Cancer-related Fatigue In Patients Research Articles

Efficacy of treatment with traditional Chinese patent medicine (Fufang E'jiao Syrup) for cancer-related fatigue in patients with advanced cancer: A randomized, double-blinded, placebo-controlled, multicenter trial.

12053 Background: There is ongoing interest in finding effective drugs for cancer-related fatigue (CRF) in advanced cancer patients, although studies have had mixed results. Fufang E'jiao Syrup (FFEJS), a traditional Chinese patent medicine, has shown promise in alleviating CRF. This trial aims to investigate whether FFEJS could reduce fatigue and improve quality of life in advanced cancer patients. Methods: This prospective, multicenter, double-blinded, placebo-controlled trial was implemented at 29 hospitals in China, enrolling 611 advanced non-small cell lung cancer, colorectal cancer, and gastric cancer patients with Visual Analogue Scale for Fatigue ≥ 4 points. The study was conducted between September 23, 2019 and April 7, 2022, with a final follow-up on May 25, 2022. Participants were randomized to receive FFEJS (20 ml, 3 times per day) or a matching placebo orally for six weeks. The safety assessments were extended until the fourth week after the trial ended. The primary outcome was the change in total mean score (range: 0 [no fatigue] to 10 [extreme fatigue] points) on the Revised Piper Fatigue Scale-Chinese Version (RPFS-CV) from baseline to week 6. Secondary outcomes include quality of life (Functional Assessment of Chronic Illness Therapy-Fatigue, FACIT-F) and adverse events. FFEJS were compared with the placebo group using a linear mixed model. Results: Among 611 patients randomized (FFEJS: 303 and placebo: 308; 210 non-small cell lung cancer [34.4%], 201 colorectal cancer [32.9%], 200 gastric cancer [32.7%]; mean [SD] age, 62.8 [9.3] years; 413 [68.3%] man; mean [SD] baseline RPFS-CV total mean score, 4.86 [1.30] points), 503 (82.3%) completed the primary end point. By the end of week 6, the FFEJS group achieved normal fatigue levels (RPFS-CV < 4) compared to the placebo group (FFEJS: 3.78 vs Placebo: 4.39, adjusted mean difference 0.59 points [95% CI, 0.45 to 0.76 points]; P < .001). The adjusted mean difference for a favorable shift to a higher FACIT-F total score at week 6 comparing FFEJS with placebo was 2.77 points (97.36 vs 94.23 points; [95% CI, 0.56-4.96 points]; P = .02). There was no difference in adverse events occurrence between FFEJS and the placebo groups (110 [20%] vs 122 [18%], P = .38). Conclusions: In this randomized clinical trial among advanced cancer patients with CRF, FFEJS reducedfatigue severity and improved quality of life compared to placebo. Research is needed to assess the mechanism, clinical effect, and long-term safety of FFEJS for CRF in advanced cancer patients. Clinical trial information: NCT04147312 .

A phase II randomized, double-blind, placebo-controlled study of Nuvastatic (C50SEW505OESA), a standardized rosmarinic acid-rich polymolecular botanical extract formulation to reduce cancer-related fatigue in patients with solid tumors.

