Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bower, J. E.
Right arrow Articles by Belin, T. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bower, J. E.
Right arrow Articles by Belin, T. R.
Journal of Clinical Oncology, Vol 18, Issue 4 (February), 2000: 743
© 2000 American Society for Clinical Oncology

Fatigue in Breast Cancer Survivors: Occurrence, Correlates, and Impact on Quality of Life

By Julienne E. Bower, Patricia A. Ganz, Katherine A. Desmond, Julia H. Rowland, Beth E. Meyerowitz, Thomas R. Belin

From the Norman Cousins Center in Psychoneuroimmunology, Departments of Biostatistics and Psychiatry and Biobehavioral Sciences, Schools of Public Health and Medicine, Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Department of Psychology, University of Southern California, Los Angeles, CA; and Department of Psychiatry, Georgetown University Medical School and Lombardi Cancer Center, Washington, DC.

Address reprint requests to Patricia A. Ganz, MD, Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, 650 Charles Young Dr South, Room A2-125, CHS Box 956900, Los Angeles, CA 90095-6900; email pganz{at}ucla.edu

PURPOSE: To describe the occurrence of fatigue in a large sample of breast cancer survivors relative to general population norms and to identify demographic, medical, and psychosocial characteristics of fatigued survivors.

PATIENTS AND METHODS: Breast cancer survivors in two large metropolitan areas completed standardized questionnaires as part of a survey study, including the RAND 36-item Health Survey, Center for Epidemiological Studies–Depression Scale, Breast Cancer Prevention Trial Symptom Checklist, Medical Outcomes Study Sleep Scale, and demographic and treatment-related measures.

RESULTS: On average, the level of fatigue reported by the breast cancer survivors surveyed (N = 1,957) was comparable to that of age-matched women in the general population, although the breast cancer survivors were somewhat more fatigued than a more demographically similar reference group. Approximately one third of the breast cancer survivors assessed reported more severe fatigue, which was associated with significantly higher levels of depression, pain, and sleep disturbance. In addition, fatigued women were more bothered by menopausal symptoms and were somewhat more likely to have received chemotherapy (with or without radiation therapy) than nonfatigued women. In multivariate analyses, depression and pain emerged as the strongest predictors of fatigue.

CONCLUSION: Although the majority of breast cancer survivors in this large and diverse sample did not experience heightened levels of fatigue relative to women in the general population, there was a subgroup of survivors who did report more severe and persistent fatigue. We identified characteristics of these women that may be helpful in elucidating the mechanisms underlying fatigue in this population, as well as directing intervention efforts.




This article has been cited by other articles:


Home page
 Journal of Pediatric Oncology NursingHome page
S. F. Whitsett, M. Gudmundsdottir, B. Davies, P. McCarthy, and D. Friedman
Chemotherapy-Related Fatigue in Childhood Cancer: Correlates, Consequences, and Coping Strategies
Journal of Pediatric Oncology Nursing, April 1, 2008; 25(2): 86 - 96.
[Abstract] [PDF]

Home page
 SURG INNOVHome page
V. Velanovich
Innovative Use of Quality-of-Life Data: Correlating Physiologic Parameters With Patient-Centered Symptoms-- The Example of Anemia on the Vitality of Surgical Oncology Patients
Surgical Innovation, March 1, 2008; 15(1): 47 - 51.
[Abstract] [PDF]

Home page
 JCOHome page
A. H. Miller, S. Ancoli-Israel, J. E. Bower, L. Capuron, and M. R. Irwin
Neuroendocrine-Immune Mechanisms of Behavioral Comorbidities in Patients With Cancer
J. Clin. Oncol., February 20, 2008; 26(6): 971 - 982.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. E. Bower
Behavioral Symptoms in Patients With Breast Cancer and Survivors
J. Clin. Oncol., February 10, 2008; 26(5): 768 - 777.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
D. J. Storey, R. A. Waters, C. J. Hibberd, R. W. Rush, A. T. Cargill, L. R. Wall, M. T. Fallon, V. A. Strong, J. Walker, and M. Sharpe
Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study
Ann. Onc., November 1, 2007; 18(11): 1861 - 1869.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
A. B. Moadel, C. Shah, J. Wylie-Rosett, M. S. Harris, S. R. Patel, C. B. Hall, and J. A. Sparano
Randomized Controlled Trial of Yoga Among a Multiethnic Sample of Breast Cancer Patients: Effects on Quality of Life
J. Clin. Oncol., October 1, 2007; 25(28): 4387 - 4395.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
P. A. Ganz and G. A. Greendale
Female Sexual Desire--Beyond Testosterone
J Natl Cancer Inst, May 2, 2007; 99(9): 659 - 661.
[Full Text] [PDF]

