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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This synthesis of the literature on the quality of life in relation to radiotherapy is based on 78 scientific articles, including 12 randomized studies, 25 prospective studies, and 20 retrospective studies. These studies involve 9884 patients. Radiotherapy is often organ-preserving, which inherently promotes a better quality of life. Many quality of life aspects related to radiotherapy have been studied, but seldom by prospective randomized studies that compare radiotherapy to other treatment (eg, surgery or chemotherapy). Radiotherapy involves numerous physical and psychological symptoms, mainly during the course of treatment. Examples include skin irritation and fatigue. Radiotherapy directed at the brain has delayed effects, in children treatment carries a substantial risk for lowering the IQ. The risk for encephalopathy in adults is probably underestimated. Patients with cancer in the head and neck may experience adverse side effects in the irradiated area long after the conclusion of radiotherapy. There are no confirmed differences in quality of life between breast cancer patients receiving adjuvant radiotherapy and those receiving chemotherapy. Impotency problems and urinary incontinence appear following radical surgery and radiotherapy for prostate cancer. The risk for delayed complications is low after radiotherapy for testicular cancer. Patients receiving radiotherapy for gynecologic cancers are often troubled by local side effects long after the conclusion of treatment.
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PMID:Radiotherapy for cancer. Quality of life. 915 7

Twenty-one node-negative breast cancer patients were interviewed shortly after completing adjuvant chemotherapy and asked about side effects they had experienced, expectation of side effects, and strategies for coping with the side effects. Eighteen of the women were interviewed 6 months later to determine their feelings about the chemotherapy experience and ending treatment and what side effects persisted or developed after chemotherapy. Hair loss, fatigue, treatment-related problems, nausea and infections/low blood counts were the most frequently described problems during the first interviews. Patients used coping strategies suggested by physicians and nurses. Six months later, hair problems, fatigue, weight gain, menopausal problems, emotional problems and nail problems were most often reported. Most patients (16/18) did not expect to be experiencing chemotherapy-related problems 6 months after ending treatment. Fatigue interfered with daily lives and weight gain caused concern. A total of 35% of participants experienced fear or anxiety at the end of chemotherapy, but most (62%) recalled at least some positive feelings 6 months later. Given the same circumstances, all but two would make the same decision to undergo adjuvant chemotherapy. Support groups would be especially useful for patients completing chemotherapy who would lose continued frequent support from clinic personnel.
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PMID:Side effects of adjuvant chemotherapy: perceptions of node-negative breast cancer patients. 920 66

The purpose of this study was to examine the factors which affect the level of fatigue among patients participating in clinical trials in which this symptom had been assessed with the EORTC QLQ-C30. Data were assembled from 2390 patients in ten clinical trials in which the QLQ-C30 had been used to assess baseline and on-study quality of life. The relationship between the level of fatigue reported by the patients on the fatigue scale of this questionnaire and patient and disease characteristics was assessed in univariate and multivariate cross-sectional analyses. In addition, changes in fatigue scores were compared in a longitudinal analysis among patients on two arms of an anti-emetic trial whose emesis control was markedly different. Baseline fatigue levels differed substantially among patients taking part in the different trials. Factors associated with greater fatigue severity on univariate analysis included: female gender, presence of metastatic disease, and poorer performance status. In addition, on multivariate analyses the oldest patients were found to have less fatigue, as were patients with breast cancer, while patients with ovarian and lung cancer experienced greater fatigue. Patients on the arm of the anti-emetic trial in which emesis was better controlled showed significantly less increase in fatigue after receiving chemotherapy. The fatigue scale of the QLQ-C30 appears to provide a useful approach to assessing this important symptom. The relationships found between fatigue and patient and disease characteristics need further exploration as does the degree to which the QLQ-C30 fully captures this dimension of quality of life.
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PMID:Fatigue in patients with cancer: results with National Cancer Institute of Canada Clinical Trials Group studies employing the EORTC QLQ-C30. 932 54

The article reports a study designed to test hypothesized relationships among healthiness, fatigue, and symptom experience derived from a holistic world view of health in women with and without breast cancer. Women with breast cancer did not differ significantly from healthy women on healthiness or fatigue or in the relationships among healthiness, fatigue, and symptom experience. Women with breast cancer had higher symptom experience scores than the healthy women, but when women with breast cancer who had completed treatment were compared with women without breast cancer, there were no significant differences in healthiness, fatigue, or symptom experience. Implications of the findings are interpreted in the framework of a holistic world view. Recommendations for further research are made.
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PMID:Healthiness, fatigue, and symptom experience in women with and without breast cancer. 938 70

Fatigue is a common and distressing symptom following cancer treatment. Research examining "off-treatment" fatigue has been weakened by limited assessments of fatigue and lack of suitable comparison groups. The extent of off-treatment fatigue following treatment for breast cancer (BC) was examined. Women with BC (n = 88; mean, 28 months posttreatment) and age-matched women (n = 88) with benign breast problems (BBP), completed a set of fatigue questionnaires at an Initial assessment and a 4-month Follow-up assessment. The BC group reported more fatigue, more weakness, and less vitality relative to the BBP group at both assessments. No relationship was found in the BC group between fatigue and extent of treatment or time since treatment completion. While the results document the existence of off-treatment fatigue following BC, elucidation of the psychobiological processes underlying this symptom and development of clinical management strategies remain as challenges for future research.
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PMID:Off-treatment fatigue in breast cancer survivors: a controlled comparison. 954 19

