Skip to main content
Top
Published in: Supportive Care in Cancer 9/2016

01-09-2016 | Original Article

Fatigue in adolescent and adult survivors of non-CNS childhood cancer: a report from project REACH

Authors: Natasha N. Frederick, Lisa Kenney, Lynda Vrooman, Christopher J. Recklitis

Published in: Supportive Care in Cancer | Issue 9/2016

Login to get access

Abstract

Purpose

Studies of fatigue in childhood cancer survivors (CCS) are inconclusive, with some reporting increased fatigue prevalence in this population while others do not. Given the potentially significant consequences of unmanaged fatigue, we sought to estimate the prevalence of fatigue and to identify factors associated with fatigue in a population of non-CNS CCS ranging from adolescence to middle adulthood using a single fatigue measurement tool.

Methods

Two hundred sixty-eight CCS ages 12–49 years followed in a survivorship clinic at a single cancer center completed validated self-report measures of fatigue, depression, and quality of life. Demographic and current health data were collected by study questionnaire and chart review

Results

Based on age-adjusted population norms, the prevalence of fatigue was 13.8 %, which is not significantly different compared to results in healthy populations. Fatigue was independently associated with having ≥3 chronic health conditions (OR 4.27, 95 % CI 1.52–11.99). Fatigued participants reported lower overall quality of life scores (OR 0.86, 95 % CI 0.82–0.89) and were more likely to be depressed compared to non-fatigued patients (20.4 vs. 1.4 %, respectively, p < 0.0001). There were 41(78.8 %) survivors with fatigue in our population who did not report significant depression.

