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Cancer-related fatigue: mechanisms, assessment and treatment in older people

Published online by Cambridge University Press:  09 February 2011

Ollie Minton*
Affiliation:
Division of Population Health Sciences and Education, St George's University of London, UK
Patrick C Stone
Affiliation:
Division of Population Health Sciences and Education, St George's University of London, UK
*
Address for correspondence: Dr Ollie Minton, Cancer Research UK Clinical Research Training Fellow and Honorary Consultant in Palliative Medicine, Division of Population Health Sciences and Education, 6th floor, Hunter Wing, St George's University of London, Cranmer Terrace, London SW17 0RE. Email: [email protected]

Summary

Cancer-related fatigue (CRF) is a debilitating symptom that affects the majority of cancer patients. It can occur at all stages of treatment, worsening in advanced disease. It can be especially troublesome in the older person. CRF is often under-recognized and insufficiently treated routinely. This review will discuss both the postulated mechanisms and clinical tools for identifying and monitoring CRF during cancer treatment. The role of drug treatment and exercise to manage CRF is also assessed. Further studies, particularly in older people, are required to improve the poor levels of evidence for current CRF management options.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2011

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References

1Minton, O, Richardson, A, Sharpe, M, Hotopf, M, Stone, P. Drug therapy for the management of cancer related fatigue. Cochrane Database Syst Rev 2010; (7): CD006704.Google Scholar
2Minton, O, Stone, P. A systematic review of the scales used for the measurement of cancer-related fatigue (CRF). Annals Oncol 2009; 20:1725.CrossRefGoogle ScholarPubMed
3Loge, JH, Ekeberg, O, Kaasa, S. Fatigue in the general Norwegian population: Normative data and associations. J Psychosom Res 1998; 45: 5365.Google Scholar
4Schwarz, R, Hinz, A. Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 2001; 37: 1345–51.Google Scholar
5David, A, Pelosi, A, McDonald, A et al. Tired, weak, or in need of rest: fatigue among general practice attenders. BMJ 1990; 301: 1199–202.CrossRefGoogle ScholarPubMed
6Avlund, K, Rantanen, T, Schroll, M. Factors underlying tiredness in older adults. Aging Clin Exp Res 2007; 19: 1625.CrossRefGoogle ScholarPubMed
7Extermann, M, Hurria, A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 2007; 25: 1824–31.Google Scholar
8Balducci, L. Geriatric oncology. Crit Rev Oncol Hematol 2003; 46: 211–20.Google Scholar
9Given, CW, Given, B, Azzouz, F, Kozachik, S, Stommel, M. Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. J Pain Symptom Manag 2001; 21: 456–66.Google Scholar
10Cella, D, Lai, JS, Chang, CH, Peterman, A, Slavin, M. Fatigue in cancer patients compared with fatigue in the general United States population. Cancer 2002; 94: 528–38.CrossRefGoogle ScholarPubMed
11Berger, AM, Walker, SN. An explanatory model of fatigue in women receiving adjuvant breast cancer chemotherapy. Nursing Res 2001; 50: 4252.CrossRefGoogle ScholarPubMed
12Cimprich, B. Attentional fatigue following breast cancer surgery. Res Nurs Health 1992; 15: 199207.Google Scholar
13Roscoe, JA, Morrow, GR, Hickok, JT, Bushunow, P, Matteson, S, Rakita, D, Andrews, PL. Temporal interrelationships among fatigue, circadian rhythm and depression in breast cancer patients undergoing chemotherapy treatment. Supportive Care in Cancer 2002; 10: 329–36.Google Scholar
14Geinitz, H, Zimmermann, FB, Stoll, P, Thamm, R, Kaffenberger, W, Ansorg, K, Keller, M, Busch, R, van Beuningen, D, Molls, M. Fatigue, serum cytokine levels, and blood cell counts during radiotherapy of patients with breast cancer. Int J Radiation Oncol Biol Physics 2001; 51: 691–98.CrossRefGoogle ScholarPubMed
15Minton, O, Stone, P. How common is fatigue in disease-free breast cancer survivors? A systematic review of the literature. Breast Cancer Res Treatment 2008; 112: 513.CrossRefGoogle ScholarPubMed
16Stone, P, Hardy, J, Broadley, K, Tookman, AJ, Kurowska, A, A'Hern, R. Fatigue in advanced cancer: a prospective controlled cross-sectional study. Br J Cancer 1999; 79: 1479–86.CrossRefGoogle Scholar
17Stone, P, Richards, M, A'Hern, R, Hardy, J. A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Annals Oncol 2000; 11: 561–67.Google Scholar
