|
|
12
|
|
| TI |
Preliminary evaluation of a clinical syndrome approach to assessing cancer-related fatigue.
|
| AU |
Sadler IJ; Jacobsen PB; Booth-Jones M; Belanger H; Weitzner MA; Fields KK
|
| SO |
J Pain Symptom Manage. 2002 May;23(5):406-16.
|
| |
| |
The objectives of this study were to evaluate the reliability, validity, and utility of a newly developed clinical syndrome approach to assessing cancer-related fatigue. Fifty-one patients who underwent blood or marrow transplantation an average of 6.9 months previously were administered a standardized interview designed to identify the presence of a clinical syndrome of cancer-related fatigue. Patients also completed self-report measures of fatigue, depression, and health-related quality of life. Comparisons among independent raters demonstrated high rates of reliability for the presence or absence of a cancer-related fatigue syndrome and its symptoms. Twenty-one percent of patients (n = 11) were found to meet criteria for diagnosis of a cancer-related fatigue syndrome. Compared to patients not meeting the diagnostic criteria, patients meeting the criteria reported fatigue that was greater (P
|
| |
| AD |
Psychosocial and Palliative Care Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
|
| PMID |
12007758
|
|
|
14
|
|
| TI |
Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition.
|
| AU |
Vogelzang NJ; Breitbart W; Cella D; Curt GA; Groopman JE; Horning SJ; Itri LM; Johnson DH; Scherr SL; Portenoy RK
|
| SO |
Semin Hematol 1997 Jul;34(3 Suppl 2):4-12.
|
| |
| |
Although fatigue is the most common symptom reported by cancer patients and has serious adverse effects on quality of life, it remains poorly understood. A survey was designed to characterize the epidemiology of cancer-related fatigue from the perspectives of the patient, primary caregiver, and oncologist. A telephone survey included 419 cancer patients recruited from 100,000 randomly selected households nationwide. Patients provided access to 200 primary caregivers (usually family members) who were also interviewed by telephone. In a separate mail survey, 197 of 600 randomly sampled oncologists (unrelated to the patients) responded to a questionnaire that assessed perceptions and attitudes concerning fatigue in cancer patients who had received chemotherapy or radiotherapy and their caregivers. The median patient age was 65 years, and the principal cancer diagnoses were breast (females) and genitourinary (males). Fifty-nine percent of the patients had received chemotherapy, 63% radiation therapy, and 24% both; 20% of patients received their last treatment within 6 weeks, 31% within 7 weeks to 1 year, and 49% more than 1 year ago. More than three quarters of patients (78%) experienced fatigue (defined as a general feeling of debilitating tiredness or loss of energy) during the course of their disease and treatment. Thirty-two percent experienced fatigue daily, and 32% reported fatigue significantly affected their daily routines. Caregivers reported observing fatigue in 86% of the index patients, and oncologists perceived that 76% of their patients experienced fatigue. Although oncologists believed that pain adversely affected their patients to a greater degree than fatigue (61% v 37%), patients felt that fatigue adversely affected their daily lives more than pain (61% v 19%). Most oncologists (80%) believed fatigue is overlooked or undertreated, and most patients (74%) considered fatigue a symptom to be endured. Fifty percent of patients did not discuss treatment options with their oncologists, and only 27% reported that their oncologists recommended any treatment for fatigue. When used, treatments for fatigue were generally perceived by patients and caregivers to be successful. These data confirm the high prevalence and adverse impact of cancer-related fatigue, although it is seldom discussed and infrequently treated. For patients and oncologists, improving the quality of life of cancer patients requires a heightened awareness of fatigue, a better understanding of its impact, and improve communication and familiarity with interventions that can reduce its debilitating effects.
|
| |
| AD |
University of Chicago, IL 60637-1463, USA.
|
| PMID |
9253778
|
|
|
23
|
|
| TI |
Fatigue in adolescents with and following a cancer diagnosis: developing an evidence base for practice.
|
| AU |
Edwards JL; Gibson F; Richardson A; Sepion B; Ream E
|
| SO |
Eur J Cancer 2003 Dec;39(18):2671-80.