We evaluated the efficacy and safety of Nuvastatic™ (C5OSEW5050ESA)in improving cancer-related fatigue (CRF) among cancer patients. This multicenter randomized double-blind placebo-controlled phase 2 trial included 110 solid malignant tumor patients (stage II-IV) undergoing chemotherapy. They were randomly selected and provided oral Nuvastatic™ 1000mg (N = 56) or placebo (N = 54) thrice daily for 9weeks. The primary outcomes were fatigue (Brief Fatigue Inventory (BFI)) and Visual Analog Scale for Fatigue (VAS-F)) scores measured before and after intervention at baseline and weeks 3, 6, and 9. The secondary outcomes were mean group difference in the vitality subscale of the Medical Outcome Scale Short Form-36 (SF-36) and urinary F2-isoprostane concentration (an oxidative stress biomarker), Eastern Cooperative Oncology Group scores, adverse events, and biochemical and hematologic parameters. Analysis was performed by intention-to-treat (ITT). Primary and secondary outcomes were assessed by two-way repeated-measures analysis of variance (mixed ANOVA). The Nuvastatic™ group exhibited an overall decreased fatigue score compared with the placebo group. Compared with the placebo group, the Nuvastatic™ group significantly reduced BFI-fatigue (BFI fatigue score, F (1.4, 147) = 16.554, p < 0.001, partial η2 = 0.333). The Nuvastatic™ group significantly reduced VAS-F fatigue (F (2, 210) = 9.534, p < 0.001, partial η2 = 0.083), improved quality of life (QoL) (F (1.2, 127.48) = 34.07, p < 0.001, partial η2 = 0.243), and lowered urinary F2-IsoP concentrations (mean difference (95% CI) = 55.57 (24.84, 86.30)), t (55) = 3.624, p < 0.001, Cohen's d (95% CI) = 0.48 (0.20, 0.75)). Reported adverse events were vomiting (0.9%), fever (5.4%), and headache (2.7%). Nuvastatic™ is potentially an effective adjuvant for CRF management in solid tumor patients and worthy of further investigation in larger trials. ClinicalTrial.gov ID: NCT04546607. Study registration date (first submitted): 11-05-2020.

The effect of self-designed metabolic equivalent exercises on cancer-related fatigue in patients with gastric cancer: A randomized controlled trial.

To investigate the effect of Self-designed Metabolic Equivalent Exercises (SMEE) on cancer-related fatigue in patients with gastric cancer. 130 patients with gastric cancer admitted to Department of Oncology of a tertiary hospital in Shanghai were enrolled and assessed for eligibility. After excluding 1 patient who declined to participate, 129 eligible patients were randomly assigned into SMEE (n = 65) and control (n = 64) groups. The Revised Piper Fatigue Scale (RPFS) and EORTC QLQ-C30 Quality of Life Scale were used to measure cancer-caused fatigue and quality of life, respectively, in both groups at the first admission and after 3 months. After excluding patients who did not receive allocated intervention due to medical (n = 3) and personal (n = 2) reasons, those who were lost to follow-up (n = 3), and those who had discontinued intervention (n = 2), 119 patients (64 in the SMEE group and 55 in the control group) were included for analysis. There were no statistically significant differences in the RPFS or QLQ-C30 score between the two groups at baseline. After 3 months, the total RPFS score of the SMEE group was significantly lower than that of the control group (2.86 ± 1.75 vs. 4.65 ± 1.29, p = 0.009), with significant improvements in affective meaning (0.83 ± 0.92 vs. 1.13 ± 0.77, p = 0.044) and sensory (0.70 ± 0.71 vs. 1.00 ± 0.54, p < 0.001) subscales; in the SMEE group, QLQ-C30 scores in somatic (2.00 ± 0.27 vs. 1.31 ± 0.26, p < 0.001), emotional (2.67 ± 0.58 vs. 2.07 ± 0.48, p < 0.001), and social (3.23 ± 0.58 vs. 1.64 ± 0.51, p < 0.001) functioning were significantly higher than those in the control group, with significant improvements in fatigue (p < 0.001), nausea/vomiting (p = 0.014), shortness of breath (p < 0.001), constipation (p < 0.001), and diarrhea (p = 0.001) dimensions. The self-programmed metabolic equivalent manipulation as an exercise intervention could effectively reduce the degree of cancer-caused fatigue and improve quality of life in patients with gastric cancer.