18Donovan, KA, Jacobsen, PB. Fatigue, depression, and insomnia: evidence for a symptom cluster in cancer. Seminars Oncol Nursing 2007; 23: 127–35.CrossRefGoogle ScholarPubMed
19Cleeland, CS, Mendoza, TR, Wang, XS, Chou, C, Harle, MT, Morrissey, M, Engstrom, MC. Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer 2000; 89: 1634–46.Google Scholar
20Stone, P, Ream, E, Richardson, A, Thomas, H, Andrews, P, Campbell, P, Dawson, T, Edwards, J, Goldie, T, Hammick, M, Kearney, N, Lean, M, Rapley, D, Smith, AG, Teague, C, Young, A. Cancer-related fatigue – a difference of opinion? Results of a multi-centre survey of healthcare professionals, patients and caregivers. Eur J Cancer Care 2003; 12: 2027.CrossRefGoogle Scholar
21Glaus, A. Assessment of fatigue in cancer and non-cancer patients and in healthy individuals. Supportive Care in Cancer 1993; 1: 305–15.Google Scholar
22NCCN. Clinical practice guidelines in oncology. Cancer-related fatigue. Available at: http://www.nccn.org (accessed 8 January 2008).Google Scholar
23Storey, DJ, Waters, RA, Hibberd, CJ, Rush, RW, Cargill, AT, Wall, LR, Fallon, MT, Strong, VA, Walker, J, Sharpe, M. Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study. Annals Oncol 2007; 18: 1861–69.CrossRefGoogle ScholarPubMed
24Aaronson, NK, Ahmedzai, S, Bergman, B et al. 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 1993; 85: 365–76.CrossRefGoogle ScholarPubMed
25Radbruch, L, Strasser, F, Elsner, F, Gonçalves, JF, Løge, J, Kaasa, S, Nauck, F, Stone, P; Research Steering Committee of the European Association for Palliative Care (EAPC). Fatigue in palliative care patients – an EAPC approach. Palliative Medicine 2008; 22: 1332.Google Scholar
26Ream, E, Richardson, A. Fatigue: a concept analysis. Int J Nursing Studies 1996; 33: 519–29.Google Scholar
27Streiner, DL, Norman, GR. Health Measurement Scales – A practical guide to their development and use (1st edn). Oxford, Oxford University Press, 1989.Google Scholar
28Lai, J-S, Crane, P, Cella, D. Factor analysis techniques for assessing sufficient unidimensionality of cancer related fatigue. Quality of Life Res 2006; 15: 1179–90.Google Scholar
29Cella, D. The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Seminars Hematol 1997; 34: 1319.Google Scholar
30Cella, D, Peterman, A, Passik, S, Jacobsen, P, Breitbart, W. Progress toward guidelines for the management of fatigue. Oncology (Huntington) 1998; 12: 369–77.Google ScholarPubMed
31Fukuda, K, Straus, SE, Hickie, I, Sharpe, MC, Dobbins, JG, Komaroff, A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals Internal Med 1994; 121: 953–59.CrossRefGoogle ScholarPubMed
32APA. Diagnostic and Statistical Manual of Mental Disorders (4th edn). Washington, DC; 1994.Google Scholar
33Andrykowski, MA, Schmidt, JE, Salsman, JM, Beacham, AO, Jacobsen, PB. Use of a case definition approach to identify cancer-related fatigue in women undergoing adjuvant therapy for breast cancer. J Clin Oncol 2005; 23: 6613–22.CrossRefGoogle ScholarPubMed
34Fernades, R, Stone, P, Andrews, P, Morgan, R, Sharma, S. Comparison between fatigue, sleep distrurbance, and circadian rhythm in cancer inpatients and healthy volunteers: Evaluation of diagnostic criteria for cancer-related fatigue. J Pain Symptom Manag 2006; 32: 245–54.CrossRefGoogle Scholar
35Van Belle, S, Paridaens, R, Evers, G, Kerger, J, Bron, D, Foubert, J, Ponnet, G, Vander Steichel, D, Heremans, C, Rosillon, D. Comparison of proposed diagnostic criteria with FACT-F and VAS for cancer-related fatigue: proposal for use as a screening tool. Supportive Care in Cancer 2005; 13: 246–54.Google Scholar
36Alexander, S, Minton, O, Stone, PC. Evaluation of screening instruments for cancer-related fatigue syndrome in breast cancer survivors. J Clin Oncol 2009; 27: 1197–201.CrossRefGoogle ScholarPubMed
37Prue, G, Rankin, J, Allen, J, Gracey, J, Cramp, F. Cancer-related fatigue: A critical appraisal. Eur J Cancer 2006; 42: 846–63.CrossRefGoogle ScholarPubMed
38Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatry Scandinavia 1983; 67: 361–70.Google Scholar
39Savard, J, Morin, CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 2001; 19: 895908.Google Scholar
40Palesh, OG, Roscoe, JA, Mustian, KM, Roth, T, Savard, J, Ancoli-Israel, S, Heckler, C, Purnell, JQ, Janelsins, MC, Morrow, GR. Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center – Community Clinical Oncology Program. J Clin Oncol 2010; 28: 292–98.CrossRefGoogle ScholarPubMed