|
| |
| |
Although fatigue has been a focus for research in adult cancer care for some time, the same cannot be said for adolescent oncology practice. This paper summarises the literature concerning fatigue in adolescents with, and following, cancer diagnoses, drawing on data from four empirical studies. Fatigue is multidimensional, multifactorial and highly subjective, but can be managed to enhance self-caring and coping strategies. All of the studies reviewed within indicate that fatigue is a troublesome symptom, which impacts on quality of life. From this review, we set up a research study. This paper provides a brief report of preliminary data from this study drawn from a group of adolescents in late remission from childhood cancer. These data are used to evaluate the utility of focus groups as a method of data collection in exploring the concept of fatigue in adolescents. Concurring with the studies we reviewed, findings from the preliminary data suggest that fatigue is a highly subjective and 'abnormal' phenomenon that holds a variety of implied meanings and associated metaphors connected with past experiences of childhood cancer. The focus group proved to be a viable research method to facilitate mutual disclosure and provoke discussion. Recognition of the research challenges with adolescents, where there is the potential for a range of meanings for the experience of fatigue, is an important finding for future studies.
|
| |
| AD |
Children's Cancer Nursing, Great Ormond Street Hospital for Children NHS Trust, Directorate of Nursing, Great Ormond Street Hospital, London WCIN 3JH, UK. edwarj2@gosh.nhs.uk
|
| PMID |
14642930
|
|
|
40
|
|
| TI |
Fatigue after treatment for malignant and benign bone and soft tissue tumors.
|
| AU |
Servaes P; Verhagen S; Schreuder HW; Veth RP; Bleijenberg G
|
| SO |
J Pain Symptom Manage 2003 Dec;26(6):1113-22.
|
| |
| |
Fatigue has been mentioned as an important complaint in several groups of disease-free patients after curative treatment for cancer. However, it has never been investigated in a sample of patients who have been treated for a bone or soft tissue tumor in the past. In the current study, these patients participated. Measurement included posted questionnaires at baseline and at follow-up (two years later). Baseline results indicated that fatigue is a severe problem for 28% of the investigated patients. Percentages were equal for patients who were treated for malignant or benign tumors. Fatigue complaints seem to be most severe for patients who finished treatment relatively recently, and for patients who had to undergo more than one operation. In addition, fatigue was associated with several psychological and physical variables. At follow-up, the majority of all patients who were severely fatigued at baseline continued to be severely fatigued. Severe fatigue at follow-up was predicted by oncological complications after initial treatment, less optimism, and more somatization. It can be concluded that fatigue is an important problem for more than a quarter of a sample of patients who have been treated for a malignant or benign bone or soft tissue tumor in the past.
|
| |
| AD |
Department of Medical Psychology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
|
| PMID |
14654263
|
|
|
43
|
|
| TI |
Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer.
|
| AU |
Arndt V; Merx H; Stegmaier C; Ziegler H; Brenner H
|
| SO |
J Clin Oncol 2005 Aug 1;23(22):4945-53.
|
| |
| |
PURPOSE: To assess whether detriments in quality of life (QOL) among women with breast cancer persist over years. PATIENTS AND METHODS: QOL was assessed in a population-based cohort of 314 women with breast cancer from Saarland (Germany) 1 and 3 years after diagnosis and compared internally and with reference data from the general population. RESULTS: Three years after diagnosis, deficits in QOL were still apparent for role, emotional, cognitive, and social functioning and for the symptoms of insomnia, fatigue, dyspnea, and financial difficulties. Differences between breast cancer patients and women from the general population were predominantly found in younger ages. Compared with the QOL scores measured 1 year after diagnosis, only minor functional changes were observed, but recurrence of breast cancer during the follow-up interval had a deleterious effect on QOL. CONCLUSION: Deficits in role, emotional, cognitive, and social functioning persist over years in women with breast cancer and predominantly affect younger patients.
|
| |
| AD |
German Centre for Research on Ageing, Department of Epidemiology, Bergheimer Strasse 20, D-69115 Heidelberg, Germany. arndt@dzfa.uni-heidelberg.de
|
| PMID |
16051947
|
|
|
44
|
|
| TI |
Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report.
|
| AU |
Meeske K; Smith AW; Alfano CM; McGregor BA; McTiernan A; Baumgartner KB; Malone KE; Reeve BB; Ballard-Barbash R; Bernstein L
|
| SO |
Qual Life Res. 2007 Aug;16(6):947-60. Epub 2007 Apr 25.
