Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Supportive Care in Cancer
Published in: Supportive Care in Cancer 12/2020

01-12-2020 | Breast Cancer | Original Article

Cancer-related fatigue among long-term survivors of breast, cervical, and colorectal cancer: a French registry–based controlled study

Authors: François Gernier, Florence Joly, Delphine Klein, Mariette Mercier, Michel Velten, Idlir Licaj

Published in: Supportive Care in Cancer | Issue 12/2020

Login to get access

Abstract

Background

While several studies have documented fatigue during and after cancer treatment, long-term cancer survivor fatigue is underreported. In this study, we compare fatigue, quality of life (QoL), and anxiety between relapse-free cancer survivors 15 years after diagnosis and healthy controls.

Methods

Cancer survivors (CS) were randomly selected from three large population-based cancer registries (Bas-Rhin, Calvados, and Doubs, France). Cancer-free controls were randomly selected from electoral lists with stratification on age group, residence area, and gender. All participants completed self-reported fatigue (MFI), QoL (EORTC QLQ-C30), and anxiety (STAI) questionnaires. Univariable and multivariable logistic regression were used to study the association between fatigue and cancer status, in three cancer subgroups: breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC).

Results

Two hundred sixty-three CS and 688 controls (125/275, 45/153, 93/260 CS/controls for BC, CC, and CRC respectively) were included. The mean age was 66 years. In multivariable analyses, CS had higher general and mental fatigue than controls p = 0.04 and p = 0.02, respectively. No difference in QoL was observed between CS and controls. CS were more anxious than controls (p < 0.01). Anxiety was associated with general fatigue (p < 0.0001) and mental fatigue (p < 0.0001).

