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Published in: Supportive Care in Cancer 10/2018

01-10-2018 | Original Article

Health status among long-term breast cancer survivors suffering from higher levels of fatigue: a cross-sectional study

Authors: Francisco Álvarez-Salvago, Noelia Galiano-Castillo, Manuel Arroyo-Morales, Mayra Cruz-Fernández, Mario Lozano-Lozano, Irene Cantarero-Villanueva

Published in: Supportive Care in Cancer | Issue 10/2018

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Abstract

Purpose

The aims of this study were to evaluate the health status of long-term breast cancer survivors (LTBCS) suffering from higher levels of fatigue, to highlight their needs, and to establish the key points of intervention support programs.

Methods

A cross-sectional observational study was conducted at the Sport and Health Joint University Institute (iMUDS) between September 2016 and July 2017 with 80 LTBCS that were classified into non-fatigued (≤ 3.9) or fatigued (≥ 4) according to the Piper Fatigue Scale (PFS) total score. The instruments used were the European Organization for Research and Treatment of Cancer Core 30 and its breast cancer (BC) module, the Visual Analog Scale (VAS), the Brief Pain Inventory (BPI), the Scale for Mood Assessment (EVEA), the International Fitness Scale (IFIS), and the Charlson Comorbidity Index.

Results

The analysis revealed that 41.2% of LTBCS were considered moderately fatigued and showed significantly higher levels for the categories of “nausea and vomiting” (P = .005), “pain,” “dyspnea” and “insomnia” (P < .001), “appetite loss” (P = .002), “financial difficulties” (P = .010), “systemic therapy side effects” (P < .001), “breast symptoms” and “arm symptoms” (P = .002), and “upset by hair loss” (P = .016). In addition, LTBCS presented significantly higher levels of pain in the affected and non-affected arm, “sadness-depression.” “anxiety,” “anger/hostility” (All: P < .001), and lower general physical fitness (P < .001). The rest of the variables did not show significant differences.

