Fatigue in cancer patients is not related to changes in oxyhaemoglobin dissociation
Department of Mental Health, St George's Hospital Medical School, Cranmer Terrace, London, SW17 ORE, UK. Supportive Care Cancer
(Impact Factor: 2.36).
11/2005; 13(10):854-8. DOI: 10.1007/s00520-005-0850-3
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.
Available from: Vijayakumar Narayanan
- "Decrease in levels of fatigue was observed in patients treated with erythropoietin. However, the association between hemoglobin and fatigue is weak and it is postulated that the impairment in the function of hemoglobin in cancer is the reason for fatigue. "
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ABSTRACT: Fatigue is a common symptom in patients with cancer and in disease-free survivors. It has a significant impact on the quality of life. Although subjective fatigue is often related to objective changes in physical functioning or impaired performance status, the two phenomena are not synonymous and need to be distinguished. A number of robust and reliable assessment instruments to measure fatigue severity are now available and criteria for cancer-related fatigue syndrome have been proposed. The underlying mechanisms and pathophysiology of cancer-related fatigue are unclear. Management strategies include the use of psycho-educational interventions, exercise programmes and pharmacological treatments. The best evidence for the effectiveness of drug treatments is for the haematopoietic agents in anaemic patients undergoing chemotherapy and for methylphenidate in an on-treatment population.
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