Development and validation of a nomogram for predicting sever cancer-related fatigue in patients with cervical cancer

ObjectiveCancer-related fatigue (CRF) has been considered the biggest influencing factor for cancer patients after surgery. This study aimed to develop and validate a nomogram for severe cancer-related fatigue (CRF) patients with cervical cancer (CC).MethodsA cross-sectional study was conducted to develop and validate a nomogram (building set = 196; validation set = 88) in the Department of Obstetrics and Gynecology of a Class III hospital in Shenyang, Liaoning Province. We adopted the questionnaire method, including the Cancer Fatigue Scale (CFS), Medical Uncertainty in Illness Scale (MUIS), Medical Coping Modes Questionnaire (MCMQ), Multidimensional Scale of Perceived Social Support (MSPSS), and Sense of Coherence-13 (SOC-13). Binary logistic regression was used to test the risk factors of CRF. The R4.1.2 software was used to develop and validate the nomogram, including Bootstrap resampling method, the ability of Area Under Curve (AUC), Concordance Index (C-Index), Hosmer Lemeshow goodness of fit test, Receiver Operating Characteristic (ROC) curve, Calibration calibration curve, and Decision Curve Analysis curve (DCA).ResultsThe regression equation was Logit(P) = 1.276–0.947 Monthly income + 0.989 Long-term passive smoking − 0.952 Physical exercise + 1.512 Diagnosis type + 1.040 Coping style − 0.726 Perceived Social Support − 2.350 Sense of Coherence. The C-Index of the nomogram was 0.921 (95% CI: 0.877\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\sim $$\\end{document}0.958). The ROC curve showed the sensitivity of the nomogram was 0.821, the specificity was 0.900, and the accuracy was 0.857. AUC was 0.916 (95% CI: 0.876\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\sim $$\\end{document}0.957). The calibration showed that the predicted probability of the nomogram fitted well with the actual probability. The DCA curve showed when the prediction probability was greater than about 10%, the benefit of the nomogram was positive. The results in the validation group were similar.ConclusionThis nomogram had good identifiability, accuracy and clinical practicality, and could be used as a prediction and evaluation tool for severe cases of clinical patients with CC.

Effect of acupoint conditioning nursing technology based on holistic view of traditional Chinese medicine on cancer-related fatigue of patients with lung cancer after chemotherapy.

Effect of acupoint conditioning nursing technology based on holistic view of traditional Chinese medicine on cancer-related fatigue of patients with lung cancer after chemotherapy.

Effect of grape-based syrup on cancer-related fatigue in patients with breast cancer: a double-blind randomized clinical trial

Effect of grape-based syrup on cancer-related fatigue in patients with breast cancer: a double-blind randomized clinical trial

Effect of yoga on cancer-related fatigue in patients with breast cancer: A systematic review and meta-analysis.

Breast cancer is a common malignant tumor in women and most patients with breast cancer experience fatigue. Numerous studies have investigated the relationship between yoga and cancer-related fatigue (CRF) in patients with breast cancer. However, these studies drew their conclusions from small sample sizes and lacked sufficient evidence to demonstrate that yoga can effectively alleviate CRF. Therefore, this meta-analysis aims to systematically examine the effects of yoga on cancer fatigue in patients with breast cancer and establish a scientific basis for enhancing their quality of life. To assess the effect of yoga on CRF in patients with breast cancer. Computer searches were conducted on PubMed, Embase, Web of Science, CKNI, and Wanfang databases to retrieve articles related to yoga and CRF in patients with breast cancer from the hospital establishment date to July 2023. The literature was independently screened, and the information was extracted by the researchers. A meta-analysis was conducted using Review Manager Software (version 5.3). The findings from the meta-analysis of 18 studies indicate that yoga can effectively enhance CFR (standardized mean difference (SMD) = -0.51, 95% confidence interval [CI] = -0.92 to -0.10), improve sleep quality (MD = -3.86, 95%CI = -4.03 to -3.70) in patients with breast cancer, alleviate anxiety and depression (SMD = -0.93, 95%CI = -1.68, -0.18, SMD = -1.23, 95%CI = -2.02 to -0.44), and enhance quality of life (MD = -11.20, 95%CI = -14.16 to -8.24). Our study offers evidence for the subsequent reduction of CFR in patients with breast cancer. Yoga can alleviate fatigue, improve sleep quality and negative emotions, and improve the quality of life of patients with breast cancer.