|
| |
| |
PURPOSE: The purpose of this study was to estimate prevalence of fatigue, identify correlates of fatigue and evaluate the relationship between fatigue and health-related quality of life (HRQOL) in a large cohort of disease-free breast cancer survivors. METHODS: Participants are enrolled in the HEAL Study, a multi-center prospective study of women diagnosed with in-situ to Stage IIIA breast cancer. HEAL participants (n = 1183) completed a baseline and a 24-month follow-up interview. Women in this report (n = 800) also completed a quality of life questionnaire that included the Piper Fatigue Scale and the RAND SF-36 two to five years after diagnosis. Multivariate regression methods were used to identify significant factors associated with fatigue. SF-36 scores for fatigued survivors were compared to non-fatigued survivor scores and population norms. RESULTS: Forty-one percent of the breast cancer survivors were fatigued. Significant correlates of fatigue included pain, cognitive problems, physical inactivity, weight gain/personal appearance and antidepressant use. Fatigue was associated with poorer HRQOL, most notably in areas of role and social functioning. CONCLUSION: This study provides further support for the conclusion that a significant proportion of breast cancer survivors experience fatigue that compromises HRQOL two to five years post-diagnosis.
|
| |
| AD |
Department of Preventive Medicine, Keck School of Medicine of University of Southern California, USC/Norris Comprehensive Cancer Center, 1444 Eastlake Avenue, Room 4449, Los Angeles, CA 90033, USA.
|
| PMID |
17457697
|
|
|
45
|
|
| TI |
Hodgkin's disease survivors more fatigued than the general population.
|
| AU |
Loge JH; Abrahamsen AF; Ekeberg O; Kaasa S
|
| SO |
J Clin Oncol 1999 Jan;17(1):253-61.
|
| |
| |
PURPOSE: To estimate the level of fatigue and frequency of fatigue cases among Hodgkin's disease survivors (HDS) and compare them with normative data from the general population. PATIENTS AND METHODS: A cross-sectional follow-up study was done of 557 HDS (age range, 19 to 74 years) treated at the Norwegian Radium Hospital from 1971 to 1991. The sample was approached by mail, and their data were compared with normative data from 2,214 controls (age range, 19 to 74 years) representative of the general Norwegian population. Of the 557 HDS, 459 (82%) responded. The mean age (+/- SD) at the time of study was 44+/-12 years, and the mean observation time was 12+/-6 years. The Fatigue Questionnaire (11 items) measures physical and mental fatigue. Two systems of scoring were used, dichotomized (0, 0, 1, and 1) and Likert (0, 1, 2, and 3). Total fatigue (TF) constitutes the sum of all the Likert scores. Caseness was defined as a total dichotomized score of>or =4 and fatigue that lasted 6 months or longer. RESULTS: The HDS had significantly higher levels of TF than the controls (14.3 v 12.2) (P<.001). Fatigue among the HDS equaled that of the controls in poorest health. More HDS (61%) than controls (31%) reported fatigue symptoms lasting 6 months or longer (P<.001). Fatigue cases were more frequent among HDS (men, 24%; women, 27%) than among the controls (men, 9%; women, 12%) (P<.001). Disease stage/substage IB/IIB predicted fatigue caseness (P = .03). No significant associations were found between treatment characteristics and fatigue. CONCLUSION: Hodgkin's disease survivors are considerably more fatigued than the general population and report fatigue of a substantially longer duration.
|
| |
| AD |
Department of Behavioral Sciences in Medicine, University of Oslo, Norway. j.h.loge@medisin.uio.no
|
| PMID |
10458240
|
|
|
46
|
|
| TI |
Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life.
|
| AU |
Bower JE; Ganz PA; Desmond KA; Rowland JH; Meyerowitz BE; Belin TR
|
| SO |
J Clin Oncol 2000 Feb;18(4):743-53.
