Fatigue in cancer patients is not related to changes in oxyhaemoglobin dissociation.
ABSTRACT There is only a weak association between the degree of anaemia and severity of fatigue in cancer patients. It has been hypothesised that there may be functional changes in the erythrocytes or haemoglobin of cancer patients and that this may result in fatigue even in the presence of a "normal" or "low normal" haematocrit.
The purpose of the study was to investigate the relationship between oxyhaemoglobin dissociation and fatigue in patients with cancer and to compare oxyhaemoglobin dissociation between cancer patients and healthy controls.
A heterogeneous group of patients with cancer (n = 22) and a control group of healthy subjects without cancer (n = 28) were studied. Subjects completed a fatigue questionnaire [the Functional Assessment of Cancer Therapy Fatigue (FACT-F) scale] and provided 10 ml of blood for analysis. Specimens were analysed to determine the partial pressure of oxygen at which 50% haemoglobin saturation occurred (P50) and were also sent for routine haematological and biochemical analysis.
No differences were found between the oxyhaemoglobin dissociation curves of patients with cancer and controls. There was no significant correlation between fatigue severity and P50 in either patients or controls.
There is no evidence to support the hypothesis that cancer-related fatigue is due to differences in oxyhaemoglobin dissociation.
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ABSTRACT: Fatigue in cancer patients is defined as an unusual, persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning, despite good rest. Fatigue is one of the first symptoms that can appear in patients with cancer and quality of life is severely impacted by it. The main goal of this review is to describe the different causes that influence fatigue and the different ways to asses this symptom. The methodology we have used for this review is narrative. In this work we describe fatigue as a multidimensional concept that it is caused by multiple mechanisms. This multidimensionality is also involved in understanding the pathophysiology. For that reason we are going to define fatigue as primary and secondary, and we are going to describe each of them. We are also going to analyse the type of scales used to measure fatigue; describing the differences between the ones that measure only fatigue and the ones that are used to asses fatigue from a multidimensional perspective.Medicina Paliativa 01/2013; DOI:10.1016/j.medipa.2013.01.006 · 0.16 Impact Factor
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ABSTRACT: Fatigue is a common symptom of advanced cancer limiting one's activity and affecting the quality of life. It is a multidimensional symptom complex with subjective and objective components. Hence, its definition and assessment seems arbitrary, incomplete, and elusive. Components of fatigue often merge with other 'disease states' as anemia, depression and so on, compounding difficulty to assess it separately. Fatigue has a high prevalence rate, and lasts longer in chronic diseases like cancer. Its association with treatment modalities like chemotherapy, radiotherapy alongside the primary disease process makes it seemingly ubiquitous in many cases. Systemic manifestation of cancer causes excess demand on body resources on cell repair, uncontrolled growth with metabolite accumulation causing fatigue. Co-morbid conditions of organic and psychological nature causes fatigue. There are many assessment tools for fatigue with different uses and objectives, simple and reproducible tools like Brief Fatigue Inventory, Edmonton Symptom assessment scale seem feasible in everyday practice. Management of fatigue is not straightforward and rewarding. Although treatment of cause appears to be an attractive option, it is not possible in all cases. Therapeutic agents targeting cytokine load is in early stages of study and available results are not favorable. Specific measures aimed at pain relief, prevention/treatment of sepsis, management of depression, avoidance of drugs causing fatigue, restoring the metabolic profile are important. Methyl phenidate, megestrol, and modafinil are some drugs with promising effect to treat fatigue, though confirmatory studies are yet to be established. Non-pharmacological methods are also helpful. Forewarning patients on upcoming fatigue, active regular exercise, and stress management are some of them. Fatigue being a multidimensional entity, single mode of therapy is insufficient. Combined modality tailored to individual patient need and understanding may be the right way to battle this ill-understood symptom. This review article examines the etiopathogenesis and management strategies of fatigue in cancer.Indian Journal of Palliative Care 03/2009; 15(1):19-25. DOI:10.4103/0973-1075.53507This article is viewable in ResearchGate's enriched formatRG Format enables you to read in context with side-by-side figures, citations, and feedback from experts in your field.
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ABSTRACT: Although many cancer patients receiving palliative care experience distressing levels of fatigue, no well-designed studies have investigated contributing factors in Korean patients. We conducted a cross-sectional study using the Brief Fatigue Inventory-K (BFI-K) to measure fatigue while assessing a variety of possible correlates. Ninety patients with incurable cancer in the terminal stage (median survival: 27 days) participated in a structured interview and questionnaire related to their medical conditions and underwent blood sampling for laboratory data and cytokines, including interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Body mass index, dyspnea, the Eastern Cooperative Oncology Group performance status, and levels of albumin, blood urea nitrogen (BUN), total bilirubin, and C-reactive protein were significantly associated with fatigue. However, levels of the two proinflammatory cytokines, IL-6 and TNF-α, were not significantly correlated with the BFI-K score. In stepwise multiple linear regression, fatigue was related to elevated BUN (β = 0.376, p = 0.002), severe pain intensity (β = 0.349, p = 0.004), and impaired performance status (β = 0.268, p = 0.027), but not related to levels of inflammatory cytokines. In conclusion, the diagnostic work-up and therapeutic plan for patients with cancer-related fatigue should include an evaluation of laboratory parameters, pain severity, and physical performance.Palliative Medicine 08/2011; 26(3):275-82. DOI:10.1177/0269216311406991 · 2.61 Impact Factor