The following study is available in J. Clin. Oncol · April 05, 2022: "Long-Term Longitudinal Patterns of Patient-Reported Fatigue After Breast Cancer".
I thought some of you might be interested in reading the comment (given below) which appeared today online in Oncology since it summaries the study. Do note that there is a passing reference to the fact that endocrine therapy also contributes to fatique. The group studied consisted of 6619 women followed up four or more years after a diagnosis of breast cancer. I'd be interested in your thoughts after reading this.
"The most frequent symptom reported by my patients after breast cancer treatment is fatigue, and often, we are at a loss to address it, in part because it is difficult to understand its time course relative to the other factors in a patient’s life. This prospective study assessed fatigue from diagnosis and repeatedly through 4 years of follow-up. Importantly, the investigators looked at the trajectory of fatigue since single time-point measurements do not accurately reflect the impact on quality of life. High-risk patients (ie, 21% of all patients) had severe global fatigue at diagnosis, and 2 out of 3 still noted severe fatigue at year 4; 19% of the patients followed a deteriorating course, with fatigue going from 14% at diagnosis to 65% at year 4, whereas 60% were in the low-risk group (<4% severe at diagnosis, and <10% at year 4).
In determining the characteristics of each group, univariate factors associated with severe global fatigue included depression, pain, insomnia, smoking, Charlson score, and marital status. Clinical cancer features, treatment type, and socioeconomic factors had no impact, with the exception of endocrine therapy and hot flashes in the deteriorating group. The authors suggest a survivorship framework that measures risk factors at diagnosis and addresses modifiable elements, including insomnia, depression, anxiety, and pain, to avoid deteriorating or elevated levels of fatigue. Given that a minority of patients fall into the high-risk/deteriorating categories, it should be possible to support vulnerable patients appropriately with currently available resources. This important work could have a meaningful impact on survivorship. Studies to address the effect of early and repeat measurements of fatigue, coupled with mitigation strategies in the real-world setting, are eagerly awaited."