Fatigue is a common complaint of individuals receiving treatment for cancer. There is a dearth of rigorous research investigating the clinical course and prognosis of fatigue over the course of radiation therapy. Seventy six patients with breast cancer receiving external radiation therapy were followed longitudinally from the onset of treatment to 6 months post-treatment. Fatigue significantly increased over the course of treatment, was highest at the last week of treatment, and returned to pretreatment levels by 3 months after treatment. Fatigue was not influenced by the patient's age, stage of disease, time since surgery, weight, and length of time since diagnosis. Fatigue was significantly related to symptom distress, psychologic distress, and self-reported fatigue relief strategies. The most frequently reported self-relief strategies were "sit" and "sleep." Fatigue had a negative impact on the patient's quality of life. Impairment in quality of life was evident by the end of treatment, with improvement by 3 and 6 months after treatment. The second week through to the last week of radiation therapy are critical times to target interventions for the management of fatigue. The amelioration of concomitant symptoms is a supportive approach that might be helpful. Self-help strategies focusing on the cessation of activity and increasing rest were reported as successful by patients.
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PMID:Fatigue in women with breast cancer receiving radiation therapy. 955 39

The purpose of this report is to describe variables associated with fatigue for disease-free survivors of breast cancer. On the basis of Mishel's theory of illness uncertainty and the antecedents of uncertainty, a cross-sectional, descriptive, correlational design was used to examine (a) the relationship of fatigue with cancer-related variables and the presence of concurrent illness and (b) whether fatigue and educational level explained a significant proportion of the variation in illness uncertainty. The Mishel Uncertainty in Illness Scale (MUIS) and a single fatigue item on the McCorkle & Young Symptom Distress Scale were used as variable measures. Data were collected from 109 women 1 to 6 years after treatment for Stage I to III breast cancer with no known metastasis. Findings showed that low to moderate fatigue persisted for women, which was related significantly to the presence of concurrent illness. When concurrent illness was taken into account, fatigue was significantly related to treatment with chemotherapy, irrespective of length of time since treatment, age, disease stage, or tamoxifen use. Finally, fatigue and education level explained a significant level of the variation in illness uncertainty. Nurses can identify and assist women who are at risk for fatigue and illness uncertainty after treatment for breast cancer ends.
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PMID:Correlates of fatigue in survivors of breast cancer. 955 40

Women treated for breast cancer have shown attentional fatigue manifested as a decreased capacity to concentrate or direct attention in daily life activities. This study was conducted to determine if age and extent of surgery increase the risk of early development of attentional fatigue in 74 women newly diagnosed with Stage I or II breast cancer. Measures of capacity to direct attention (CDA) were obtained at two time points, about 12 days before, and 15 days after, breast-conserving surgery or mastectomy. ANOVA showed significant age and age by time interaction effects (p < .05). Women aged 65-79 showed a significant mean decline (p < .05) in CDA over time regardless of extent of surgery. Women aged 46-64, who underwent mastectomy, showed a mean loss in CDA, whereas those having breast-conserving surgery showed a significant mean gain (p < .05). Women aged 25-45 showed no significant mean change in CDA over time. Older age and more extensive surgery increase the likelihood of loss of attention due, in part, to greater risk of attentional fatigue.
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PMID:Age and extent of surgery affect attention in women treated for breast cancer. 960 8

Although fatigue is one of the most common and debilitating symptoms experienced by cancer patients, it has received little systematic attention. This situation is due in large part to the lack of adequate instruments to measure fatigue. The primary aim of this study was to validate a newly developed measure of fatigue for use with cancer patients: the Fatigue Symptom Inventory (FSI). This 13 item self-report measure was designed to measure the intensity and duration of fatigue and its impact on quality of life. The psychometric properties of the FSI were assessed in women undergoing treatment for breast cancer, women who had completed treatment for breast cancer and women with no history of cancer. A seven-item interference subscale was found to have good internal consistency, with alpha coefficients above 0.90 in all three groups. The complete FSI was found to have rather weak to moderate test-retest reliability among patients in active treatment and healthy comparison subjects assessed on three separate occasions. Convergent validity was demonstrated using comparisons with existing measures of fatigue. Construct validity was demonstrated using comparisons between and within groups as well as comparisons with measures of anxiety and depression. Overall, the FSI was established as a valid and reliable measure of fatigue in cancer patients and healthy individuals. Suggestions are made for the potential application of the measure in clinical research.
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PMID:Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. 961 Feb 14

A total of 91 breast cancer patients died of advanced and recurrent breast cancer at the Osaka Teishin Hospital from 1986 to 1996. There were 18 cases (19.8%) among them showing hypercalcemia (serum corrected Ca > or = 11.0 mg/dl). These 18 cases were analyzed to determine the incidence of hypercalcemia and to find a more effective treatment. All these patients had multiple bone metastases during their clinical course, and six patients (33.3%) had pathologic bone fracture just before the occurrence of hypercalcemia. Their common symptoms were general fatigue, gastrointestinal symptoms, renal dysfunction or neurological symptoms. There was no definitive correlation between clinical signs and serum calcium values. Among various therapies, the use of pamidronate disodium (Aredia) in combination with hydration, steroid and calcitonin was found to be the most effective treatment for hypercalcemia. The survival time from the diagnosis of hypercalcemia in the patients undergoing treatment with Aredia was significantly better than without it (p < 0.01). This suggests that Aredia should be effective and useful for advanced breast cancer patients with hypercalcemia.
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PMID:[Analysis of 18 breast cancer patients with hypercalcemia]. 961 23


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