Efficacy of Moxibustion for Cancer-Related Fatigue in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.

Breast cancer is the most commonly diagnosed cancer worldwide, and most patients experience fatigue. However, there are no effective treatments for cancer-related fatigue (CRF). Several randomized controlled trials (RCTs) have suggested that moxibustion improves CRF. We conducted a systematic review and meta-analysis to compare the differences in fatigue scale scores, quality of life, and clinical efficacy in patients with breast cancer who developed CRF and did versus did not receive moxibustion. RCTs were searched in 7 databases using a standardized search method from database inception to March 2023, and RCTs that met the inclusion criteria were selected. Among 1337 initially identified RCTs, 10 RCTs involving 744 participants were selected for this study. The meta-analysis involved assessment of the revised Piper Fatigue Scale scores, Cancer Fatigue Scale scores, Karnofsky Performance Scale scores, Athens Insomnia Scale scores, clinical efficacy, and Qi deficiency syndrome scale scores. Compared with the control, moxibustion was associated with significantly better Piper Fatigue Scale scores (P < 0.0001), quality of life [Karnofsky Performance Scale scores (P < 0.0001)], clinical efficacy (P = 0.0007), and Qi deficiency syndrome scale scores (P = 0.02). Moxibustion improves CRF in patients with breast cancer. The efficacy of moxibustion should be further examined by high-quality studies in various countries with patients subdivided by their breast cancer treatment status. PROSPERO ID: CRD42023451292.

Understanding experiences of cancer-related fatigue in patients with lung cancer after their cancer treatment: a qualitative content analysis.

Cancer-related fatigue (CRF) is an important symptom affecting the quality of life of patients with lung cancer. However, research on the characteristics of CRF in lung cancer and their relationship to cancer treatment is limited. We aimed to explore the unique features of CRF in patients with lung cancer, and investigate the influencing factors. Semi-structured interviews were conducted with 21 adult patients with lung cancer until data saturation was reached. The collected data were analyzed using qualitative content analysis. An inductive coding process and deductive content analysis incorporating the established CRF domains were employed. Patient data from electronic medical records were used for data triangulation. The analysis revealed five themes of CRF: (1) energy depletion, the double burden of illness and treatment, and daily life impediments; (2) feeling down and anxious; (3) neurovascular disturbances and changes in sensory perception; (4) cognitive impairment; and (5) personal and social isolation. CRF tended to improve over time, except for persistent emotional fatigue beyond 6months. Patients who underwent surgery followed by adjuvant cancer treatment exhibited the most diverse CRF symptoms. The concurrent chemoradiation therapy group experienced significant physical fatigue, whereas the radiosurgery group reported distinct emotional fatigue. Certain factors, such as exercise, can serve as both alleviating and aggravating factors for CRF. Tailored interventions that take into account the multidimensional symptoms of CRF and patient characteristics are crucial. These findings will guide healthcare professionals when implementing patient-centered symptom management and patient education.

Non-pharmacological fatigue interventions for patients with a primary brain tumour: a scoping review protocol

IntroductionFatigue is the most prevalent symptom for patients with a primary brain tumour (PBT), significantly reducing quality of life and limiting daily activities. Currently, there are limited options for managing...

Influencing factors of cancer-related fatigue in acute leukemia patients: A cross-sectional study

PurposeTo investigate influencing factors of cancer-related fatigue (CRF) in adult patients with acute leukemia (AL). MethodsA total of 288 adult patients diagnosed with acute leukemia in West China Hospital were included in this study. A cross-sectional survey, including the Clinical Information Questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HAD), was provided to the patients. Hierarchical multiple linear regression analyses were conducted to evaluate the associations of the variable factors and the AL patients’ CRF. ResultsThe CRF score of AL patients was 33.25 ± 10.35. Gender, age, albumin level, depression, anxiety status of the patients and treatment cycles were identified as influencing factors of CRF in AL patients (P < 0.05). The CRF level of acute leukemia patients in the complete remission group was lower than that of patients who were not achieving complete remission. Depression, anxiety, age, employment, albumin, and sleep disturbance were independent influencing factors for CRF in patients who were not achieving complete remission. ConclusionsAcute leukemia patients who are female, older, hypoalbuminemia，or in the induction therapy have a higher risk of developing a high degree of CRF. Clinical staff should pay more attention to the CRF of patients who were not achieving complete remission. Early screening and aggressive intervention could be adopted in caring for these patients.

