Prevalence,predictors, and characteristics of off‐treatment fatigue in breast cancer survivors

BACKGROUND:

Lack of consensus regarding how to identify cancer patients with significant fatigue has hampered research regarding cancer‐related fatigue (CRF).

METHODS:

Specific criteria were used to identify CRF cases in women with stage 0‐II breast cancer (BC group, n = 304). Women completed assessments before adjuvant therapy (baseline), end of adjuvant therapy (Post‐Tx), and 6 and 42 months after end of adjuvant therapy (6 and 42 Month Post‐Tx). At each, women completed a clinical interview and questionnaires assessing physical and mental health. A healthy control (HC) group with no history of BC (n = 337) completed 2 similar assessments 36 months apart.

RESULTS:

Off‐treatment CRF prevalence was 9% and 13% at the 6 and 42 Month Post‐Tx assessments, respectively. Thus, 15% of the sample evidenced off‐treatment CRF with 7% evidencing delayed onset CRF. CRF at the 6 Month Post‐Tx assessment was associated only with CRF at baseline (OR = 3.2) and Post‐Tx assessments (OR = 3.9). CRF at the 42 Month Post‐Tx assessment was associated with CRF at the Post‐Tx assessment (OR = 6.1), obesity at baseline, and several baseline measures of coping in response to fatigue. Off‐treatment CRF cases differed markedly from CRF noncases and healthy controls on a spectrum of health status indices (mean effect size >1.0 SD).

CONCLUSIONS:

Results document the prevalence of off‐treatment and delayed onset CRF, suggest the utility of a cognitive‐behavioral model of CRF, and support NCCN guidelines recommending monitoring fatigue across the cancer trajectory. Cancer 2010. © 2010 American Cancer Society.