Conclusions

CCS did not demonstrate increased fatigue compared to age-matched normative data. Fatigued survivors were more likely to have multiple chronic conditions, depression, and decreased quality of life. Longitudinal study will promote better understanding of the relationship between fatigue and specific chronic conditions, thereby facilitating early identification of those individuals most at risk.
Literature
1.
go back to reference Mariotto AB, Rowland JH, Yabroff KR, Scoppa S, Hachey M, Ries L, Feuer EJ (2009) Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomark Prev 18:1033–1040CrossRef Mariotto AB, Rowland JH, Yabroff KR, Scoppa S, Hachey M, Ries L, Feuer EJ (2009) Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomark Prev 18:1033–1040CrossRef
2.
go back to reference Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivvastave DK, Robison LL (2013) Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA 309:2371–2381CrossRefPubMedPubMedCentral Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivvastave DK, Robison LL (2013) Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA 309:2371–2381CrossRefPubMedPubMedCentral
3.
go back to reference Armstrong GT, Kawashima T, Leisenring W, Stratton K, Stovall M, Hudson MM, Sklar CA, Robison LL, Oeffinger KC (2014) Aging and risk of severe, disabling, life-threatening, and fatal events in the childhood cancer survivor study. J Clin Oncol 32:1218–1227CrossRefPubMedPubMedCentral Armstrong GT, Kawashima T, Leisenring W, Stratton K, Stovall M, Hudson MM, Sklar CA, Robison LL, Oeffinger KC (2014) Aging and risk of severe, disabling, life-threatening, and fatal events in the childhood cancer survivor study. J Clin Oncol 32:1218–1227CrossRefPubMedPubMedCentral
4.
go back to reference Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. Semin Hematol 34:4–12PubMed Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. Semin Hematol 34:4–12PubMed
5.
go back to reference Andrykowski MA, Curran SL, Lightner R (1998) Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med 21:1–18CrossRefPubMed Andrykowski MA, Curran SL, Lightner R (1998) Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med 21:1–18CrossRefPubMed
6.
go back to reference Loge JH, Abrahamsen AF, Ekeberg Ø, Kaasa S (1999) Hodgkin’s disease survivors more fatigued than the general population. J Clin Oncol 17:253–261PubMed Loge JH, Abrahamsen AF, Ekeberg Ø, Kaasa S (1999) Hodgkin’s disease survivors more fatigued than the general population. J Clin Oncol 17:253–261PubMed
7.
go back to reference Calaminus G, Dörffel W, Baust K, Teske C, Riepenhausen M, Brämswig J, Flechtner H-H, Singer S, Hinz A, Schellong G (2014) Quality of life in long-term survivors following treatment for Hodgkin’s disease during childhood and adolescence in the German multicentre studies between 1978 and 2002. Support Care Cancer 22:1519–1529CrossRefPubMed Calaminus G, Dörffel W, Baust K, Teske C, Riepenhausen M, Brämswig J, Flechtner H-H, Singer S, Hinz A, Schellong G (2014) Quality of life in long-term survivors following treatment for Hodgkin’s disease during childhood and adolescence in the German multicentre studies between 1978 and 2002. Support Care Cancer 22:1519–1529CrossRefPubMed
8.
go back to reference Jóhannsdóttir IMR, Hjermstad MJ, Moum T, Wesenberg F, Hjorth L, Schroder H, Mort S, Jonmundsson G, Loge JH (2012) Increased prevalence of chronic fatigue among survivors of childhood cancers : a population-based study. Pediatr Blood Cancer 58:415–420CrossRefPubMed Jóhannsdóttir IMR, Hjermstad MJ, Moum T, Wesenberg F, Hjorth L, Schroder H, Mort S, Jonmundsson G, Loge JH (2012) Increased prevalence of chronic fatigue among survivors of childhood cancers : a population-based study. Pediatr Blood Cancer 58:415–420CrossRefPubMed
9.
go back to reference Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK, Robison LL, Mertens AC (2008) Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS). Sleep 31:271–281PubMedPubMedCentral Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK, Robison LL, Mertens AC (2008) Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS). Sleep 31:271–281PubMedPubMedCentral
10.
go back to reference Langeveld NE, Grootenhuis M a, Voûte P a, de Haan RJ, van den Bos C (2003) No excess fatigue in young adult survivors of childhood cancer. Eur J Cancer 39:204–214. Langeveld NE, Grootenhuis M a, Voûte P a, de Haan RJ, van den Bos C (2003) No excess fatigue in young adult survivors of childhood cancer. Eur J Cancer 39:204–214.
11.
go back to reference Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L (2005) Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:5501–5510CrossRefPubMed Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L (2005) Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:5501–5510CrossRefPubMed
12.
go back to reference Arnett JJ (2000) Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol 55:469–480CrossRefPubMed Arnett JJ (2000) Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol 55:469–480CrossRefPubMed
13.
go back to reference Bober SL, Zhou ES, Chen B, Manley PE, Kenney LB, Recklitis CJ (2013) Sexual function in childhood cancer survivors: a report from project REACH. J Sex Med 10:2084–2093CrossRefPubMed Bober SL, Zhou ES, Chen B, Manley PE, Kenney LB, Recklitis CJ (2013) Sexual function in childhood cancer survivors: a report from project REACH. J Sex Med 10:2084–2093CrossRefPubMed
14.
go back to reference Varni JW, Ph D, Burwinkle TM, Katz ER, Meeske K, Dickinson P, Pedsql T (2002) The PedsQL ™ in pediatric cancer reliability and validity of the pediatric quality of life inventory ™ generic Core. Cancer 94:2090–2106CrossRefPubMed Varni JW, Ph D, Burwinkle TM, Katz ER, Meeske K, Dickinson P, Pedsql T (2002) The PedsQL ™ in pediatric cancer reliability and validity of the pediatric quality of life inventory ™ generic Core. Cancer 94:2090–2106CrossRefPubMed
15.
go back to reference Varni JW, Limbers CA (2008) The PedsQL multidimensional fatigue scale in young adults: feasibility, reliability and validity in a university student population. Qual Life Res 17:105–114CrossRefPubMed Varni JW, Limbers CA (2008) The PedsQL multidimensional fatigue scale in young adults: feasibility, reliability and validity in a university student population. Qual Life Res 17:105–114CrossRefPubMed