Conclusion

LTBCS suffering from higher levels of fatigue had lower QoL, higher level of pain, worse mood state, and lower physical fitness.
Literature
3.
go back to reference Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Supplement 1):4–10CrossRefPubMed Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Supplement 1):4–10CrossRefPubMed
4.
go back to reference Lee B-N, Dantzer R, Langley KE, Bennett GJ, Dougherty PM, Dunn AJ, Meyers CA, Miller AH, Payne R, Reuben JM (2004) A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 11(5):279–292CrossRefPubMed Lee B-N, Dantzer R, Langley KE, Bennett GJ, Dougherty PM, Dunn AJ, Meyers CA, Miller AH, Payne R, Reuben JM (2004) A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 11(5):279–292CrossRefPubMed
5.
go back to reference Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR (2007) Mechanisms of cancer-related fatigue. Oncologist 12(Supplement 1):22–34CrossRefPubMed Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR (2007) Mechanisms of cancer-related fatigue. Oncologist 12(Supplement 1):22–34CrossRefPubMed
7.
go back to reference Kober KM, Smoot B, Paul SM, Cooper BA, Levine JD, Miaskowski C (2016) Polymorphisms in cytokine genes are associated with higher levels of fatigue and lower levels of energy in women after breast cancer surgery. J Pain Symptom Manag 52(5):695–708. e694CrossRef Kober KM, Smoot B, Paul SM, Cooper BA, Levine JD, Miaskowski C (2016) Polymorphisms in cytokine genes are associated with higher levels of fatigue and lower levels of energy in women after breast cancer surgery. J Pain Symptom Manag 52(5):695–708. e694CrossRef
8.
go back to reference Schmidt ME, Semik J, Habermann N, Wiskemann J, Ulrich CM, Steindorf K (2016) Cancer-related fatigue shows a stable association with diurnal cortisol dysregulation in breast cancer patients. Brain Behav Immun 52:98–105CrossRefPubMed Schmidt ME, Semik J, Habermann N, Wiskemann J, Ulrich CM, Steindorf K (2016) Cancer-related fatigue shows a stable association with diurnal cortisol dysregulation in breast cancer patients. Brain Behav Immun 52:98–105CrossRefPubMed
9.
go back to reference LaVoy EC, Fagundes CP, Dantzer R (2016) Exercise, inflammation, and fatigue in cancer survivors. Exerc Immunol Rev 22:82PubMedPubMedCentral LaVoy EC, Fagundes CP, Dantzer R (2016) Exercise, inflammation, and fatigue in cancer survivors. Exerc Immunol Rev 22:82PubMedPubMedCentral
10.
go back to reference Schmidt ME, Chang-Claude J, Vrieling A, Heinz J, Flesch-Janys D, Steindorf K (2012) Fatigue and quality of life in breast cancer survivors: temporal courses and long-term pattern. J Cancer Surviv 6(1):11–19CrossRefPubMed Schmidt ME, Chang-Claude J, Vrieling A, Heinz J, Flesch-Janys D, Steindorf K (2012) Fatigue and quality of life in breast cancer survivors: temporal courses and long-term pattern. J Cancer Surviv 6(1):11–19CrossRefPubMed
11.
go back to reference Romito F, Cormio C, Giotta F, Colucci G, Mattioli V (2012) Quality of life, fatigue and depression in Italian long-term breast cancer survivors. Support Care Cancer 20(11):2941–2948CrossRefPubMed Romito F, Cormio C, Giotta F, Colucci G, Mattioli V (2012) Quality of life, fatigue and depression in Italian long-term breast cancer survivors. Support Care Cancer 20(11):2941–2948CrossRefPubMed
12.
go back to reference Romito F, Montanaro R, Corvasce C, Di Bisceglie M, Mattioli V (2008) Is cancer-related fatigue more strongly correlated to haematological or to psychological factors in cancer patients? Support Care Cancer 16(8):943–946CrossRefPubMed Romito F, Montanaro R, Corvasce C, Di Bisceglie M, Mattioli V (2008) Is cancer-related fatigue more strongly correlated to haematological or to psychological factors in cancer patients? Support Care Cancer 16(8):943–946CrossRefPubMed
14.
go back to reference Schmidt ME, Chang-Claude J, Seibold P, Vrieling A, Heinz J, Flesch-Janys D, Steindorf K (2015) Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study. Psycho-Oncology 24(1):40–46CrossRefPubMed Schmidt ME, Chang-Claude J, Seibold P, Vrieling A, Heinz J, Flesch-Janys D, Steindorf K (2015) Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study. Psycho-Oncology 24(1):40–46CrossRefPubMed
15.
go back to reference Reinertsen KV, Cvancarova M, Loge JH, Edvardsen H, Wist E, Fosså SD (2010) Predictors and course of chronic fatigue in long-term breast cancer survivors. J Cancer Surviv 4(4):405–414CrossRefPubMedPubMedCentral Reinertsen KV, Cvancarova M, Loge JH, Edvardsen H, Wist E, Fosså SD (2010) Predictors and course of chronic fatigue in long-term breast cancer survivors. J Cancer Surviv 4(4):405–414CrossRefPubMedPubMedCentral
16.
go back to reference Carlsen K, Jensen AJ, Rugulies R, Christensen J, Bidstrup PE, Johansen C, Huitfeldt Madsen IE, Dalton SO (2013) Self-reported work ability in long-term breast cancer survivors. A population-based questionnaire study in Denmark. Acta Oncol 52(2):423–429CrossRefPubMed Carlsen K, Jensen AJ, Rugulies R, Christensen J, Bidstrup PE, Johansen C, Huitfeldt Madsen IE, Dalton SO (2013) Self-reported work ability in long-term breast cancer survivors. A population-based questionnaire study in Denmark. Acta Oncol 52(2):423–429CrossRefPubMed