41Bohlius, J, Wilson, J, Seidenfeld, J, Piper, M, Schwarzer, G, Sandercock, J, Trelle, S, Weingart, O, Bayliss, S, Brunskill, S, Djulbegovic, B, Benett, CL, Langensiepen, S, Hyde, C, Engert, E. Erythropoietin or Darbepoetin for patients with cancer. Cochrane Database Syst Rev 2006; (3): CD003407.Google Scholar
42Jones, M, Schenkel, B, Just, J, Fallowfield, L. Epoetin alfa improves quality of life in patients with cancer. Cancer 2004; 101: 1720–32.CrossRefGoogle ScholarPubMed
43De Lorenzo, F, Xiao, H, Mukherjee, M, Harcup, J, Suleiman, S, Kadziola, Z, Kakkar, VV. Chronic fatigue syndrome: physical and cardiovascular deconditioning. QJM 1998; 91: 475–81.Google Scholar
44Lane, RJ, Barrett, MC, Woodrow, D, Moss, J, Fletcher, R, Archard, LC. Muscle fibre characteristics and lactate responses to exercise in chronic fatigue syndrome. J Neurol Neurosurg Psychiat 1998; 64: 362–67.CrossRefGoogle ScholarPubMed
45Evans, WJ, Lambert, CP. Physiological basis of fatigue. Am J Physical Med Rehabil 2007; 86: S2946.CrossRefGoogle ScholarPubMed
46Cleare, AJ. The HPA axis and the genesis of chronic fatigue syndrome. Trends Endocrinol Metab 2004; 15: 5559.CrossRefGoogle ScholarPubMed
47Sanders, P, Korf, J. Neuroaetiology of chronic fatigue syndrome: an overview. World J Biol Psychiat 2008; 9: 165–71.Google Scholar
48Cleare, AJ, Blair, D, Chambers, S, Wessely, S. Urinary free cortisol in chronic fatigue syndrome. Am J Psychiat 2001; 158: 641–43.Google Scholar
49Bower, JE, Ganz, PA, Dickerson, SS, Petersen, L, Aziz, N, Fahey, JL. Diurnal cortisol rhythm and fatigue in breast cancer survivors. Psychoneuroendocrinology 2005; 30: 92100.CrossRefGoogle ScholarPubMed
50Bower, JE, Ganz, PA, Aziz, N. Altered cortisol response to psychologic stress in breast cancer survivors with persistent fatigue. Psychosom Med 2005; 67: 277–80.CrossRefGoogle ScholarPubMed
51Alexander, S, Minton, O, Andrews, P, Stone, P. A comparison of the characteristics of disease-free breast cancer survivors with or without cancer-related fatigue syndrome. Eur J Cancer 2009; 45: 384392.CrossRefGoogle ScholarPubMed
52Schubert, C, Hong, S, Natarajan, L, Mills, PJ, Dimsdale, JE. The association between fatigue and inflammatory marker levels in cancer patients: A quantitative review. Brain Behav Immunity 2007; 21: 413–27.CrossRefGoogle ScholarPubMed
53Andrews, P, Morrow, G, Hickok, J et al. Mechanisms and models of fatigue associated with cancer and its treatment: Evidence of pre-clinical and clinical studies. In Armes, J, Krishnasamy, M, Higginson, I (eds), Fatigue in Cancer. Oxford, OUP, 2004; pp. 5187.CrossRefGoogle Scholar
54Minton, O, Stone, PC. The use of proteomics as a research methodology for studying cancer-related fatigue: a review. Palliative Med 2010; 24: 310–16.CrossRefGoogle ScholarPubMed
55Cochrane: Review Manager (RevMan) [Computer programme] (Version 4.2.10 for Windows). Oxford, UK: The Cochrane Collaboration, 2002.Google Scholar
56Minton, O, Richardson, A, Sharpe, M, Hotopf, M, Stone, P. Drug therapy for the management of cancer-related fatigue. Cochrane Database Syst Rev 2010; (7): CD006704.Google Scholar
57Cramp, F, Daniel, J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2008; (2): CD006145.Google Scholar
58Goedendorp, MM, Gielissen, MF, Verhagen, CA, Bleijenberg, G. Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev 2009; (1): CD006953.Google Scholar
59Minton, O, Richardson, A, Sharpe, M et al. Psychostimulants for the nanagement of cancer-related fatigue: a systematic review and meta-analysis. J Pain Symptom Manag 2010; doi:10.1016/j.jpainsymman.2010.06.020.Google Scholar
60Bohlius, J, Schmidlin, K, Brillant, C, Schwarzer, G, Trelle, S, Seidenfeld, J, Zwahlen, M, Clarke, M, Weingart, O, Kluge, S, Piper, M, Rades, D, Steensma, DP, Djulbegovic, B, Fey, MF, Ray-Coquard, I, Machtay, M, Moebus, V, Thomas, G, Untch, M, Schumacher, M, Egger, M, Engert, A. Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials. Lancet 2009; 373: 1532–42.Google Scholar
61Monk, JP, Phillips, G, Waite, R, Kuhn, J, Schaaf, LJ, Otterson, GA, Guttridge, D, Rhoades, C, Shah, M, Criswell, T, Caligiuri, MA, Villalona-Calero, MA. Assessment of tumor necrosis factor alpha blockade as an intervention to improve tolerability of dose-intensive chemotherapy in cancer patients. J Clin Oncol 2006; 24: 1852–59.Google Scholar
62Markes, M, Brockow, T, Resch, KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2006; (4): CD005001.Google Scholar