Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study
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Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study. / Schmidt, Martina E; Chang-Claude, Jenny; Seibold, Petra; Vrieling, Alina; Heinz, Judith; Flesch-Janys, Dieter; Steindorf, Karen.
in: PSYCHO-ONCOLOGY, Jahrgang 24, Nr. 1, 01.01.2015, S. 40-6.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study
AU - Schmidt, Martina E
AU - Chang-Claude, Jenny
AU - Seibold, Petra
AU - Vrieling, Alina
AU - Heinz, Judith
AU - Flesch-Janys, Dieter
AU - Steindorf, Karen
N1 - Copyright © 2014 John Wiley & Sons, Ltd.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - OBJECTIVE: Fatigue is among the most distressing symptoms across the breast cancer continuum. However, little is known about the factors contributing to long-term persisting fatigue. Therefore, we explored determinants of long-term physical, affective, and cognitive fatigue in a prospective cohort of breast cancer patients.METHODS: Breast cancer patients recruited in a population-based case-control study (MARIE study) provided comprehensive data on sociodemographics, lifestyle, and preexisting medical conditions. At follow-up (median 6.3 years post-diagnosis, MARIEplus), disease-free cancer survivors (N = 1928) reported current fatigue using a validated multidimensional questionnaire. Additionally, survivors retrospectively rated their fatigue levels before diagnosis, during the treatment phase, and 1 year post-surgery. Linear regression analyses were performed.RESULTS: As major determinants of long-term physical, affective, and cognitive fatigue, multiple regression analyses revealed preexisting psychological or depressive disorders, migraine, analgesic use, peripheral arterial obstructive disease (PAOD), and arthritis. A physically inactive lifestyle and obesity were associated with persisting physical fatigue. Aromatase inhibitors were also associated with long-term fatigue, especially cognitive fatigue. Chemotherapy and, to a lower extent, radiotherapy were major contributors to the development of fatigue during the treatment phase, yet were not associated with long-term fatigue.CONCLUSIONS: Although the development of fatigue in breast cancer patients seems largely impacted by cancer therapy, for the long-term persistence of fatigue, preexisting medical or psychological conditions related to depression or pain and lifestyle factors appear to be more relevant. Physicians, psycho-oncologists, and researchers may need to distinguish between acute fatigue during therapy and long-term persisting fatigue with regard to its pathophysiology and treatment.
AB - OBJECTIVE: Fatigue is among the most distressing symptoms across the breast cancer continuum. However, little is known about the factors contributing to long-term persisting fatigue. Therefore, we explored determinants of long-term physical, affective, and cognitive fatigue in a prospective cohort of breast cancer patients.METHODS: Breast cancer patients recruited in a population-based case-control study (MARIE study) provided comprehensive data on sociodemographics, lifestyle, and preexisting medical conditions. At follow-up (median 6.3 years post-diagnosis, MARIEplus), disease-free cancer survivors (N = 1928) reported current fatigue using a validated multidimensional questionnaire. Additionally, survivors retrospectively rated their fatigue levels before diagnosis, during the treatment phase, and 1 year post-surgery. Linear regression analyses were performed.RESULTS: As major determinants of long-term physical, affective, and cognitive fatigue, multiple regression analyses revealed preexisting psychological or depressive disorders, migraine, analgesic use, peripheral arterial obstructive disease (PAOD), and arthritis. A physically inactive lifestyle and obesity were associated with persisting physical fatigue. Aromatase inhibitors were also associated with long-term fatigue, especially cognitive fatigue. Chemotherapy and, to a lower extent, radiotherapy were major contributors to the development of fatigue during the treatment phase, yet were not associated with long-term fatigue.CONCLUSIONS: Although the development of fatigue in breast cancer patients seems largely impacted by cancer therapy, for the long-term persistence of fatigue, preexisting medical or psychological conditions related to depression or pain and lifestyle factors appear to be more relevant. Physicians, psycho-oncologists, and researchers may need to distinguish between acute fatigue during therapy and long-term persisting fatigue with regard to its pathophysiology and treatment.
U2 - 10.1002/pon.3581
DO - 10.1002/pon.3581
M3 - SCORING: Journal article
C2 - 24839264
VL - 24
SP - 40
EP - 46
JO - PSYCHO-ONCOLOGY
JF - PSYCHO-ONCOLOGY
SN - 1057-9249
IS - 1
ER -