The relationship of exercise and cancer-related fatigue in patients with advanced liver cancer: a cross-sectional study

There is increasing interest in understanding exercise as a potential treatment for cancer-related fatigue (CRF); however, rarely research has been conducted on more aggressive cancers with short survival, such as liver cancer. The purpose of this study was to provide educational ideas for insufficient exercise and provide clues for the design of effective and safe exercise intervention programs with high compliance in patients of advanced liver cancer in the future. Participants were recruited from a tertiary cancer hospital using convenience sampling. All participants were asked to complete self-report questionnaires that assessed their medical and demographic variables, exercise habits and CRF during their hospitalization in the interventional department. Spearman’s correlation analysis and Nonparametric test was used to explore correlations between exercise subgroups and CRF. The Baron and Kenny’s Approach was used to investigate the mediating effect of exercise index between P-EX and CRF. 207 out of 255 participants were enrolled in this study, with an average age of 55.4 years. The CRF score was 33 (28, 36), and 93.2% had insufficient exercise. Exercise frequency (≥ 3 Times/week) (Z = 4.34, p = 0.037) and maintaining exercise trend (Z = 15.85, p = 0.001) had a positive effect on CRF. P-EX had a great impact on exercise index and affecting CRF directly. Participants in the study showed serious fatigue and insufficient exercise. Exercise education can be initiated earlier, particularly those without regular exercise experience. Sustained light exercise, compliant with exercise habits and interests, three times a week may be a practical way to reduce the risk of CRF in advanced liver cancer.

Characteristics and predictors associated with cancer-related fatigue among solid and liquid tumors.

Cancer-related fatigue (CRF) is a devastating complication with limited recognized clinical risk factors. We examined characteristics among solid and liquid cancers utilizing Machine learning (ML) approaches for predicting CRF. We utilized 2017 National Inpatient Sample database and employed generalized linear models to assess the association between CRF and the outcome of burden of illness among hospitalized solid and non-solid tumors patients. And further applied lasso, ridge and Random Forest (RF) for building our linear and non-linear ML models. The 2017 database included 196,330 prostate (PCa), 66,385 leukemia (Leuk), 107,245 multiple myeloma (MM), and 41,185 cancers of lip, oral cavity and pharynx (CLOP) patients, and among them, there were 225, 140, 125 and 115 CRF patients, respectively. CRF was associated with a higher burden of illness among Leuk and MM, and higher mortality among PCa. For the PCa patients, both the test and the training data had best areas under the ROC curve [AUC = 0.91 (test) vs. 0.90 (train)] for both lasso and ridge ML. For the CLOP, this was 0.86 and 0.79 for ridge; 0.87 and 0.84 for lasso; 0.82 for both test and train for RF and for the Leuk cohort, 0.81 (test) and 0.76 (train) for both ridge and lasso. This study provided an effective platform to assess potential risks and outcomes of CRF in patients hospitalized for the management of solid and non-solid tumors. Our study showed ML methods performed well in predicting the CRF among solid and liquid tumors.

Validation of the Korean Version of the Cancer Fatigue Scale in Patients with Cancer.