Conclusion

Fifteen years after diagnosis, cancer survivors reported more general and mental fatigue compared with controls. Our results reinforce guidelines, identifying fatigue as a persistent symptom.
Appendix
Available only for authorised users
Literature
1.
Uhry Z, Hédelin G, Colonna M, Asselain B, Arveux P, Exbrayat C, Guldenfelds C, Soler-Michel P, Molinié F, Trétarre B, Rogel A, Courtial I, Danzon A, Guizard AV, Ancelle-Park R, Eilstein D, Duffy S (2011) Modelling the effect of breast cancer screening on related mortality using French data. Cancer Epidemiol 35(3):235–242. https://​doi.​org/​10.​1016/​j.​canep.​2010.​10.​009CrossRefPubMed
2.
Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S (2007) Human papillomavirus and cervical cancer. Lancet 370(9590):890–907CrossRef
3.
Dahlberg M, Glimelius B, Pahlman L (1999) Changing strategy for rectal cancer is associated with improved outcome. Br J Surg 86:379–384CrossRef
4.
5.
Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang XS, Bannon F, Ahn JV, Johnson CJ, Bonaventure A, Marcos-Gragera R, Stiller C, Azevedo e Silva G, Chen WQ, Ogunbiyi OJ, Rachet B, Soeberg MJ, You H, Matsuda T, Bielska-Lasota M, Storm H, Tucker TC, Coleman MP, CONCORD Working Group (2015) Global surveillance of cancer survival 1995-2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 385(9972):977–1010CrossRef
6.
Kuhnt S, Ernst J, Singer S, Rüffer JU, Kortmann R-D, Stolzenburg J, Schwarz R (2009) Fatigue in cancer survivors – prevalence and correlates. Onkologie 32:312–317CrossRef
7.
Bower JE (2014) Cancer-related fatigue-mechanisms, risk factors, and treatments. Nat Rev Clin Oncol 11:597–609CrossRef
8.
9.
Sekse RJT, Raaheim M, Blaaka G, Gjengedal E (2010) Life beyond cancer: women’s experiences 5 years after treatment for gynaecological cancer. Scand J Caring Sci 24(4):799–807CrossRef
10.
11.
Bower JE, Bak K, Berger A, Breitbart W, Escalante CP, Ganz PA, Schnipper HH, Lacchetti C, Ligibel JA, Lyman GH, Ogaily MS, Pirl WF, Jacobsen PB, American Society of Clinical Oncology (2014) Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation. J Clin Oncol 32:1840–1850CrossRef
12.
Gaston-Johansson F, Fall-Dickson JM, Bakos AB, Kennedy MJ (1999) Fatigue, pain, and depression in pre-autotransplant breast cancer patients. Cancer Pract 7(5):240–247CrossRef
13.
Jacobsen PB, Hann DM, Azzarello LM, Horton J, Balducci L, Lyman GH (1999) Fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates. J Pain Symptom Manag 18(4):233–242CrossRef
14.
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. The Fatigue Coalition. Semin Hematol 34(3 Suppl 2):4–12PubMed
15.
Curt GA, Breitbart W, Cella D, Groopman JE, Horning SJ, Itri LM, Johnson DH, Miaskowski C, Scherr SL, Portenoy RK, Vogelzang NJ (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the fatigue coalition. Oncologist. 5:353–360CrossRef
16.
Bower JE, Ganz PA, Desmond KA, Bernaards C, Rowland JH, Meyerowitz BE, Belin TR (2006) Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer. 106(4):751–758CrossRef
17.
Fabi A, Falcicchio C, Giannarelli D, Maggi G, Cognetti F, Pugliese P (2017) The course of cancer related fatigue up to ten years in early breast cancer patients: what impact in clinical practice? Breast 34:44–52CrossRef
18.
Sprauten M, Haugnes HS, Brydøy M, Kiserud C, Tandstad T, Bjøro T, Bjerner J, Cvancarova M, Fosså SD, Oldenburg J (2015) Chronic fatigue in 812 testicular cancer survivors during long-term follow-up: increasing prevalence and risk factors. Ann Oncol 26:2133–2140CrossRef
19.
20.
21.
Le Borgne G, Mercier M, Woronoff AS et al (2013) Quality of life in long-term cervical cancer survivors: a population-based study. Gynecol Oncol 129:222–228CrossRef
22.
23.
Smets EM, Garssen B, Bonke B, De Haes JC (1995) The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 39(3):315–325CrossRef
24.
Gentile S, Delarozière JC, Favre F, Sambuc R, San Marco JL (2003) Validation of the French “multidimensional fatigue inventory” (MFI-20). Eur J Cancer Care 12(1):58–64CrossRef
25.
Smets EM, Garssen B, Cull A, de Haes JC (1996) Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br J Cancer 73(2):241–245CrossRef
26.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRef
27.
Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A (2001) In (eds): EORTC QLQ-C30 scoring manual, 3rd edn. EORTC Quality of Life Group, Brussels, pp 1–49
28.
Spielberger CD (1993) Paris: Centre de Psychologie Appliquée. Inventaire d’Anxiété tat-Trait: Adaptation Frana¸ise de Bruchon-Schweitzer M, Paulhan I; p 1–68. In French
29.
30.
Husson O, Mols F, Poll-Franse L, De VJ, Schep G, Thong MS (2015) Variation in fatigue among 6011 (long-term) cancer survivors and a normative population: a study from the population-based PROFILES registry. Support Care Cancer 23(7):2165–2174CrossRef
31.
Orre IJ, Fosså SD, Murison R, Bremnes R, Dahl O, Klepp O et al (2008) Chronic cancer-related fatigue in long-term survivors of testicular cancer. J Psychosom Res 64(4):363–371CrossRef
32.
33.
Schmidt ME, Chang-Claude J, Seibold P, Vrieling A, Heinz J, Steindorf DF-JK (2015) Determinants of long-term fatigue in breast cancer survivors: results of a prospective patient cohort study. Psycho-Oncology 24:40–46CrossRef
34.
Greenwald HP, McCorkle R, Baumgartner K, Gotay C, Neale AV (2014) Quality of life and disparities among long-term cervical cancer survivors. J Cancer Surviv 8(3):419–426CrossRef
35.
Steen R, Dahl AA, Hess SL, Kiserud CE (2017) A study of chronic fatigue in Norwegian cervical cancer survivors. Gynecol Oncol 146(3):630–635CrossRef
36.
Wu H-S, Harden JK (2015) Symptom burden and quality of life in survivorship: a review of the literature. Cancer Nurs 38:E29–E54CrossRef
37.
Vahdaninia M, Omidvari S, Montazeri A (2010) What do predict anxiety and depression in breast cancer patients? A follow-up study. Soc Psychiatry Psychiatr Epidemiol 45(3):355–361CrossRef
38.
Vistad I, Fossa S, Kristensen G, Dahl AA (2007) Chronic fatigue and its correlates in long-term survivors of cervical cancer treated with radiotherapy. BJOG 114:1150–1158CrossRef
39.
Fosså SD, Dahl AA, Loge JH (2003) Fatigue, anxiety, and depression in long-term survivors of testicular cancer. J Clin Oncol 21(7):1249–1254CrossRef
40.
Kröz M, Reif M, Bartsch C, Heckmann C, Zerm R, Schad F et al (2014) Impact of autonomic and self-regulation on cancer-related fatigue and distress in breast cancer patients--a prospective observational study. J Cancer Surviv 8(2):319–328CrossRef
41.
Sprangers MA, Schwartz CE (1999) Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med 48(11):1507–1515CrossRef
42.
43.
44.
Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C, National comprehensive cancer network (2015) Cancer-related fatigue, version 2.2015. National comprehensive cancer network. J Natl Compr Cancer Netw 13(8):1012–1039CrossRef
45.
Joly F, Lange M, Dos Santos M, Di Meglio IVLA (2019) Long-term fatigue and cognitive disorders in breast cancer survivors. Cancers 11:1896CrossRef
46.
Hager MA, Wilson S, Pollak TH, Rooney PM (2003) Response rates for mail surveys of nonprofit organizations: a review and empirical test. Nonprofit Volunt Sect Q 32:252–267CrossRef
Metadata
Title
Cancer-related fatigue among long-term survivors of breast, cervical, and colorectal cancer: a French registry–based controlled study
Authors
François Gernier
Florence Joly
Delphine Klein
Mariette Mercier
Michel Velten
Idlir Licaj
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 12/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-020-05427-8

Other articles of this Issue 12/2020

Supportive Care in Cancer 12/2020 Go to the issue

Original Article

Fear of cancer recurrence in haematological cancer patients: exploring socio-demographic, psychological, existential and disease-related factors

Commentary

Immunotherapy-mediated dermatological adverse events: the urgent need for a common, clinically meaningful, management strategy

Original Article

Safety and efficacy of cell-free and concentrated ascites reinfusion therapy (CART) in gastrointestinal cancer patients with massive ascites treated with systemic chemotherapy

Commentary

Increasing access to psychosocial oncology services means becoming more person-centered and situation-responsive

Original Article

Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study

Original Article

Improvements in muscle strength, power, and size and self-reported fatigue as mediators of the effect of resistance exercise on physical performance breast cancer survivor women: a randomized controlled trial
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

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
Image Credits