Fatigue is a very common problem that is very difficult to really understand. Of course we are all tired during cancer treatment, and there ae lots of good reasons: worry, difficulties with sleep, drugs that keep us awake, drugs that make us tried, etc. Most women continue to be tired for a while after treatment has ended. The rule of thumb is that it takes at least as long as the total duration of treatment to fully recover physically and emotionally. This means months. For some women, however, persistent fatigue is a very long-lasting problem. Here is an editorial from the Journal of Clinical Oncology about that kind of fatigue. Per usual, I give you the abstract and then a link:
Cancer-Related Fatigue in Women With Breast Cancer: Outcomes of a 5-Year Prospective Cohort Study
David Goldstein, Barbara K. Bennett, Kate Webber, Fran Boyle, Paul L. de Souza, Nicholas R.C. Wilcken, Elizabeth M. Scott, Ruth Toppler, Penelope Murie, Linda O'Malley, Junie McCourt, Michael Friedlander, Ian B. Hickie, and Andrew R. Lloyd
Prolonged and disabling fatigue is prevalent after cancer treatment, but the early natural history of cancer-related fatigue (CRF) has not been systematically examined to document consistent presence of symptoms. Hence, relationships to cancer, surgery, and adjuvant therapy are unclear.
Patients and Methods
A prospective cohort study of women receiving adjuvant treatment for early-stage breast cancer was conducted. Women were enrolled after surgery and observed at end treatment and at 1, 3, 6, 9, and 12 months as well as 5 years. Structured interviews and self-report questionnaires were used to record physical and psychologic health as well as disability and health care utilization. Patients with CRF persisting for 6 months were assessed to exclude alternative medical and psychiatric causes of fatigue. Predictors of persistent fatigue, mood disturbance, and health care utilization were sought by logistic regression.
The case rate for CRF was 24% postsurgery and 31% at end of treatment; it became persistent in 11% at 6 months and 6% at 12 months. At each time point, approximately one third of the patients had comorbid mood disturbance. Persistent CRF was predicted by tumor size but not demographic, psychologic, surgical, or hematologic parameters. CRF was associated with significant disability and health care utilization.
CRF is common but generally runs a self-limiting course. Much of the previously reported high rates of persistent CRF may be attributable to factors unrelated to the cancer or its treatment.
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