Home page
 Ann OncolHome page
P. Dagnelie, M. Pijls-Johannesma, P Lambin, S Beijer, D De Ruysscher, and G. Kempen
Impact of fatigue on overall quality of life in lung and breast cancer patients selected for high-dose radiotherapy
Ann. Onc., May 1, 2007; 18(5): 940 - 944.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
M. Hofman, J. L. Ryan, C. D. Figueroa-Moseley, P. Jean-Pierre, and G. R. Morrow
Cancer-Related Fatigue: The Scale of the Problem
Oncologist, May 1, 2007; 12(suppl_1): 4 - 10.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
J. L. Ryan, J. K. Carroll, E. P. Ryan, K. M. Mustian, K. Fiscella, and G. R. Morrow
Mechanisms of Cancer-Related Fatigue
Oncologist, May 1, 2007; 12(suppl_1): 22 - 34.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
J. A. Roscoe, M. E. Kaufman, S. E. Matteson-Rusby, O. G. Palesh, J. L. Ryan, S. Kohli, M. L. Perlis, and G. R. Morrow
Cancer-Related Fatigue and Sleep Disorders
Oncologist, May 1, 2007; 12(suppl_1): 35 - 42.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
P. A. Ganz
Monitoring the Physical Health of Cancer Survivors: A Survivorship-Focused Medical History
J. Clin. Oncol., November 10, 2006; 24(32): 5105 - 5111.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
K. C. Oeffinger and M. S. McCabe
Models for Delivering Survivorship Care
J. Clin. Oncol., November 10, 2006; 24(32): 5117 - 5124.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
A. Glaus, Ch. Boehme, B. Thurlimann, T. Ruhstaller, S. F. Hsu Schmitz, R. Morant, H. J. Senn, and R. von Moos
Fatigue and menopausal symptoms in women with breast cancer undergoing hormonal cancer treatment
Ann. Onc., May 1, 2006; 17(5): 801 - 806.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
A. Collado-Hidalgo, J. E. Bower, P. A. Ganz, S. W. Cole, and M. R. Irwin
Inflammatory Biomarkers for Persistent Fatigue in Breast Cancer Survivors.
Clin. Cancer Res., May 1, 2006; 12(9): 2759 - 2766.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
P. Nieboer, C. Buijs, S. Rodenhuis, C. Seynaeve, L. V.A.M. Beex, E. van der Wall, D. J. Richel, M. A. Nooij, E. E. Voest, P. Hupperets, et al.
Fatigue and Relating Factors in High-Risk Breast Cancer Patients Treated With Adjuvant Standard or High-Dose Chemotherapy: A Longitudinal Study
J. Clin. Oncol., November 20, 2005; 23(33): 8296 - 8304.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. E. Bower
Prevalence and Causes of Fatigue After Cancer Treatment: The Next Generation of Research
J. Clin. Oncol., November 20, 2005; 23(33): 8280 - 8282.
[Full Text] [PDF]

Home page
 JCOHome page
H. G. M. Fan, N. Houede-Tchen, Q.-L. Yi, I. Chemerynsky, F. P. Downie, K. Sabate, and I. F. Tannock
Fatigue, Menopausal Symptoms, and Cognitive Function in Women After Adjuvant Chemotherapy for Breast Cancer: 1- and 2-Year Follow-Up of a Prospective Controlled Study
J. Clin. Oncol., November 1, 2005; 23(31): 8025 - 8032.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
M. A. Andrykowski, J. E. Schmidt, J. M. Salsman, A. O. Beacham, and P. B. Jacobsen
Use of a Case Definition Approach to Identify Cancer-Related Fatigue in Women Undergoing Adjuvant Therapy for Breast Cancer
J. Clin. Oncol., September 20, 2005; 23(27): 6613 - 6622.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
K. A. Meeske, S. E. Siegel, D. R. Globe, W. J. Mack, and L. Bernstein
Prevalence and Correlates of Fatigue in Long-Term Survivors of Childhood Leukemia
J. Clin. Oncol., August 20, 2005; 23(24): 5501 - 5510.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
P. A. Ganz
A Teachable Moment for Oncologists: Cancer Survivors, 10 Million Strong and Growing!
J. Clin. Oncol., August 20, 2005; 23(24): 5458 - 5460.
[Full Text] [PDF]

