Perception, magnitude and implications of cancer related fatigue in breast cancer survivors: Study from a developing country

Abstract

Background: Cancer Related Fatigue(CRF) is one of the most common, distressing & incompletely addressed symptom among breast cancer survivors. We have analyzed perceptions, magnitude & overall implications of CRF in breast cancer survivors. Methods: Breast cancer survivors who attended breast cancer follow-up clinic at our institute between Jan-March 2018 were asked to fill a questionnaire. This questionnaire focused on assessing an individual's perception, severity, potential causes, implications on quality of life and measures taken to deal with CRF. Results: 65 patients (median age 52 years) completed the CRF questionnaire. Of these 54(83%) had undergone surgery, 59(91%) chemotherapy, 43(66%) radiation therapy and 36(55%) hormonal/targeted therapy. 62(95%) patients experienced any grade CRF. 55(85%) patients experienced moderate to severe CRF affecting work (58%) and activities of daily living (27%). CRF was perceived as generalized weakness by 54(83%), diminished concentration/attention span by 24(37%), decreased motivation and interest in usual activities by 29(45%) and emotional labiality by 16(25%) patients. 56(86%) patients believed that fatigue was due to the effect of cancer treatment on the body, while only 8(12%) attributed it to underlying cancer. 21(32%) also attributed it to psycho-social factors and 5(8%) to genetic/environmental factors. CRF had negative impact on mood, daily activities, interpersonal relationships and professional work in 40(62%), 39(60%), 13(20%) and 10(15%) patients, respectively. Measures taken to overcome CRF were increased physical exercise, psychosocial interventions, mindbody interventions and pharmacological interventions in 32(49%), 8(12%), 28(43) and 17(26%) patients, respectively. 39(60%) patients reported persistence of CRF after completion of treatment while it took upto 6 months, 6-12 months and more than 12 months for resolution of CRF in 13, 10 and 3 patients, respectively. Conclusions: Development and persistence of moderate to severe intensity CRF impacts multiple aspects of Quality of Life of breast cancer survivors. Current interventions are not able to substantially mitigate this problem and further research in this field is warranted.