|
| |
| |
PURPOSE: To describe the occurrence of fatigue in a large sample of breast cancer survivors relative to general population norms and to identify demographic, medical, and psychosocial characteristics of fatigued survivors. PATIENTS AND METHODS: Breast cancer survivors in two large metropolitan areas completed standardized questionnaires as part of a survey study, including the RAND 36-item Health Survey, Center for Epidemiological Studies-Depression Scale, Breast Cancer Prevention Trial Symptom Checklist, Medical Outcomes Study Sleep Scale, and demographic and treatment-related measures. RESULTS: On average, the level of fatigue reported by the breast cancer survivors surveyed (N = 1,957) was comparable to that of age-matched women in the general population, although the breast cancer survivors were somewhat more fatigued than a more demographically similar reference group. Approximately one third of the breast cancer survivors assessed reported more severe fatigue, which was associated with significantly higher levels of depression, pain, and sleep disturbance. In addition, fatigued women were more bothered by menopausal symptoms and were somewhat more likely to have received chemotherapy (with or without radiation therapy) than nonfatigued women. In multivariate analyses, depression and pain emerged as the strongest predictors of fatigue. CONCLUSION: Although the majority of breast cancer survivors in this large and diverse sample did not experience heightened levels of fatigue relative to women in the general population, there was a subgroup of survivors who did report more severe and persistent fatigue.We identified characteristics of these women that may be helpful in elucidating the mechanisms underlying fatigue in this population, as well as directing intervention efforts.
|
| |
| AD |
Norman Cousins Center in Psychoneuroimmunology, Departments of Biostatistics and Psychiatry and Biobehavioral Sciences, Schools of Public Health and Medicine, University of California, Los Angeles, CA, USA.
|
| PMID |
10673515
|
|
|
47
|
|
| TI |
Off-treatment fatigue in breast cancer survivors: a controlled comparison.
|
| AU |
Andrykowski MA; Curran SL; Lightner R
|
| SO |
J Behav Med 1998 Feb;21(1):1-18.
|
| |
| |
Fatigue is a common and distressing symptom following cancer treatment. Research examining "off-treatment" fatigue has been weakened by limited assessments of fatigue and lack of suitable comparison groups. The extent of off-treatment fatigue following treatment for breast cancer (BC) was examined. Women with BC (n = 88; mean, 28 months posttreatment) and age-matched women (n = 88) with benign breast problems (BBP), completed a set of fatigue questionnaires at an Initial assessment and a 4-month Follow-up assessment. The BC group reported more fatigue, more weakness, and less vitality relative to the BBP group at both assessments. No relationship was found in the BC group between fatigue and extent of treatment or time since treatment completion. While the results document the existence of off-treatment fatigue following BC, elucidation of the psychobiological processes underlying this symptom and development of clinical management strategies remain as challenges for future research.
|
| |
| AD |
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington 40536-0086, USA.
|
| PMID |
9547419
|
|
|
48
|
|
| TI |
Fatigue in Long-Term Hodgkin's Disease Survivors: A Follow-Up Study.
|
| AU |
Hjermstad MJ; Fossa SD; Oldervoll L; Holte H; Jacobsen AB; Loge JH
|
| SO |
J Clin Oncol 2005 Sep 20;23(27):6587-95.
|
| |
| |
PURPOSE To describe total fatigue (TF) and chronic fatigue (CF) in 476 long-term Hodgkin's disease survivors (HDSs). The development in CF over time was explored in 280 of the patients who had also been assessed 8 years earlier. PATIENTS AND METHODS In 2003, the Fatigue Questionnaire was mailed to 610 successfully treated HDSs at the Norwegian Radium Hospital from 1971 to 1997. Mean TF scores and occurrence of CF were compared with general population (GP) values. Results Four hundred seventy-six complete forms (81%) were received (median age, 46 years; 56% males, median follow-up time, 195 months). There was a positive association between age and TF (P<.05), whereas presence of B symptoms at diagnosis and treatment before 1980 were associated with CF. Mean TF scores were elevated in HDSs compared with the GP (mean TF score, 14.6; 95% CI, 14.1 to 15.7 v 12.1; 95% CI, 11.9 to 12.3, respectively; P<.001), as was the proportion of persons with CF (30% v 11%, respectively; odds ratio = 3.6; P<.001). The 70 patients with CF 8 years earlier still reported higher TF at follow-up than the 210 patients without CF at the previous assessment (mean TF score, 17.0; 95% CI, 15.6 to 18.3 v 13.1; 95% CI, 12.9 to 14.1, respectively; P<.001). Significantly more patients with persisting CF had B symptoms at diagnosis compared with patients who had recovered (P = .05). No significant association with treatment modality and intensity was found. CONCLUSION Fatigue remains a major complaint in HDSs several years after treatment, but the association between treatment and fatigue still remains unclear. Many HDSs may recover fromCF, particularly patients without B symptoms at diagnosis.