Home page
 JCOHome page
T. A. Ahles, A. J. Saykin, C. T. Furstenberg, B. Cole, L. A. Mott, L. Titus-Ernstoff, K. Skalla, M. Bakitas, and P. M. Silberfarb
Quality of Life of Long-Term Survivors of Breast Cancer and Lymphoma Treated With Standard-Dose Chemotherapy or Local Therapy
J. Clin. Oncol., July 1, 2005; 23(19): 4399 - 4405.
[Abstract] [Full Text] [PDF]

Home page
 Psychosom. Med.Home page
J. E. Bower, P. A. Ganz, and N. Aziz
Altered Cortisol Response to Psychologic Stress in Breast Cancer Survivors With Persistent Fatigue
Psychosom Med, March 1, 2005; 67(2): 277 - 280.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
N. de Jong, M. J. J. M. Candel, H. C. Schouten, H. Huijer Abu-Saad, and A. M. Courtens
Course of mental fatigue and motivation in breast cancer patients receiving adjuvant chemotherapy
Ann. Onc., March 1, 2005; 16(3): 372 - 382.
[Abstract] [Full Text] [PDF]

Home page
 J Natl Cancer Inst MonogrHome page
J. Mandelblatt, C. Armetta, K. R. Yabroff, W. Liang, and W. Lawrence
Descriptive Review of the Literature on Breast Cancer Outcomes: 1990 Through 2000
J Natl Cancer Inst Monographs, October 1, 2004; 2004(33): 8 - 44.
[Abstract] [Full Text] [PDF]

Home page
 J Natl Cancer Inst MonogrHome page
C. C. Gotay
Assessing Cancer-Related Quality of Life Across a Spectrum of Applications
J Natl Cancer Inst Monographs, October 1, 2004; 2004(33): 126 - 133.
[Abstract] [Full Text] [PDF]

Home page
 J Natl Cancer Inst MonogrHome page
D. P. Lawrence, B. Kupelnick, K. Miller, D. Devine, and J. Lau
Evidence Report on the Occurrence, Assessment, and Treatment of Fatigue in Cancer Patients
J Natl Cancer Inst Monographs, July 1, 2004; 2004(32): 40 - 50.
[Abstract] [Full Text] [PDF]

Home page
 J Natl Cancer Inst MonogrHome page
V. Mock
Evidence-Based Treatment for Cancer-Related Fatigue
J Natl Cancer Inst Monographs, July 1, 2004; 2004(32): 112 - 118.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
N. de Jong, M. J. J. M. Candel, H. C. Schouten, H. Huijer Abu-Saad, and A. M. Courtens
Prevalence and course of fatigue in breast cancer patients receiving adjuvant chemotherapy
Ann. Onc., June 1, 2004; 15(6): 896 - 905.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
P. A. Ganz, L. Kwan, A. L. Stanton, J. L. Krupnick, J. H. Rowland, B. E. Meyerowitz, J. E. Bower, and T. R. Belin
Quality of Life at the End of Primary Treatment of Breast Cancer: First Results From the Moving Beyond Cancer Randomized Trial
J Natl Cancer Inst, March 3, 2004; 96(5): 376 - 387.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
N. Tchen, H. G. Juffs, F. P. Downie, Q.-L. Yi, H. Hu, I. Chemerynsky, M. Clemons, M. Crump, P. E. Goss, D. Warr, et al.
Cognitive Function, Fatigue, and Menopausal Symptoms in Women Receiving Adjuvant Chemotherapy for Breast Cancer
J. Clin. Oncol., November 15, 2003; 21(22): 4175 - 4183.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
P. A. Ganz, G. A. Greendale, L. Petersen, B. Kahn, and J. E. Bower
Breast Cancer in Younger Women: Reproductive and Late Health Effects of Treatment
J. Clin. Oncol., November 15, 2003; 21(22): 4184 - 4193.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
Y. Brandberg, H. Michelson, B. Nilsson, C. Bolund, B. Erikstein, P. Hietanen, S. Kaasa, J. Nilsson, T. Wiklund, N. Wilking, et al.
Quality of Life in Women With Breast Cancer During the First Year After Random Assignment to Adjuvant Treatment With Marrow-Supported High-Dose Chemotherapy With Cyclophosphamide, Thiotepa, and Carboplatin or Tailored Therapy With Fluorouracil, Epirubicin, and Cyclophosphamide: Scandinavian Breast Group Study 9401
J. Clin. Oncol., October 1, 2003; 21(19): 3659 - 3664.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
P. A. Ganz, C. M. Moinpour, D. K. Pauler, A. B. Kornblith, E. R. Gaynor, S. P. Balcerzak, G. S. Gatti, H. P. Erba, S. McCoy, O. W. Press, et al.
Health Status and Quality of Life in Patients With Early-Stage Hodgkin's Disease Treated on Southwest Oncology Group Study 9133
J. Clin. Oncol., September 15, 2003; 21(18): 3512 - 3519.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Research in NursingHome page
C. A. Niven
Recognising pain as a component of symptom clusters: A means of informing the nursing management of symptoms and side-effects
Journal of Research in Nursing, September 1, 2003; 8(5): 354 - 363.
[Abstract] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
J. E. Bower, P. A. Ganz, N. Aziz, J. L. Fahey, and S. W. Cole
T-Cell Homeostasis in Breast Cancer Survivors With Persistent Fatigue
J Natl Cancer Inst, August 6, 2003; 95(15): 1165 - 1168.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. Rayson
Adjuvant Chemotherapy For Women With Young Children: Our Patients as Parents
J. Clin. Oncol., May 1, 2003; 21(90090): 114s - 116.
[Full Text] [PDF]

