Cancer-related fatigue and disturbed rest–activity rhythm in recurrence-free breast cancer patients—Results of a prospective study of CAM users

• Published in: European journal of integrative medicine Vol. 1; pp. 13 - 14
• Main Authors: Zerm, R., Kröz, M., Brauer, D., von Laue, H.B., Kuhnert, N., Bockelbrink, A., Reif, M., Schad, F., Willich, S.N., Feder, G., Girke, M.
• Format: Journal Article
• Language: English
• Published: Elsevier GmbH 01.11.2008
• ISSN: 1876-3820; 1876-3839
• DOI: 10.1016/j.eujim.2008.08.022

Cancer-related fatigue (CRF) has a considerable long-term impact on quality of life of women with breast cancer: 5–10 years after adjuvant chemotherapy, 34% of breast cancer survivors without recurrence still suffer from CRF. Up until now there have been no prospective studies examining CRF and the rest–activity rhythm (RA) in this group of patients. The objective of our study was to determine CRF and RA in long-term survivors who used complementary therapies. In total, 56 breast cancer survivors and 56 age-matched, healthy women were followed up a mean 6.6 years after first initial assessment. At baseline and at follow-up, we administered scales measuring autonomic regulation (aR), with a sub-scale characterising the rest–activity rhythm (RA.aR), the Cancer Fatigue Scale with three sub-scales (physical, affective and cognitive fatigue), the Hospital Anxiety and Depression scale and the Karnofsky Index (KPI). For the analysis we used Fisher's exact Test and Spearman's rank correlation. Average age of participants: breast cancer survivors 62.7 years, healthy women 58.2 years. The breast cancer survivors had an average of 10.6 years from diagnosis and a KPI of 97.3%. Despite the high KPI and the fact that 60.4% of patients had improved in their global well-being compared to 6.6 years before and after adjuvant therapy, 19.6% state a relevant cancer fatigue syndrome. Breast cancer survivors show increased cognitive fatigue, anxiety and depression, decreased aR and RA.aR compared to controls (all p<0.05). Global and cognitive fatigue was correlated with r=0.41–0.50 with the aR and RA.aR (all p<0.05). Cognitive cancer fatigue among BCa CAM users is still increased 10.6 years after the first diagnosis and is accompanied by a disturbed autonomic and rest–activity regulation. Unrestful sleep and disturbed daily functioning are long-term sequelae of breast cancer in survivors free of recurrence.