Subtypes of Cancer Fatigue

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

OCTOBER 02, 2017

I am uncertain whether this article from the Journal of Cancer Survivorship is useful or arcane. It is, at least to me, interesting. I have written before about the common problem of cancer fatigue. We are all aware that it is quite different from the not having enough sleep fatigue that happens in normal life. (and as an aside and a lesson : yesterday morning we were blasted from sleep at 3 AM by the fire alarm going off in our house. You can imagine what the first few seconds were like. The fireman came, axes and all, and, blessedly there was no fire. The best explanation, since the alarm system indicated that it came from the basement smoke detector, was that there were cobwebs around the sensor, and a moving spider likely set it off. Lesson: clean off your smoke detectors.)

This article suggests that there are several distinct types of cancer-related fatigue. The potentially helpful part is that there are different suggestions of how to manage them. Here is the abstract and a link to read more. Note that you can access the full article from this page:

Identifying the subtypes of cancer-related fatigue: results from the population-based PROFILES registry.

Thong MSY1, Mols F2,3, van de Poll-Franse LV2,3,4, Sprangers MAG5, van der Rijt CCD6, Barsevick AM7, Knoop H5,8, Husson O9

Little research has been done to identify possible cancer-related fatigue (CRF) subtypes and to classify cancer survivors accordingly. We aimed to identify CRF subtypes in a large population-based sample of (long term) stage I-III colorectal cancer survivors. We also identified factors associated with the CRF subtypes.

Respondents completed the Multidimensional Fatigue Inventory and other validated questionnaires on anxiety and reduced positive affect (anhedonia), sleep quality, and lifestyle factors (body mass index and physical activity). Latent class analysis was used to derive the CRF subtypes. Factors associated with the derived CRF subtypes were determined with multinomial logistic regression.

Three CRF classes were identified: class 1 (no fatigue and distress, n = 644, 56%), class 2 (low fatigue, moderate distress, n = 256, 22%), and class 3 (high fatigue, moderate distress, n = 256, 22%). Multinomial logistic regression results show that survivors in class 3 were more likely to be female, were treated with radiotherapy, have comorbid diabetes mellitus, and be overweight/obese than survivors in class 1 (reference). Survivors in classes 2 and 3 were also more likely to have comorbid heart condition, report poorer sleep quality, experience anhedonia, and report more anxiety symptoms when compared with survivors in class 1.

Three distinct classes of CRF were identified which could be differentiated with sleep quality, anxiety, anhedonia, and lifestyle factors.

The identification of CRF subtypes with distinct characteristics suggests that interventions should be targeted to the CRF subtype.

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