Home page
 JCOHome page
S. D. Fossa, A. A. Dahl, and J. H. Loge
Fatigue, Anxiety, and Depression in Long-Term Survivors of Testicular Cancer
J. Clin. Oncol., April 1, 2003; 21(7): 1249 - 1254.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. PsychiatryHome page
W. A. Bardwell, P. Moore, S. Ancoli-Israel, and J. E. Dimsdale
Fatigue in Obstructive Sleep Apnea: Driven by Depressive Symptoms Instead of Apnea Severity?
Am J Psychiatry, February 1, 2003; 160(2): 350 - 355.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
Z. W. Zhuang, G. J. Teng, R. F. Jeffery, J. M. Gemery, B. J. d'Othee, and M. A. Bettmann
Long-Term Results and Quality of Life in Patients Treated with Transjugular Intrahepatic Portosystemic Shunts
Am. J. Roentgenol., December 1, 2002; 179(6): 1597 - 1603.
[Abstract] [Full Text] [PDF]

Home page
 Psychosom. Med.Home page
J. E. Bower, P. A. Ganz, N. Aziz, and J. L. Fahey
Fatigue and Proinflammatory Cytokine Activity in Breast Cancer Survivors
Psychosom Med, July 1, 2002; 64(4): 604 - 611.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
B. Holzner, G. Kemmler, R. Greil, M. Kopp, A. Zeimet, M. Raderer, M. Hejna, S. Zochbauer, G. Krajnik, H. Huber, et al.
The impact of hemoglobin levels on fatigue and quality of life in cancer patients
Ann. Onc., June 1, 2002; 13(6): 965 - 973.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. M. Prieto, J. Blanch, J. Atala, E. Carreras, M. Rovira, E. Cirera, and C. Gasto
Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation
J. Clin. Oncol., April 1, 2002; 20(7): 1907 - 1917.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
P. Servaes, S. Verhagen, and G. Bleijenberg
Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study
Ann. Onc., April 1, 2002; 13(4): 589 - 598.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
P. A. Ganz, K. A. Desmond, B. Leedham, J. H. Rowland, B. E. Meyerowitz, and T. R. Belin
Quality of Life in Long-Term, Disease-Free Survivors of Breast Cancer: a Follow-up Study
J Natl Cancer Inst, January 2, 2002; 94(1): 39 - 49.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
F. Joly, J. F. Heron, L. Kalusinski, P. Bottet, D. Brune, N. Allouache, J. Mace-Lesec'h, J. E. Couette, J. Peny, and M. Henry-Amar
Quality of Life in Long-Term Survivors of Testicular Cancer: A Population-Based Case-Control Study
J. Clin. Oncol., January 1, 2002; 20(1): 73 - 80.
[Abstract] [Full Text] [PDF]

Home page
 J Natl Cancer Inst MonogrHome page
A. H. Partridge, H. J. Burstein, and E. P. Winer
Side Effects of Chemotherapy and Combined Chemohormonal Therapy in Women With Early-Stage Breast Cancer
J Natl Cancer Inst Monographs, December 1, 2001; 2001(30): 135 - 142.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
C. L. Shapiro and A. Recht
Side Effects of Adjuvant Treatment of Breast Cancer
N. Engl. J. Med., June 28, 2001; 344(26): 1997 - 2008.
[Full Text] [PDF]

Home page
 JCOHome page
D. Rayson
Adjuvant Chemotherapy For Women With Young Children: Our Patients as Parents
J. Clin. Oncol., January 1, 2001; 19(1): 279 - 281.
[Full Text] [PDF]


About
JCO		 Editorial
Roster		 Advertising
Information		 Librarians &
Institutions		 Rights &
Permissions		 PDA Services

Copyright © 2000 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online