|
| |
| AD |
Department of Oncology, Ulleval University Hospital HF, KSLB, 0407 Oslo, Norway; e-mail: m.j.hjermstad@basalmed.uio.no.
|
| PMID |
16170166
|
|
|
49
|
|
| TI |
Fatigue after treatment for early stage breast cancer: a controlled comparison.
|
| AU |
Jacobsen PB; Donovan KA; Small BJ; Jim HS; Munster PN; Andrykowski MA
|
| SO |
Cancer. 2007 Oct 15;110(8):1851-9.
|
| |
| |
BACKGROUND.: Evidence suggests that fatigue may be a greater problem for cancer survivors than people without cancer. The present study sought to determine whether fatigue was greater in women who had completed treatment for early-stage breast cancer relative to a demographically matched comparison group of women with no cancer history. METHODS.: As part of a larger study, women with stage 0-II breast cancer were recruited before the start of chemotherapy and radiotherapy (n = 100) or radiotherapy only (n = 121). Fatigue was assessed at the end of treatment and 2, 4, and 6 months later. An age- and geographically matched sample of women with no history of cancer was recruited and assessed for comparison purposes. RESULTS.: Relative to comparison subjects, breast cancer survivors reported more days of fatigue in the past week at all 4 study assessments (P<.05). These differences appeared to be clinically meaningful in that a greater percentage of patients than nonpatients earned scores in the abnormal range on this measure at each assessment (P<.05). Additional analyses indicated that differences in fatigue between patients and comparison subjects were attributable primarily to heightened fatigue in women who received both chemotherapy and radiotherapy. CONCLUSIONS.: Findings suggest that fatigue is a greater problem for breast cancer survivors in the 6 months after completion of chemotherapy than for women with no cancer history. Future research should include longer-term follow-up to determine the persistence of fatigue in this population of survivors. Cancer 2007. (c) 2007 American Cancer Society.
|
| |
| AD |
Health Outcomes and Behavior Program, Moffitt Cancer Center&Research Institute, Tampa, Florida.
|
| PMID |
17847016
|
|
|
50
|
|
| TI |
Evidenced-based report on the occurrence of fatigue in long-term cancer survivors.
|
| AU |
Braun IM; Greenberg DB; Pirl WF
|
| SO |
J Natl Compr Canc Netw. 2008 Apr;6(4):347-54.
|
| |
| |
Although some cancer survivors report persistent fatigue years after treatment, little is known about the prevalence of the symptom in this population as compared with the general population. This article examines current evidence for the occurrence of fatigue in long-term cancer survivors by reviewing published population-based studies that incorporated controls from the general population. Using the search criteria "fatigue AND cancer survivors" in PubMed, the authors identified 16 articles (based on 15 cross-sectional datasets) comparing fatigue severities in survivors of adult cancers with those in the general population. When data allowed, Hedges' g effect size calculations were generated. A total of 8096 cancer survivors were examined across datasets. Cancer survivor sample sizes ranged from 15 to 1933 per dataset. Most datasets focused on either breast cancer (7) or Hodgkin's disease survivors (6). Four studies did not clearly exclude patients undergoing active treatment. Nine articles (based on 8 datasets) showed statistically significant (P<.05) differences among groups; 4 articles showed negative results; and 3 showed both positive and negative results depending on fatigue dimension measured. Among the studies that reported scores for the fatigue subscale of the European Organization for Research and Treatment of Cancer Core Questionnaire for Quality of Life (most studies), mean fatigue levels in cancer survivors ranged from 28.7 to 36.5 out of an overall score of 100, and mean fatigue levels in matched general population controls ranged from 20 to 30 out of 100. No associations between instruments and results were apparent.Although the small numbers of studies prevented comparisons among cancer subtypes, equal positive and negative studies were seen in breast cancer survivors and, notably, no negative studies were seen involving Hodgkin's disease survivors. Most effect sizes calculated were small. Fatigue was a burden to both cancer survivors and members of the general population. While evidence for greater fatigue severity in cancer survivors was mixed, most studies reported greater fatigue in cancer survivors as compared with controls. The magnitude of this effect was generally small. Inferences from the data were limited by variability in both the definition of survivor and the fatigue assessments used, as well as by the cross-sectional design of the studies. Prospective longitudinal studies are needed to determine causal relationships between excessive fatigue and surviving cancer.
