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| COGNITIVE BEHAVIORAL ASPECTS OF CANCER RELATED FATIGUESummaryPrincipal Investigator: Paul Jacobsen Affiliation: H. Lee Moffitt Cancer Center and Research Institute Country: USA Abstract: It is estimated that 178,700 American women will be diagnosed with breast cancer in 1998. A large proportion of these women will receive adjuvant chemotherapy, radiotherapy, and/or hormonal therapy based on evidence indicating that such treatment extends disease-free survival as well as overall survival. As more women receive adjuvant treatment, there is growing recognition of the potential for long-term side effects. Along these lines, it has been shown that administration of adjuvant chemotherapy can result in secondary leukemia, cardiotoxicity, and ovarian failure. Clinical observations and a limited number of research reports suggest that persistent fatigue may also be a long-term side effect of adjuvant chemotherapy. Although fatigue has been identified as one of the most frequent and distressing symptoms affecting breast cancer patients treated with adjuvant chemotherapy, relatively little is known about its characteristics, etiology, or treatment. We propose to address these issues by conducting the first controlled, longitudinal study of fatigue in breast cancer patients before, during, and after adjuvant chemotherapy and radiotherapy treatment. Women with early stage breast cancer scheduled to receive adjuvant treatment will be recruited and undergo a baseline assessment before the start of chemotherapy. Additional assessments will be performed during the course of chemotherapy and before and during a subsequent course of radiotherapy. Following completion of radiotherapy, patients will continue to be monitored for six months. An age-matched sample of women with no history of cancer will be recruited and monitored over a six-month period for comparison purposes. These data will be used: 1) to determine the severity, chronicity, and course of fatigue associated with adjuvant treatment of breast cancer; 2) to characterize the cognitive, affective, and behavioral manifestations of fatigue that persists following completion of adjuvant treatment; and 3) to test the utility of a cognitive-behavioral model designed to explain the perpetuation of fatigue following completion of adjuvant treatment. Preliminary analyses of study data are expected to provide empirical support for adaptation and pilot testing, during the final months of funding, of a cognitive-behavioral intervention originally developed for chronic fatigue syndrome for use with breast cancer patients experiencing persistent fatigue related to adjuvant treatment. Funding Period: 1999-09-01 - 2004-05-31 more information: NIH RePORT Top Publications
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Use of a case definition approach to identify cancer-related fatigue in women undergoing adjuvant therapy for breast cancerMichael A Andrykowski
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536 0086, USA
J Clin Oncol 23:6613-22. 2005..Use a proposed case-definition approach to identify the prevalence of cancer-related fatigue (CRF), demographic, clinical and psychosocial predictors of subsequent CRF, and psychosocial factors associated with concurrent CRF...
Relationship of body image to breast and skin self-examination intentions and behaviorsSari R Chait
University of South Florida, Tampa, Florida, USA
Body Image 6:60-3. 2009..Future research should further examine this relationship utilizing longitudinal designs and more diverse populations...- Magnitude and correlates of response shift in fatigue ratings in women undergoing adjuvant therapy for breast cancerMichael A Andrykowski
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky 40536 0086, USA
J Pain Symptom Manage 37:341-51. 2009..Most importantly, consideration of the observed response shift in fatigue ratings significantly altered the conclusions drawn regarding the magnitude and persistence of fatigue during and after adjuvant therapy for breast cancer... - Identifying clinically meaningful fatigue with the Fatigue Symptom InventoryKristine A Donovan
Health Outcomes and Behavior Program, Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
J Pain Symptom Manage 36:480-7. 2008..Findings suggest that the Fatigue Symptom Inventory can be used to discriminate effectively between individuals with and without clinically meaningful fatigue... - Exploring the differential experience of breast cancer treatment-related symptoms: a cluster analytic approachClement K Gwede
Department of Interdisciplinary Oncology, H Lee Moffitt Cancer Center and University of South Florida, 12902 Magnolia Drive, MRC CANCONT, Tampa, FL, 33612, USA
Support Care Cancer 16:925-33. 2008.... - Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatiguePaul B Jacobsen
Health Outcomes and Behavior Program, Moffitt Cancer Center and University of South Florida, 12902 Magnolia Drive, Tampa FL 33612, USA
Health Psychol 26:660-7. 2007..Fatigue is among the most common and distressing symptoms experienced by cancer patients... 
Physical symptoms/side effects during breast cancer treatment predict posttreatment distressHeather S Jim
Health Outcomes and Behavior Program, H Lee Moffitt Cancer Center, University of South Florida, Tampa, FL 33612, USA
Ann Behav Med 34:200-8. 2007..Studies suggest that the period following completion of treatment can be distressing for cancer patients. One potentially important predictor of distress is physical symptoms/side effects during treatment...- Fatigue after treatment for early stage breast cancer: a controlled comparisonPaul B Jacobsen
Health Outcomes and Behavior Program, Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
Cancer 110:1851-9. 2007..The present study sought to determine whether fatigue was greater in women who had completed treatment for early-stage breast cancer relative to a demographically matched comparison group of women with no cancer history... - Utility of a cognitive-behavioral model to predict fatigue following breast cancer treatmentKristine A Donovan
Health Outcomes and Behavior Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
Health Psychol 26:464-72. 2007..Findings suggest considerable heterogeneity in the experience of fatigue following treatment and support the utility of a cognitive-behavioral model in predicting the course of posttreatment fatigue... - Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancerMichael A Andrykowski
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536 0086, USA
Cancer Epidemiol Biomarkers Prev 16:430-8. 2007.... - Cognitive functioning after adjuvant chemotherapy and/or radiotherapy for early-stage breast carcinomaKristine A Donovan
Psychosocial and Palliative Care Program, Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
Cancer 104:2499-507. 2005..Future research should use prospective longitudinal research designs incorporating appropriate comparison groups to further explore this issue... - Relationship of problem-focused coping strategies to changes in quality of life following treatment for early stage breast cancerSean Ransom
Psychosocial Oncology and Palliative Care, H. Lee Moffitt Cancer Center, Tampa, Florida 33612, USA
J Pain Symptom Manage 30:243-53. 2005..Results suggest that focusing on symptoms is a maladaptive approach to illness, but that information seeking may yield benefits to physical recovery... - Cognitive functioning in breast cancer survivors: a controlled comparisonHeather S L Jim
Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center, Tampa, Florida, USA
Cancer 115:1776-83. 2009..The current study was performed to determine whether neuropsychologic functioning differs in breast cancer survivors 6 months after the completion of adjuvant treatment compared with women without cancer...