Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report
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Purpose The purpose of this study was to estimate prevalence of fatigue, identify correlates of fatigue and evaluate the relationship between fatigue and health-related quality of life (HRQOL) in a large cohort of disease-free breast cancer survivors.
Methods Participants are enrolled in the HEAL Study, a multi-center prospective study of women diagnosed with in-situ to Stage IIIA breast cancer. HEAL participants (n = 1183) completed a baseline and a 24-month follow-up interview. Women in this report (n = 800) also completed a quality of life questionnaire that included the Piper Fatigue Scale and the RAND SF-36 two to five years after diagnosis. Multivariate regression methods were used to identify significant factors associated with fatigue. SF-36 scores for fatigued survivors were compared to non-fatigued survivor scores and population norms.
Results Forty-one percent of the breast cancer survivors were fatigued. Significant correlates of fatigue included pain, cognitive problems, physical inactivity, weight gain/personal appearance and antidepressant use. Fatigue was associated with poorer HRQOL, most notably in areas of role and social functioning.
Conclusion This study provides further support for the conclusion that a significant proportion of breast cancer survivors experience fatigue that compromises HRQOL two to five years post-diagnosis.
KeywordsBreast cancer survivors Fatigue Quality of life Piper Fatigue Scale
Health-Related Quality Of Life
Quality Of Life
Surveillance, Epidemiology and End Results
Health, Eating, Activity and Lifestyle
Revised-Piper Fatigue Scale
Breast Cancer Prevention Trial
Hormone-related Symptom Checklist
This study was supported by NCI contracts N01-CN-75036-20, N01-CN-05228, N01-PC-67010 and a training grant T32 CA90661 that supports Dr. Meeske. Data collection for the Women’s CARE Study at the University of Southern California was supported by contract N01-HD-3-3175 from the National Institute of Child Health and Human Development and patient identification was supported in part by contract 050Q-8709-S1528 from the California Department of Health Services.
- 1.Cancer facts and figures. (2003). Atlanta, GA: American Cancer Society.Google Scholar
- 15.Curt, G. A., Breitbart, W., Cella, D., Groopman, J. E., Horning, S. J., Itri, L. M., Johnson, D. H., Miaskowski, C., Scherr, S. L., Portenoy, R. K., & Volgelzang, N. J. (2000). Impact of cancer-related fatigue on the lives of patients: New findings from the fatigue coalition. Oncologist, 4, 353–360.CrossRefGoogle Scholar
- 21.Berger, A. M., WonEssen, S., Kuhn, B. R., Piper, B. F., Farr, L., Agrawal, S., Lynch, J. C., & Higginbotham P. (2003). Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: Results of a feasibility intervention study. Oncology Nursing Forum, 30, 513–522.PubMedCrossRefGoogle Scholar
- 40.Kriska, A. (1997). Modifiable activity questionnaire. Medicine and Science in Sports and Exercise, 29, S73–78.Google Scholar
- 42.Ware, J. E. Jr., Snow, K. K., & Kosinski, M. (2000). SF-36 health survey: Manual and interpretation guide. Lincoln, RI: Quality Metric Inc.Google Scholar
- 44.Kleinbaum, K. D., Kupper, L. L., Muller, K. E., & Nizam, A. (1998). Applied regression analysis and other multivariable methods, (3rd ed.). Pacific Grove, CA: Duxbury Press.Google Scholar
- 45.Breslow, N. E. & Day, N. E. (1980). Statistical methods in cancer research. vol I. The analysis of case–control studies. International Agency for Research on Cancer (IARC) Scientific Publications, vol. 32, pp. 5–338.Google Scholar
- 46.Ware, J. E. Jr., & Kosinski, M. (2001). SF-36 physical & mental health summary scales: A manual for users of version 1 (2nd ed.). Lincoln, RI: Quality Metric Inc.Google Scholar
- 63.Anonymous. (2002). NIH State-of-the-Science Statement on symptom management in cancer: Pain, depression and fatigue. NIH Consensus & State-of-the-Science Statements (Vol. 19, pp. 1–29).Google Scholar
- 66.Kohrt, W. M., Bloomfield, S. A., Little, K. D., Nelson, M. E., & Yingling, V. R. (2004). Physical activity and bone health. Medicine and Science in Sports and Exercise, 36, 1955–1996.Google Scholar