Cancer-related fatigue is a highly prevalent and distressing symptom that negatively affects the quality of life of patients in all stages of cancer, including survivors. The Cancer Fatigue Scale (CFS) is a 15-item multidimensional instrument with the potential to enhance comprehension of fatigue. This study aimed to translate the original English version of the CFS into Korean and establish the validity and reliability of the translated version. A cross-sectional descriptive design was used to translate and validate the CFS in Korean. Factor analyses were performed to understand and establish construct and convergent validity with the Brief Fatigue Inventory (BFI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACT-F), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). The CFS demonstrated good internal consistency (Cronbach's alpha coefficient for all 15 items = 0.806); the Kaiser-Meyer-Olkin Measure of Sampling Adequacy was found to be 0.897, and Bartlett's test of sphericity was significant (p < 0.001). Moderate correlations were found between BFI, FACT-F, and EROTC QLQ-C30, indicating moderate validity. However, there were differences in factorial validity between the original scale and the Korean version, demonstrating a need for further testing in a homogenous population of cancer patients. The findings of this validation and reliability study showed that the Korean version of the CFS is a concise, reliable, feasible, and practical tool for evaluating the multidimensional aspects of cancer-related fatigue in patients with cancer.

Governor vessel moxibustion for cancer-related fatigue in colorectal patients: a randomized trial.

This study aimed to investigate the efficacy and mechanism of action of Governor Vessel Moxibustion (GVM) in the treatment of Cancer-Related Fatigue (CRF) in patients who have completed treatment for colorectal cancer. We randomly assigned 80 CRF patients in a 1:1 ratio to either the experimental group or the control group. During the three-week treatment period, both groups of patients received usual care for CRF provided by professional nurses. The experimental group received additional GVM treatment (three times a week, nine times total). The primary outcome was the mean change in total fatigue score from baseline to the end of treatment, assessed using the Chinese version of the Piper Fatigue Scale. At baseline, the total fatigue scores were 6.20 ± 0.12 in the experimental group and 6.16 ± 0.14 in the control group. At the end of treatment, the total fatigue scores decreased by 2.03 points (32.7% decrease from baseline) in the experimental group and by 0.99 points (15.6% decrease from baseline) in the control group. The absolute reduction in total fatigue scores in the experimental group was 1.04 points higher than in the control group (95% CI, 0.93 to 1.15; P<0.001), corresponding to a relative difference of 17.1% (95% CI, 15.2% to 18.9%; P<0.001). At the end of treatment, the experimental group showed greater reductions in interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels compared to the control group. No serious adverse events related to GVM treatment were observed. GVM appears to be safe and effective for alleviating CRF in patients who have completed colorectal cancer treatment, which may be related to the modulation of IL-6 and TNF-α levels. Chinese Clinical Trials Registry: ChiCTR2300069208.

Effect of exercise therapy on cancer-related fatigue in patients with breast cancer: A systematic review and network meta-analysis.

This study aimed to explore the efficacy of different exercise therapies in reducing fatigue in patients with breast cancer. PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CBM, CNKI, VIP, and Wanfang databases were searched from their inception to March 2022. The authors independently screened all randomized controlled trials (RCTs) of exercise therapy in patients with breast cancer. A network meta-analysis was performed using Stata 16.0 software. Seventy-eight studies were analyzed, with 167 comparisons and 6235 patients. The network results showed that stretching (SMD = -0.74, CI: -1.43, -0.06), yoga (SMD = -0.49, CI: -0.75, -0.22), combined exercise (SMD = -0.47, CI: -0.70, -0.24), aerobic exercise (SMD = -0.46, CI: -0.66, -0.26), and resistance exercise (SMD = -0.42, CI: -0.77, -0.08) significantly reduced fatigue. Pairwise comparisons confirmed that yoga, combined exercise, aerobic exercise, and resistance exercise were positively associated with fatigue relief. However, no significant association was identified between reduced fatigue and traditional Chinese exercises or stretching. The most effective exercise therapy to relieve cancer-related fatigue in patients with breast cancer was yoga, followed by combined aerobic and resistance exercises. It is expected that more RCTs will be conducted to further explore the efficacy and mechanisms of exercise.

