Cancer-related fatigue (CRF) is common after treatment for early stage breast cancer, but new results indicate that the phenomenon fades over time, according to a study published in the Journal of Clinical Oncology.
Breast cancer is the most commonly diagnosed type of cancer (other than skin cancer) in US women. Each year, roughly 227,000 women are diagnosed with breast cancer and close to 40,000 die of the disease. Treatment of early breast cancer may include breast-conserving surgery, radiation, and (when appropriate) systemic therapies such as chemotherapy and hormonal therapy.
After treatment, some survivors experience long-term adverse effects, including prolonged, disabling fatigue—referred to as cancer-related fatigue or CRF. There is no clear understanding of the underlying causes of CRF and there are no effective prevention or treatment strategies.
Researchers from Australia studied CRF in a cohort of 218 women who received some sort of adjuvant treatment for early breast cancer. The women were enrolled in the study after surgery and were observed at 1, 3, 6, 9, and 12 months as well as 5 years. At each interval, the women underwent structured interviews and responded to questionnaires about their physical and psychological health.
Immediately after treatment, 31% of women experienced CRF; however, the rate of CRF dropped to 11% six months after treatment and 6% one year after treatment. Women who were still experiencing persistent fatigue after six months were evaluated to rule out other causes such as low thyroid levels or depression.
The researchers noted that CRF was associated with significant disability and healthcare utilization. It was not clear why some women remained fatigued for months after treatment. There is speculation that inflammation could be a factor or that some patients may have a genetic predisposition that creates an exaggerated response to chemotherapy. As of yet, there is no data to support these theories.
The researchers concluded that CRF is common among women treated for early breast cancer, but generally fades over time. Women who suffer from CRF might benefit from following a healthy diet and getting regular exercise and sleep.
Goldstein D, Bennett BK, Webber K, et al. Cancer-related fatigue in women with breast cancer: outcomes of a 5-year prospective cohort study. Journal of Clinical Oncology. Published early online: April 16, 2012. doi:10.1200/JCO.2011.34.6148
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