psychosocial variables were examined. Five distinct trajectories of fatigue were identified: Stable Low (66%), with low levels of fatigue across assessments; Stable High (13%), with high fatigue across assessments; Decreasing (4%), with high fatigue at baseline that resolved over time; Increasing (9%), with low fatigue at baseline that increased over time; and Reactive (8%), with increased fatigue after treatment that resolved over time. Both psychological and treatment-related factors were found to be associated with fatigue trajectories, with psychological factors most strongly linked to high fatigue at the beginning of and over the course of treatment. There is considerable variability in the experience of fatigue among women with early-stage breast cancer. Although the majority of women report relatively low fatigue, those with a history of depression and elevated psychological distress may be at risk of more severe and persistent fatigue.

Sections du résumé

BACKGROUND
Fatigue is a common and expected side effect of cancer treatment. However, the majority of studies to date have focused on average levels of fatigue, which may obscure important individual differences in the severity and course of fatigue over time. The current study was designed to identify distinct trajectories of fatigue from diagnosis into survivorship in a longitudinal study of women with early-stage breast cancer.
METHODS
Women with stage 0 to stage IIIA breast cancer (270 women) were recruited before (neo)adjuvant therapy with radiotherapy, chemotherapy, and/or endocrine therapy and completed assessments at baseline; posttreatment; and at 6 months, 12 months, and 18 months of follow-up. Growth mixture modeling was used to identify trajectories of fatigue, and differences among the trajectory groups with regard to demographic, medical, and psychosocial variables were examined.
RESULTS
Five distinct trajectories of fatigue were identified: Stable Low (66%), with low levels of fatigue across assessments; Stable High (13%), with high fatigue across assessments; Decreasing (4%), with high fatigue at baseline that resolved over time; Increasing (9%), with low fatigue at baseline that increased over time; and Reactive (8%), with increased fatigue after treatment that resolved over time. Both psychological and treatment-related factors were found to be associated with fatigue trajectories, with psychological factors most strongly linked to high fatigue at the beginning of and over the course of treatment.
CONCLUSIONS
There is considerable variability in the experience of fatigue among women with early-stage breast cancer. Although the majority of women report relatively low fatigue, those with a history of depression and elevated psychological distress may be at risk of more severe and persistent fatigue.

Identifiants

DOI: 10.1002/cncr.33327 PMID: 33606273 PMC: PMC8562726
pubmed: 33606273
doi: 10.1002/cncr.33327
pmc: PMC8562726
mid: NIHMS1724203
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1334-1344

Subventions

Organisme : NCI NIH HHS
ID : P30 CA016042
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA160427
Pays : United States

Informations de copyright

© 2020 American Cancer Society.

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Auteurs

Julienne E Bower (JE)

Department of Psychology, University of California at Los Angeles, Los Angeles, California.
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.
Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.
Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.
ORCID: 0000-0003-0813-4444

Patricia A Ganz (PA)

Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.
School of Medicine, University of California at Los Angeles, Los Angeles, California.
Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California.
ORCID: 0000-0002-1841-4143

Michael R Irwin (MR)

Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.
Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.

Steve W Cole (SW)

Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.
Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.
Department of Medicine, University of California at Los Angeles, Los Angeles, California.

Deborah Garet (D)

Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.

Laura Petersen (L)

Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.

Arash Asher (A)

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California.

Sara A Hurvitz (SA)

Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.
Department of Medicine, University of California at Los Angeles, Los Angeles, California.

Catherine M Crespi (CM)

Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.
Department of Biostatistics, University of California at Los Angeles, Los Angeles, California.

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Classifications MeSH

questionsmedicales.fr › Maladies de la peau et du tissu conjonctif › Maladies de la peau › Maladies du sein › Tumeurs du sein › Do all patients with cancer experience...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Dépression › Do all patients with cancer experience...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Évolution de la maladie › Do all patients with cancer experience...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Fatigue › Do all patients with cancer experience...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Do all patients with cancer experience...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études longitudinales › Do all patients with cancer experience...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Do all patients with cancer experience...
questionsmedicales.fr › Diagnostic › Pronostic › Stadification tumorale › Do all patients with cancer experience...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Détresse psychologique › Do all patients with cancer experience...
questionsmedicales.fr › Caractéristiques de la population › Facteurs socioéconomiques › Do all patients with cancer experience...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Adaptation psychologique › Survie (démographie) › Do all patients with cancer experience...