Fatigue before cancer treatment impacts fatigue afterwards

Feb 28 2013

By Sarah Guy, medwireNews Reporter

Individuals who survive cancer are significantly more likely to develop severe persistent fatigue a year after treatment if they were fatigued before and shortly after treatment, indicate Dutch study findings.

In addition, depressed mood and impaired sleep and rest shortly after treatment correlated significantly with persistent fatigue in cancer survivors, report Martine Goegendorp (University Nijmegen Medical Centre) and co-workers.

They observed that almost a quarter of study participants were severely persistently fatigued in the year after cancer treatment.

Based on the findings, the researchers advise cognitive behavioral therapy (CBT) for cancer patients suffering from severe fatigue "shortly (from 2 months) after the cancer treatment is completed."

A total of 60 individuals aged a mean of 57 years took part in the study, of whom 48% had breast cancer and 30% prostate cancer. The majority of patients (93%) received surgical treatment.

Participants were assessed before cancer treatment (T1), 2 months after treatment (T2), and 1 year after T2.

Overall, 22% of participants had severe persistent fatigue during the last 6 months of the first year after completing cancer treatment, write Goegendorp and colleagues in the Journal of Pain and Symptom Management.

The team measured severe fatigue using a subscale of the Checklist Individual Strength (CIS-fat), where a score of 35 or more indicates severe fatigue.

Depressive mood (measured on the Symptom Checklist-90), impaired sleep and rest (measured on the Sickness Impact Profile-8), higher levels of retrospectively reported fatigue 1 year before diagnosis (measured on the CIS-fat), and higher levels of fatigue at T1 all correlated significantly and positively with persistent fatigue.

After excluding fatigue levels at T2, which accounted for 48.2% of the overall variance, the researchers found that more negative interactions, fatigue catastrophizing, and impaired sleep - all known fatigue-perpetuating factors - significantly predicted higher levels of persistent fatigue.

"The clinical implications of our findings include the importance of identifying patients at risk shortly after cancer treatment is completed," say Goegendorp et al, who recommend CBT for such patients.

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