Association of serum level of vitamin D on gastric and colorectal cancer-related fatigue in patients

Association of serum level of vitamin D on gastric and colorectal cancer-related fatigue in patients

Effect of a family-involvement combined aerobic and resistance exercise protocol on cancer-related fatigue in patients with breast cancer during postoperative chemotherapy: study protocol for a quasi-randomised controlled trial

IntroductionCancer-related fatigue (CRF) is one of the most common and debilitating side effects experienced by patients with breast cancer (BC) during postoperative chemotherapy. Family-involvement combined aerobic and resistance exercise has...

Analysis of the Occurrence of Predicative Factors of Chronic Fatigue in Female Patients with Cancer of the Reproductive Organs with Respect to Stage of Treatment

The aim of this study was to search for mechanisms contributing to cancer-related fatigue in patients with gynecologic cancer. The study involved 51 women with advanced endometrial cancer and ovarian cancer undergoing chemotherapy. Data were gathered at four points in time. After giving consent, each of the women had their blood drawn several times (before surgery and the first, third, and sixth cycle of chemotherapy) to determine serum levels of pro- and anti-inflammatory cytokines. Empirical data were collected using the MFSI-SF and an original questionnaire. Cancer-related fatigue (CRF) was present at every stage of treatment, but the highest mean scores were noted before cytoreductive surgery (8.745 ± 4.599), and before the sixth cycle of chemotherapy (9.667 ± 4.493). Statistically significant relationships were found between IL-1α, IL-1β, IL-2, Il-6, and IL-10 and fatigue at different stages of treatment. Older age and an above-normal BMI were the major prerequisite factors for the occurrence of fatigue in female oncological patients. The analysis of changes in cytokine levels and the severity of fatigue may be used to improve our understanding of cancer-related fatigue, and to take action to alleviate the obtrusive symptoms experienced by female patients with cancer of the reproductive organs.

Reallocating sedentary time to physical activity: effects on fatigue and quality of life in patients with breast cancer in the Phys-Can project

PurposeWe aimed to investigate the effects of reallocating sedentary time to an equal amount of light (LPA) or moderate-to-vigorous intensity physical activity (MVPA) on cancer-related fatigue and health-related quality of life (HRQoL) in patients with breast cancer. We also aimed to determine the daily amount of sedentary time needed to be reallocated to LPA or MVPA to produce minimal clinically important changes in these outcomes.MethodsPooled baseline data from three studies were used, including women with breast cancer who participated in the Phys-Can project. Fatigue was assessed with the Multidimensional Fatigue Inventory questionnaire (MFI; five dimensions, 4–20 scale) and HRQoL with the European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30; 0–100 scale). Sedentary time and physical activity were measured with accelerometry. Isotemporal substitution modelling was used for the analyses.ResultsOverall, 436 participants (mean age 56 years, fatigue 11 [MFI], HRQoL 66 [EORTC QLQ-C30], LPA 254 min/day, MVPA 71 min/day) were included. Fatigue significantly decreased in two MFI dimensions when reallocating 30 min/day of sedentary time to LPA: reduced motivation and reduced activity (β = − 0.21). Fatigue significantly decreased in three MFI dimensions when reallocating 30 min/day of sedentary time to MVPA: general fatigue (β = − 0.34), physical fatigue (β = − 0.47) and reduced activity (β = − 0.48). To produce minimal clinically important changes in fatigue (− 2 points on MFI), the amount of sedentary time needed to be reallocated to LPA was ≈290 min/day and to MVPA was ≥ 125 min/day. No significant effects were observed on HRQoL when reallocating sedentary time to LPA or MVPA.ConclusionsOur results suggest that reallocating sedentary time to LPA or MVPA has beneficial effects on cancer-related fatigue in patients with breast cancer, with MVPA having the greatest impact. In relatively healthy and physically active breast cancer populations, a large amount of time reallocation is needed to produce clinically important changes. Future studies are warranted to evaluate such effects in broader cancer populations.Trial registration: NCT02473003 (10/10/2014) and NCT04586517 (14/10/2020).