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Cancer-related fatigue in breast cancer survivors: more evidence for a physiological substrate

Date

09 Oct 2016

Session

Poster display

Presenters

Javier Ramos

Citation

Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390

Authors

J. Ramos1, B. Cantos1, C. Maximiano1, H. Cebolla2, C. Fiuza-Luces3, L. Gutierrez1, P. Osorio4, J. Cerrato4, J.L. Sanchez4, B. Nuñez1, A. Garate4, I. Pagola5, L.B. Alejo4, A. Lucia3, A. Ruiz-Casado1

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Puerta de Hierro, 28222 - Madrid/ES
  • 2 Estructura Social, Universidad Nacional Eduación a Distancia, Madrid/ES
  • 3 Biomedicine, Universidad Europea de Madrid, Madrid/ES
  • 4 Master Af Y Salud, Universidad Europea de Madrid, Madrid/ES
  • 5 Motricidad, Universidad Europea de Madrid, Madrid/ES
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Resources

Abstract 2181

Background

Cancer-related fatigue (CRF) is a complex multi-dimensional construct related to reduced physical function and health-related quality of life. This symptom is under-reported by patients and and undertreated by clinicians. Recent reviews have concluded that exercise reduces cancer-related fatigue. The NCCN recommends that all cancer patients should be screened for fatigue regularly. As management of CRF is currently suboptimal, a change of approach is required.

Methods

Breast cancer survivors who had finished their treatments in the last 6 months, did not have any evidence of disease and were able to manage the accelerometer were offered to participate in a cross sectional study. CRF was evaluated through PERFORM, a questionnaire developed and validated in Spanish speakers. Weekly moderate-vigorous physical activity (WMVA) was objectively evaluated with accelerometers. Physical condition was evaluated through the one mile-walk test, hand-held dynamometer and sit to stand test.

Results

96 women with a history of breast cancer were recruited between March -2014 and April-2016. Age 52 (29-78), BMI 26 (18-41), waist 86 cm (65-116). 72% had received anthracyclines, 17% Herceptin, 70% radiotherapy. Basal heart rate 74 bpm (56-102); Final heart rate (after walking one mile) 107 bpm (68-159); Estimated VO2max 27,7 ml/kg/min (7,7-47); Strength right upper extremity was 26 Kg (10-40). Sit to stand test 7,4 (4,1-18,4) s. WMVPA was 231 min (69,5-424,5). Median PERFORM score was 46 (12-60). There were not any significant correlations for previous treatments, physical condition, anthropometry or physical activity with fatigue score. Heart rate (both basal and final) were significantly associated to fatigue (p 

Conclusions

Despite of meeting international recommendations for physical activity, this sample exhibited a poor cardiorespiratory fitness and cardiometabolic profile. Basal and post exercise heart rate were the only predictors of fatigue in our series. Neither previous treatments nor physical condition or adiposity signs had a definitive relationship with fatigue. Other authors have suggested that fatigue is associated with a maladaptive autonomic profile. Further research studying heart rate variability is warranted.

Clinical trial identification

Legal entity responsible for the study

Hospital Universitario Puerta de Hierro-Majadahonda

Funding

Hospital Universitario Puerta de Hierro-Majadahonda

Disclosure

All authors have declared no conflicts of interest.

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