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journal article Feb 19, 2021

Do all patients with cancer experience fatigue? A longitudinal study of fatigue trajectories in women with breast cancer

Julienne E. Bower Patricia A. Ganz ORCID Michael R. Irwin ORCID Steve W. Cole ORCID Deborah Garet Laura Petersen ORCID Arash Asher Sara A. Hurvitz ORCID Catherine M. Crespi
Cancer Vol. 127 No. 8 pp. 1334-1344 · Wiley
View at Publisher Save 10.1002/cncr.33327
Abstract
BackgroundFatigue is a common and expected side effect of cancer treatment. However, the majority of studies to date have focused on average levels of fatigue, which may obscure important individual differences in the severity and course of fatigue over time. The current study was designed to identify distinct trajectories of fatigue from diagnosis into survivorship in a longitudinal study of women with early‐stage breast cancer.MethodsWomen with stage 0 to stage IIIA breast cancer (270 women) were recruited before (neo)adjuvant therapy with radiotherapy, chemotherapy, and/or endocrine therapy and completed assessments at baseline; posttreatment; and at 6 months, 12 months, and 18 months of follow‐up. Growth mixture modeling was used to identify trajectories of fatigue, and differences among the trajectory groups with regard to demographic, medical, and psychosocial variables were examined.ResultsFive distinct trajectories of fatigue were identified: Stable Low (66%), with low levels of fatigue across assessments; Stable High (13%), with high fatigue across assessments; Decreasing (4%), with high fatigue at baseline that resolved over time; Increasing (9%), with low fatigue at baseline that increased over time; and Reactive (8%), with increased fatigue after treatment that resolved over time. Both psychological and treatment‐related factors were found to be associated with fatigue trajectories, with psychological factors most strongly linked to high fatigue at the beginning of and over the course of treatment.ConclusionsThere is considerable variability in the experience of fatigue among women with early‐stage breast cancer. Although the majority of women report relatively low fatigue, those with a history of depression and elevated psychological distress may be at risk of more severe and persistent fatigue.
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Metrics
52
Citations
37
References
Details
Published
Feb 19, 2021
Vol/Issue
127(8)
Pages
1334-1344
License
View
Authors
J
Julienne E. Bower

Department of Psychology University of California at Los Angeles Los Angeles California; Department of Psychiatry and Biobehavioral Sciences University of California at Los Angeles Los Angeles California; Norman Cousins Center for Psychoneuroimmunology University of California at Los Angeles Los Angeles California; Jonsson Comprehensive Cancer Center University of California at Los Angeles Los Angeles California

P
Patricia A. Ganz

Jonsson Comprehensive Cancer Center University of California at Los Angeles Los Angeles California; School of Medicine University of California at Los Angeles Los Angeles California; Health Policy and Management School of Public Health University of California at Los Angeles Los Angeles California

M
Michael R. Irwin

Department of Psychiatry and Biobehavioral Sciences University of California at Los Angeles Los Angeles California; Norman Cousins Center for Psychoneuroimmunology University of California at Los Angeles Los Angeles California

S
Steve W. Cole

Department of Psychiatry and Biobehavioral Sciences University of California at Los Angeles Los Angeles California; Norman Cousins Center for Psychoneuroimmunology University of California at Los Angeles Los Angeles California; Department of Medicine University of California at Los Angeles Los Angeles California

D
Deborah Garet

Norman Cousins Center for Psychoneuroimmunology University of California at Los Angeles Los Angeles California

L
Laura Petersen

Jonsson Comprehensive Cancer Center University of California at Los Angeles Los Angeles California

A
Arash Asher

Samuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical Center Los Angeles California

S
Sara A. Hurvitz

Jonsson Comprehensive Cancer Center University of California at Los Angeles Los Angeles California; Department of Medicine University of California at Los Angeles Los Angeles California

C
Catherine M. Crespi

Jonsson Comprehensive Cancer Center University of California at Los Angeles Los Angeles California; Department of Biostatistics University of California at Los Angeles Los Angeles California

Funding
National Cancer Institute Award: R01 CA160427
Cite This Article
Julienne E. Bower, Patricia A. Ganz, Michael R. Irwin, et al. (2021). Do all patients with cancer experience fatigue? A longitudinal study of fatigue trajectories in women with breast cancer. Cancer, 127(8), 1334-1344. https://doi.org/10.1002/cncr.33327
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