16.
go back to reference Robert RS, Paxton RJ, Palla SL, Yang G, Askins M, Joy SE, Ater JL (2012) Feasibility, reliability, and validity of the pediatric quality of life inventory generic Core Scales, cancer module, and multidimensional fatigue scale in long-term adult survivors of pediatric cancer. Pediatr Blood Cancer 59:703–707CrossRefPubMedPubMedCentral Robert RS, Paxton RJ, Palla SL, Yang G, Askins M, Joy SE, Ater JL (2012) Feasibility, reliability, and validity of the pediatric quality of life inventory generic Core Scales, cancer module, and multidimensional fatigue scale in long-term adult survivors of pediatric cancer. Pediatr Blood Cancer 59:703–707CrossRefPubMedPubMedCentral
17.
go back to reference Derogatis L (2000) BSI 18: brief symptom inventory 18. National Computer Systems, Inc., Minneapolis Derogatis L (2000) BSI 18: brief symptom inventory 18. National Computer Systems, Inc., Minneapolis
18.
go back to reference Zabora J, Brintzenhofseszoc K, Jacobsen P, Curbow B, Piantadosi S, Hooker C, Owens A, Derogatis L (2001) A new psychosocial screening instrument for use with cancer patients. Psychosomatics 42:241–246CrossRefPubMed Zabora J, Brintzenhofseszoc K, Jacobsen P, Curbow B, Piantadosi S, Hooker C, Owens A, Derogatis L (2001) A new psychosocial screening instrument for use with cancer patients. Psychosomatics 42:241–246CrossRefPubMed
19.
go back to reference Recklitis CJ, Parsons SK, Shih M-C, Mertens A, Robison LL, Zeltzer L (2006) Factor structure of the brief symptom inventory-18 in adult survivors of childhood cancer: results from the childhood cancer survivor study. Psychol Assess 18:22–32CrossRefPubMed Recklitis CJ, Parsons SK, Shih M-C, Mertens A, Robison LL, Zeltzer L (2006) Factor structure of the brief symptom inventory-18 in adult survivors of childhood cancer: results from the childhood cancer survivor study. Psychol Assess 18:22–32CrossRefPubMed
20.
go back to reference Beck JS, Beck AT, Jolly JB, Steer RA (2005) Manual for Beck youth inventories, second edi. Harcourt Assessment, Oxford Beck JS, Beck AT, Jolly JB, Steer RA (2005) Manual for Beck youth inventories, second edi. Harcourt Assessment, Oxford
21.
go back to reference Kenney LB, Nancarrow CM, Najita J, Vrooman LM, Rothwell M, Recklitis C, Li FP, Diller L (2010) Health status of the oldest adult survivors of cancer during childhood. Cancer 116:497–505CrossRefPubMed Kenney LB, Nancarrow CM, Najita J, Vrooman LM, Rothwell M, Recklitis C, Li FP, Diller L (2010) Health status of the oldest adult survivors of cancer during childhood. Cancer 116:497–505CrossRefPubMed
22.
go back to reference Gordijn MS, van Litsenburg RR, Gemke RJ, Huisman J, Bierings MB, Hoogerbrugge PM, Kaspers GJL (2013) Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 60:479–485CrossRefPubMed Gordijn MS, van Litsenburg RR, Gemke RJ, Huisman J, Bierings MB, Hoogerbrugge PM, Kaspers GJL (2013) Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 60:479–485CrossRefPubMed
23.
go back to reference Langeveld NE, Stam H, Grootenhuis M, Last BF (2002) Quality of life in young adult survivors of childhood cancer. Support Care Cancer 10:579–600CrossRefPubMed Langeveld NE, Stam H, Grootenhuis M, Last BF (2002) Quality of life in young adult survivors of childhood cancer. Support Care Cancer 10:579–600CrossRefPubMed
24.
go back to reference Armstrong GT, Pan Z, Ness KK, Srivastava D, Robison LL (2010) Temporal trends in cause-specific late mortality among 5-year survivors of childhood cancer. J Clin Oncol 28:1224–1231CrossRefPubMedPubMedCentral Armstrong GT, Pan Z, Ness KK, Srivastava D, Robison LL (2010) Temporal trends in cause-specific late mortality among 5-year survivors of childhood cancer. J Clin Oncol 28:1224–1231CrossRefPubMedPubMedCentral
25.
go back to reference Krischer JP, Epstein S, Cuthbertson DD, Goorin AM, Epstein ML, Lipshultz SE (1997) Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the pediatric oncology group experience. J Clin Oncol 15:1544–1552PubMed Krischer JP, Epstein S, Cuthbertson DD, Goorin AM, Epstein ML, Lipshultz SE (1997) Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the pediatric oncology group experience. J Clin Oncol 15:1544–1552PubMed
26.
go back to reference Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kaden-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582CrossRefPubMed Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kaden-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582CrossRefPubMed
27.
go back to reference Visser MR, Smets EM (1998) Fatigue, depression and quality of life in cancer patients: how are they related? Support Care Cancer 6:101–108CrossRefPubMed Visser MR, Smets EM (1998) Fatigue, depression and quality of life in cancer patients: how are they related? Support Care Cancer 6:101–108CrossRefPubMed
28.
go back to reference Kanellopoulos A, Hamre HM, Dahl AA, Ruud E, Fossa SD (2013) Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma. Pediatr Blood Cancer 60(5):849–855 Kanellopoulos A, Hamre HM, Dahl AA, Ruud E, Fossa SD (2013) Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma. Pediatr Blood Cancer 60(5):849–855
29.
go back to reference Clanton NR, Klosky JL, Li C, Jain N, Srivastava DK, Mulrooney D, Zeltzer L, Stovall M, Robison LL, Krull KR (2011) Fatigue, vitality, sleep, and neurocognitive functioning in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Cancer 117:2559–2568CrossRefPubMedPubMedCentral Clanton NR, Klosky JL, Li C, Jain N, Srivastava DK, Mulrooney D, Zeltzer L, Stovall M, Robison LL, Krull KR (2011) Fatigue, vitality, sleep, and neurocognitive functioning in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Cancer 117:2559–2568CrossRefPubMedPubMedCentral
Metadata
Title
Fatigue in adolescent and adult survivors of non-CNS childhood cancer: a report from project REACH
Authors
Natasha N. Frederick
Lisa Kenney
Lynda Vrooman
Christopher J. Recklitis
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3230-2

Other articles of this Issue 9/2016

Supportive Care in Cancer 9/2016 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine