Fatigue in long-term breast carcinoma survivors

Jan 9 2006

Up to one third of women treated for breast cancer report fatigue symptoms up to 10 years after diagnosis, according to a new study.

Published in the February 15, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study--the first 10 year follow-up study of fatigue in breast cancer to be published--reveals women who have concomitant medical conditions, specifically cardiovascular problems and depressive symptoms, or who were treated with combined radiation and chemotherapy, have a higher risk of suffering from fatigue.

Though it is a subjective complaint associated with many illnesses, fatigue can be a debilitating symptom that significantly and adversely affects quality of life and many of the activities of daily living. Fatigue is often experienced by cancer patients for reasons that are not clearly understood, although it is thought to be linked to the disease, treatment side effects, psychosocial experiences, or other ongoing medical problems, such as heart problems and chronic pain.

Studies have shown that in the first five years after diagnosis, about one in three breast cancer patients complain of fatigue. However, there have been no studies of breast cancer survivors that have documented the prevalence of fatigue more than five years after treatment.

Julienne E. Bower, Ph.D. of the University of California at Los Angeles and colleagues followed 763 women for up to ten years after their diagnosis and treatment for breast cancer. Study participants were questioned about their fatigue symptoms in the first five years of the diagnosis and five to ten years after diagnosis. It is the first longitudinal study to investigate the problem of fatigue in women and the risk factors.

The investigators found that similar to the first five year interval, one third of women (34 percent) reported symptoms of fatigue five to ten years after diagnosis. About one in five (21 percent) patients complained of fatigue at both time intervals. Factors associated with a higher likelihood of suffering from fatigue included concomitant depressive symptoms, pain control problems, heart disease and high blood pressure, as well as treatment with radiation and chemotherapy. "Overall, the present findings highlight the resilience of breast cancer survivors," conclude the authors, "and suggest that persistent fatigue is experienced by a minority of women in the aftermath of cancer diagnosis and treatment."

DOI: 10.1002/cncr.21671