18.
go back to reference Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM (1998) The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 4:677–684 Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM (1998) The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 4:677–684
19.
go back to reference O’Regan P, Hegarty J (2017) The importance of self-care for fatigue amongst patients undergoing chemotherapy for primary cancer. Eur J Oncol Nurs 28:47–55CrossRef O’Regan P, Hegarty J (2017) The importance of self-care for fatigue amongst patients undergoing chemotherapy for primary cancer. Eur J Oncol Nurs 28:47–55CrossRef
20.
go back to reference Chang YJ, Lee JS, Lee CG, Lee WS, Lee KS, Bang S-M, Wang XS, Mendoza TR, Cleeland CS, Yun YH (2007) Assessment of clinical relevant fatigue level in cancer. Support Care Cancer 15(7):891–896CrossRefPubMed Chang YJ, Lee JS, Lee CG, Lee WS, Lee KS, Bang S-M, Wang XS, Mendoza TR, Cleeland CS, Yun YH (2007) Assessment of clinical relevant fatigue level in cancer. Support Care Cancer 15(7):891–896CrossRefPubMed
21.
go back to reference Law 14/2007, of July 3, on Biomedical Research. Official Bulletin of the State, No 159, BOE-A-2007-12945 (Jun 2, 2011) Law 14/2007, of July 3, on Biomedical Research. Official Bulletin of the State, No 159, BOE-A-2007-12945 (Jun 2, 2011)
22.
go back to reference Cantarero-Villanueva I, Fernández-Lao C, Díaz-Rodríguez L, Cuesta-Vargas AI, Fernández-de-las-Peñas C, Piper BF, Arroyo-Morales M (2014) The Piper fatigue scale-revised: translation and psychometric evaluation in Spanish-speaking breast cancer survivors. Qual Life Res 23(1):271–276CrossRefPubMed Cantarero-Villanueva I, Fernández-Lao C, Díaz-Rodríguez L, Cuesta-Vargas AI, Fernández-de-las-Peñas C, Piper BF, Arroyo-Morales M (2014) The Piper fatigue scale-revised: translation and psychometric evaluation in Spanish-speaking breast cancer survivors. Qual Life Res 23(1):271–276CrossRefPubMed
23.
go back to reference Zawisza K, Tobiasz-Adamczyk B, Nowak W, Kulig J, Jędrys J (2010) Validity and reliability of the quality of life questionnaire (EORTC QLQ C30) and its breast cancer module (EORTC QLQ BR23). Ginekol Pol 81(4) Zawisza K, Tobiasz-Adamczyk B, Nowak W, Kulig J, Jędrys J (2010) Validity and reliability of the quality of life questionnaire (EORTC QLQ C30) and its breast cancer module (EORTC QLQ BR23). Ginekol Pol 81(4)
24.
go back to reference Sprangers M, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, Franzini L, Williams A, De Haes H, Hopwood P (1996) The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol 14(10):2756–2768CrossRefPubMed Sprangers M, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, Franzini L, Williams A, De Haes H, Hopwood P (1996) The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol 14(10):2756–2768CrossRefPubMed
25.
go back to reference Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8(12):1153–1157CrossRefPubMed Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8(12):1153–1157CrossRefPubMed
26.
go back to reference Badia X, Muriel C, Gracia A, Nunez-Olarte J, Perulero N, Galvez R, Carulla J, Cleeland C (2003) Validation of the Spanish version of the Brief Pain Inventory in patients with oncological pain. Med Clin 120(2):52–59CrossRef Badia X, Muriel C, Gracia A, Nunez-Olarte J, Perulero N, Galvez R, Carulla J, Cleeland C (2003) Validation of the Spanish version of the Brief Pain Inventory in patients with oncological pain. Med Clin 120(2):52–59CrossRef
27.
go back to reference Sanz J (2001) Un instrumento para evaluar la eficacia de los procedimientos de inducción de estado de ánimo:“La Escala de Valoración del Estado de Ánimo”(EVEA). Análisis y Modificación de Conducta 27(111):71–110 Sanz J (2001) Un instrumento para evaluar la eficacia de los procedimientos de inducción de estado de ánimo:“La Escala de Valoración del Estado de Ánimo”(EVEA). Análisis y Modificación de Conducta 27(111):71–110
28.
go back to reference Español-Moya MN, Ramírez-Vélez R (2014) Psychometric validation of the International FItness Scale (IFIS) in Colombian youth. Rev Esp de Salud Publica 88(2):271–278CrossRef Español-Moya MN, Ramírez-Vélez R (2014) Psychometric validation of the International FItness Scale (IFIS) in Colombian youth. Rev Esp de Salud Publica 88(2):271–278CrossRef
29.
go back to reference Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW (1996) Can comorbidity be measured by questionnaire rather than medical record review? Med Care 34(1):73–84CrossRefPubMed Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW (1996) Can comorbidity be measured by questionnaire rather than medical record review? Med Care 34(1):73–84CrossRefPubMed
30.
