In a nutshell
This study determined the impact of cancer-related fatigue on Hodgkin-Lymphoma patients and survivors. The authors concluded that fatigue particularly affected social integration.
Some background
Hodgkin-Lymphoma (HL) patients and survivors can experience persistent cancer-related fatigue. Reports of fatigue occur 2.5 to 3 times more often in HL survivors than in the general population. Cancer-related fatigue can affect health-related quality of life (HRQOL). HRQOL can predict cancer survival. The consequences of long-term, persistent severe fatigue (sFA) are unknown.
Methods & findings
This study investigated the impact of persistent sFA among HL patients and survivors. It examined the HRQOL of 4,529 newly-diagnosed patients from three separate trials. In these trials, patients received risk-adapted treatment. They received a varied number of courses of either ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) chemotherapy. This was followed by radiotherapy (varied doses). 1,375 patients received standard treatment. This was two ABVD courses plus radiation. Patients rated their sFA before therapy (their baseline sFA), and at nine-year follow-up. Progression-free survival (PFS) and overall survival (OS) were measured. PFS was survival from the start of the study to disease progression, relapse, or death (any cause). OS was survival from the start of the study until death from any cause.
37% of patients reported having sFA at baseline. Follow-up sFA ranged from 20% to 24%. Baseline sFA had no overall effect on survival rates. Standard-treatment patients (above), however, had lower five-year survival rates if they reported baseline sFA.
At five years, 84% of non-fatigued survivors were working or in education. This was compared to 57% of fatigued survivors. Fatigued survivors reported more financial difficulties. Fatigued survivors also had a higher average number of yearly visits to both primary care physicians (7.4) and specialists (6.3). This was compared to an average of 4.0 primary care visits and 4.3 specialist visits among the non-fatigued.
The bottom line
The authors concluded that cancer-related fatigue may affect survival rates among patients and social integration among survivors.
The fine print
The information on employment and medical visits was not externally validated. This could therefore be biased.
What’s next?
Discuss fatigue and ways to manage it with your doctor.
Published By :
Journal of clinical oncology
Date :
Dec 20, 2016
Tags: Current disease status-First occurrence of the lymphoma, Current treatment status-Did not start treatment yet, Library Item, Research, Treatment, Treatment(s) already received-None, Treatment(s) already received-Radiation, Treatment(s) now being considered-Chemotherapy, Treatment(s) now being considered-Radiation
