Prevalence, Predictors, and Characteristics of Off-Treatment Fatigue in Breast Cancer Survivors

BACKGROUND Lack of consensus regarding how to identify cancer patients with significant fatigue has hampered research regarding cancer-related fatigue (CRF) METHODS Specific criteria were used to identify CRF cases in women with stage 0-II breast cancer (BC group n = 304) Women completed assessments before adjuvant therapy (baseline) end of adjuvant therapy (Post-Tx) and 6 and 42 months after end of adjuvant therapy (6 and 42 Month Post-Tx) At each women completed a clinical interview and questionnaires assessing physical and mental health A healthy control (HC) group with no history of BC (n = 337) completed 2 similar assessments 36 months apart RESULTS Off-treatment CRF prevalence was 9% and 13% at the 6 and 42 Month Post-Tx assessments respectively Thus 15% of the sample evidenced off-treatment CRF with 7% evidencing delayed onset CRF CRF at the 6 Month Post Tx assessment was associated only with CRF at baseline (OR = 3 2) and Post-Tx assessments (OR = 3 9) CRF at the 42 Month Post-Tx assessment was associated with CRF at the Post-Tx assessment (OR = 61) obesity at baseline and several baseline measures of coping in response to fatigue Off-treatment CRF cases differed markedly from CRF noncases and healthy controls on a spectrum of health status indices (mean effect size >10 SD) CONCLUSIONS Results document the prevalence of off-treatment and delayed onset CRF suggest the utility of a cognitive-behavioral model of CRF and support NCCN guidelines recommending monitoring fatigue across the cancer trajectory Cancer 2010,116 5740-8 (C) 2010 American Cancer Society