This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Andrykowski, M. A. Articles by Jacobsen, P. B. Search for Related Content PubMed PubMed Citation Articles by Andrykowski, M. A. Articles by Jacobsen, P. B. Social Bookmarking                            What's this?

Use of a Case Definition Approach to Identify Cancer-Related Fatigue in Women Undergoing Adjuvant Therapy for Breast Cancer

From the University of Kentucky College of Medicine, Lexington; Spalding University, Louisville, KY; H. Lee Moffitt Cancer Center and Research Institute and University of South Florida, Tampa, FL

Address reprint requests to Michael A. Andrykowski, PhD, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536-0086; e-mail: mandry{at}uky.edu

PURPOSE: Use a proposed case-definition approach to identify the prevalence of cancer-related fatigue (CRF), demographic, clinical and psychosocial predictors of subsequent CRF, and psychosocial factors associated with concurrent CRF.

PATIENTS AND METHODS: Women (n = 288) undergoing adjuvant therapy for early-stage breast cancer were recruited from two outpatient clinics. Women completed a baseline assessment before adjuvant therapy and a post-treatment assessment at the conclusion of an initial course of adjuvant chemotherapy or radiotherapy. At both assessments, women completed a clinical interview and measures of fatigue, distress, coping, and quality of life (QOL). The clinical interview consisted of modules from the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) and a diagnostic interview to identify cases of CRF.

RESULTS: CRF prevalence at the baseline and post-treatment assessments was 10% and 26%, respectively. Multivariate analyses identified factors prospectively associated with greater risk for CRF at the post-treatment assessment, including receipt of adjuvant chemotherapy and a tendency to catastrophize in response to fatigue. Patients with and without CRF differed on a host of concurrent measures of fatigue, depression, functioning, and QOL with mean effect sizes in the range of 1.0 standard deviation.

CONCLUSION: CRF is a clinical syndrome experienced before and during adjuvant therapy for breast cancer. Results suggest CRF has a multifactorial etiology and support use of the proposed case definition approach to defining CRF. Future research is necessary to determine the scientific value of these criteria for understanding the etiology and management of fatigue in the oncology setting.

Supported by grant No. R01-CA82822 from the National Institutes of Health.

The research reported here has not been reported elsewhere.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. M. Berger, B. R. Kuhn, L. A. Farr, S. G. Von Essen, J. Chamberlain, J. C. Lynch, and S. Agrawal One-Year Outcomes of a Behavioral Therapy Intervention Trial on Sleep Quality and Cancer-Related Fatigue J. Clin. Oncol., December 10, 2009; 27(35): 6033 - 6040. [Abstract] [Full Text] [PDF]

				S. Alexander, O. Minton, and P. C. Stone Evaluation of Screening Instruments for Cancer-Related Fatigue Syndrome in Breast Cancer Survivors J. Clin. Oncol., March 10, 2009; 27(8): 1197 - 1201. [Abstract] [Full Text] [PDF]

				O. Minton, A. Richardson, M. Sharpe, M. Hotopf, and P. Stone A Systematic Review and Meta-Analysis of the Pharmacological Treatment of Cancer-Related Fatigue J Natl Cancer Inst, August 20, 2008; 100(16): 1155 - 1166. [Abstract] [Full Text] [PDF]

				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]

				M. A. Andrykowski, A. O. Beacham, and P. B. Jacobsen Prospective, Longitudinal Study of Leisure-Time Exercise in Women with Early-Stage Breast Cancer Cancer Epidemiol. Biomarkers Prev., March 1, 2007; 16(3): 430 - 438. [Abstract] [Full Text] [PDF]

				H. Murphy, S. Alexander, and P. Stone Investigation of diagnostic criteria for cancer-related fatigue syndrome in patients with advanced cancer: a feasibility study Palliative Medicine, June 1, 2006; 20(4): 413 - 418. [Abstract] [PDF]