|
| |
| AD |
From Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Correspondence: Ilana M. Braun, MD, Department of Psychiatry, Warren 606, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail: ibraun@partners.org.
|
| PMID |
18433605
|
|
|
51
|
|
| TI |
The biologic basis of fatigue.
|
| AU |
Gutstein HB
|
| SO |
Cancer 2001 Sep 15;92(6 Suppl):1678-83.
|
| |
| |
In spite of many remarkable advances in our understanding of the mechanisms of cancer biology, very little attention has been directed toward mechanisms underlying cancer-induced symptoms. Although fatigue is a widely prevalent complication of cancer, there is a paucity of both basic and clinical research in this area. This article details our current knowledge of mechanisms causing cancer-related fatigue and briefly discusses currently available therapeutic options. A framework for addressing gaps in our knowledge and recommendations for future research directions are proposed.
|
| |
| AD |
Division of Anesthesiology, Critical and Palliative Care, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4095, USA. hgutstein@mdanderson.org
|
| PMID |
11598886
|
|
|
52
|
|
| TI |
Symptoms in advanced cancer: relationship to endogenous cortisol levels.
|
| AU |
Lundstrom S; Furst CJ
|
| SO |
Palliat Med 2003 Sep;17(6):503-8.
|
| |
| |
We investigated a possible relationship between levels of endogenous cortisol and severity of different symptoms in patients with advanced cancer. Twenty-three patients with predominantly gastrointestinal cancer, recruited in a palliative care unit, entered the study. Urinary free cortisol (UFC) was measured together with demographic data, blood parameters, tumour burden, concurrent illness, medication, nutritional status and quality of life. Significant positive correlations were found between levels of endogenous cortisol and appetite loss, fatigue and nausea/vomiting. The findings support the view of a chronic stress condition in advanced cancer. Interaction between cytokines and the hypothalamic-pituitary-adrenal (HPA) axis may also be important in the interpretation of the results.
|
| |
| AD |
Department of Palliative Medicine, Stockholms Sjukhem, Karolinska Institutet, Stockholm, Sweden. staffan.lundstrom@stockholmssjukhem.se
|
| PMID |
14526883
|
|
|
53
|
|
| TI |
A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer.
|
| AU |
Scott HR; McMillan DC; Brown DJ; Forrest LM; McArdle CS; Milroy R
|
| SO |
Lung Cancer 2003 Jun;40(3):295-9.
|
| |
| |
The relationship between weight loss, the systemic inflammatory response and quality of life in patients with inoperable non-small cell lung cancer (NSCLC) was studied. The extent of weight loss, the systemic inflammatory response (C-reactive protein) and quality of life (EORTC-QLQ-C30) was measured in 106 patients with inoperable NSCLC (stage III and IV). Approximately 40% had more than 5% weight loss and almost 80% had elevated circulating C-reactive protein concentrations (>10 mg/l). The functional scale scores of the EORTC-QLQ-C30 were poor (50 or less) and the fatigue symptom score was also poor (50 or more). When patients were grouped according to whether or not they had experienced more than 5% weight loss, Karnofsky performance status and global quality of life were lower (P<0.05) and symptom scores fatigue (P<0.05) and pain (P<0.01) were greater in the weight-losing group. When the weight-stable cancer patients were grouped according to whether or not they had evidence of a systemic inflammatory response, the symptom fatigue was higher in the inflammatory group (P<0.05). In the weight-stable cancer patients C-reactive protein concentration was correlated with fatigue r=0.31 (P<0.05). The results of the present study indicate that both weight loss and the systemic inflammatory response impact on different aspects of quality of life. In particular, fatigue is associated with the presence of a systemic inflammatory response independent of weight loss.
|
| |
| AD |
Department of Respiratory Medicine,Wishaw General Hospital, ML 0DP, Lanarkshire, UK.
|
| PMID |
12781428
|
