Treating Cancer-Related Fatigue: The Search for Interventions That Target Those Most in Need

Jonsson Comprehensive Cancer Center at University of California, Los Angeles, Los Angeles, CA.
Journal of Clinical Oncology (Impact Factor: 18.43). 10/2012; 30(36). DOI: 10.1200/JCO.2012.46.0436
Source: PubMed
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    ABSTRACT: Background and Objective:The Fatigue related to cancer is one of the common problems of both patients and care-givers. Nowadays, acupressure as a complementary medicine has become more common in patients with cancer for balancing and improving body energy. This study aimed to assess the effect of acupressure on the fatigue of patients with cancer. Material and Methods:This blinded- randomized clinical trial was conducted on 85 patients with cancer in hematology ward of Beheshti hospital of Hamadan. The subjects were located in three groups of intervention, sham and control. First, the fatigue level was measured by Brief Fatigue Inventory (BFI) as a baseline. Then, real acupressure in intervention group and unreal acupressure in sham group was performed for 10 days and only routine cares were given in control group. The fatigue amount was measured on the fifth and tenth days. The Data was analyzed by SPSS software version 16, using paired T- test and repeated measurements. Results:Acupressure was effective on the fatigue of patients with cancer (p<0.001). However, conducting unreal acupressure in sham group was effective as well (p<0.01), but the routine cares in control group was not effective and even in some cases led to increased fatigue. Conclusion:Acupressure can be used as a complementary therapy to decrease the fatigue in the patients with cancer considering its low cost, safety and simplicity.
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    ABSTRACT: Cancer-related fatigue is one of the most pervasive and debilitating side-effects of cancer treatment and adolescents consistently rate cancer-related fatigue as one of the most distressing aspects of treatment. Because fatigue is also high in adolescents without cancer, the current study aims to describe fatigue in adolescents with cancer relative to a control group and to identify associates of such fatigue. Knowing this is important for understanding the extent of the problem in adolescents with cancer relative to healthy adolescents and for understanding who is most at risk for fatigue and related distress. Adolescents with cancer and their caregivers (n = 102) and adolescents without a history of chronic health conditions and their caregivers (n = 97) completed the Multidimensional Fatigue Scale and measures of depression, quality of life (QoL), affect, coping, and family functioning. Adolescents with cancer and their caregivers reported significantly more adolescent fatigue across all domains (with the exception of adolescent reports of cognitive fatigue) relative to adolescents without chronic health conditions. Higher fatigue was significantly related to adolescent report of more symptoms of depression, poorer QoL, higher negative affect, less positive affect, and behavioral disengagement coping style. Fatigue was not related to active coping or family functioning. Adolescents with cancer experience significantly more fatigue than peers without chronic health conditions. Reports of fatigue are closely related to multiple indicators of psychosocial well-being, suggesting that fatigue may be an important cancer-related symptom to assess and manage to improve adolescent QoL. Pediatr Blood Cancer © 2013 Wiley Periodicals, Inc.
    Pediatric Blood & Cancer 11/2013; 60(11). DOI:10.1002/pbc.24706 · 2.39 Impact Factor
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    ABSTRACT: Understanding the determinants of fatigue worsening may help distinguish between different fatigue phenotypes and inform clinical trial designs. Patients with invasive cancer of the breast, prostate, colon/rectum, or lung were enrolled from multiple sites. At enrollment during an outpatient visit and 4 or 5 weeks later, patients rated their symptoms on a numerical rating scale from zero to 10. A 2-point change on that scale was considered clinically significant for a change in fatigue. Effects of demographic and clinical factors on patient-reported fatigue were examined using logistic regression models. In total, 3123 patients were enrolled at baseline, and 3032 patients could be analyzed for fatigue change. At baseline, 23% of patients had no fatigue, 35% had mild fatigue, 25% had moderate fatigue, and 17% had severe fatigue. Key parameters in a model of fatigue worsening included fatigue at baseline (odds ratio [OR], 0.75), disease status (OR, 1.99), performance status (OR, 1.38), history of depression (OR, 1.28), patient perception of bother because of comorbidity (OR, 1.26), and treatment exposures, including recent cancer treatment (OR, 1.77) and receipt of corticosteroids (OR, 1.37). The impact of sex was examined only in patients with colorectal and lung cancer, and it was a significant factor, with men most likely to experience worsening of fatigue (OR, 1.46). Predictors of fatigue worsening included multiple factors that were difficult to modify, including the baseline fatigue level, sex, disease status, performance status, recent cancer treatment, bother because of comorbidity, and history of depression. Future fatigue prevention and treatment trial designs should account for key predictors of worsening fatigue. Cancer 2013; © 2013 American Cancer Society.
    Cancer 02/2014; 120(3):442-450. DOI:10.1002/cncr.28437 · 4.89 Impact Factor
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