go back to reference Cohen J (1977) Statistical power analysis for the behavioural sciences. Academic, New York Cohen J (1977) Statistical power analysis for the behavioural sciences. Academic, New York
31.
go back to reference Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR (2000) Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 18(4):743–743CrossRefPubMed Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR (2000) Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 18(4):743–743CrossRefPubMed
32.
go back to reference Meeske K, Smith AW, Alfano CM, McGregor BA, McTiernan A, Baumgartner KB, Malone KE, Reeve BB, Ballard-Barbash R, Bernstein L (2007) Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report. Qual Life Res 16(6):947–960CrossRefPubMed Meeske K, Smith AW, Alfano CM, McGregor BA, McTiernan A, Baumgartner KB, Malone KE, Reeve BB, Ballard-Barbash R, Bernstein L (2007) Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report. Qual Life Res 16(6):947–960CrossRefPubMed
33.
go back to reference Falk Dahl CA, Reinertsen KV, Nesvold IL, Fosså SD, Dahl AA (2010) A study of body image in long-term breast cancer survivors. Cancer 116(15):3549–3557CrossRefPubMed Falk Dahl CA, Reinertsen KV, Nesvold IL, Fosså SD, Dahl AA (2010) A study of body image in long-term breast cancer survivors. Cancer 116(15):3549–3557CrossRefPubMed
34.
go back to reference Arraras JI, Illarramendi JJ, Salgado E, de la Cruz S, Asin G, Manterola A, Ibañez B, Zarandona U, Dominguez MA, Vera R (2016) An evaluation study of the determinants of future perspective and global Quality of Life in Spanish long-term premenopausal early-stage breast cancer survivors. Contemp Oncol 20(2):165–170 Arraras JI, Illarramendi JJ, Salgado E, de la Cruz S, Asin G, Manterola A, Ibañez B, Zarandona U, Dominguez MA, Vera R (2016) An evaluation study of the determinants of future perspective and global Quality of Life in Spanish long-term premenopausal early-stage breast cancer survivors. Contemp Oncol 20(2):165–170
35.
go back to reference Kim SH, Son BH, Hwang SY, Han W, Yang J-H, Lee S, Yun YH (2008) Fatigue and depression in disease-free breast cancer survivors: prevalence, correlates, and association with quality of life. J Pain Symptom Manag 35(6):644–655CrossRef Kim SH, Son BH, Hwang SY, Han W, Yang J-H, Lee S, Yun YH (2008) Fatigue and depression in disease-free breast cancer survivors: prevalence, correlates, and association with quality of life. J Pain Symptom Manag 35(6):644–655CrossRef
37.
go back to reference Laird BJ, Scott AC, Colvin LA, McKeon A-L, Murray GD, Fearon KC, Fallon MT (2011) Pain, depression, and fatigue as a symptom cluster in advanced cancer. J Pain Symptom Manag 42(1):1–11CrossRef Laird BJ, Scott AC, Colvin LA, McKeon A-L, Murray GD, Fearon KC, Fallon MT (2011) Pain, depression, and fatigue as a symptom cluster in advanced cancer. J Pain Symptom Manag 42(1):1–11CrossRef
41.
go back to reference Resnick HE, Carter EA, Aloia M, Phillips B (2006) Cross-sectional relationship of reported fatigue to obesity, diet, and physical activity: results from the third national health and nutrition examination survey. J Clin Sleep Med 2(2):163–169PubMed Resnick HE, Carter EA, Aloia M, Phillips B (2006) Cross-sectional relationship of reported fatigue to obesity, diet, and physical activity: results from the third national health and nutrition examination survey. J Clin Sleep Med 2(2):163–169PubMed
42.
go back to reference Bouchard C (ed) (2000) Physical activity and obesity. Human Kinetics Press, Champaign Bouchard C (ed) (2000) Physical activity and obesity. Human Kinetics Press, Champaign
43.
go back to reference Mason C, Alfano CM, Smith AW, Wang C-Y, Neuhouser ML, Duggan C, Bernstein L, Baumgartner KB, Baumgartner RN, Ballard-Barbash R, McTiernan A (2013) Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomarkers Prev 22(6):1153–1161 Mason C, Alfano CM, Smith AW, Wang C-Y, Neuhouser ML, Duggan C, Bernstein L, Baumgartner KB, Baumgartner RN, Ballard-Barbash R, McTiernan A (2013) Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomarkers Prev 22(6):1153–1161
46.
go back to reference Woo HK, Park JH, Kang HS, Kim SY, Lee SI, Nam HH (2010) Charlson Comorbidity Index as a predictor of long-term survival after surgery for breast cancer: a Nationwide Retrospective Cohort Study in South Korea. J Breast Cancer 13(4):409–417CrossRef Woo HK, Park JH, Kang HS, Kim SY, Lee SI, Nam HH (2010) Charlson Comorbidity Index as a predictor of long-term survival after surgery for breast cancer: a Nationwide Retrospective Cohort Study in South Korea. J Breast Cancer 13(4):409–417CrossRef
Metadata
Title
Health status among long-term breast cancer survivors suffering from higher levels of fatigue: a cross-sectional study
Authors
Francisco Álvarez-Salvago
Noelia Galiano-Castillo
Manuel Arroyo-Morales
Mayra Cruz-Fernández
Mario Lozano-Lozano
Irene Cantarero-Villanueva
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4240-z

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