COGNITIVE BEHAVIORAL ASPECTS OF CANCER RELATED FATIGUE

Summary

Principal 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

  1. ncbi Use of a case definition approach to identify cancer-related fatigue in women undergoing adjuvant therapy for breast cancer
    Michael A Andrykowski
    Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536 0086, USA
    J Clin Oncol 23:6613-22. 2005
  2. ncbi Relationship of body image to breast and skin self-examination intentions and behaviors
    Sari R Chait
    University of South Florida, Tampa, Florida, USA
    Body Image 6:60-3. 2009
  3. ncbi Magnitude and correlates of response shift in fatigue ratings in women undergoing adjuvant therapy for breast cancer
    Michael 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
  4. ncbi Identifying clinically meaningful fatigue with the Fatigue Symptom Inventory
    Kristine 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
  5. ncbi Exploring the differential experience of breast cancer treatment-related symptoms: a cluster analytic approach
    Clement 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
  6. ncbi Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue
    Paul 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
  7. ncbi Physical symptoms/side effects during breast cancer treatment predict posttreatment distress
    Heather 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
  8. ncbi Fatigue after treatment for early stage breast cancer: a controlled comparison
    Paul B Jacobsen
    Health Outcomes and Behavior Program, Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
    Cancer 110:1851-9. 2007
  9. ncbi Utility of a cognitive-behavioral model to predict fatigue following breast cancer treatment
    Kristine 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
  10. ncbi Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancer
    Michael 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

Detail Information

Publications13

  1. ncbi Use of a case definition approach to identify cancer-related fatigue in women undergoing adjuvant therapy for breast cancer
    Michael 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...
  2. ncbi Relationship of body image to breast and skin self-examination intentions and behaviors
    Sari 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...
  3. ncbi Magnitude and correlates of response shift in fatigue ratings in women undergoing adjuvant therapy for breast cancer
    Michael 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...
  4. ncbi Identifying clinically meaningful fatigue with the Fatigue Symptom Inventory
    Kristine 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...
  5. ncbi Exploring the differential experience of breast cancer treatment-related symptoms: a cluster analytic approach
    Clement 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
    ....
  6. ncbi Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue
    Paul 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...
  7. ncbi Physical symptoms/side effects during breast cancer treatment predict posttreatment distress
    Heather 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...
  8. ncbi Fatigue after treatment for early stage breast cancer: a controlled comparison
    Paul 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...
  9. ncbi Utility of a cognitive-behavioral model to predict fatigue following breast cancer treatment
    Kristine 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...
  10. ncbi Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancer
    Michael 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
    ....
  11. ncbi Cognitive functioning after adjuvant chemotherapy and/or radiotherapy for early-stage breast carcinoma
    Kristine 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...
  12. ncbi Relationship of problem-focused coping strategies to changes in quality of life following treatment for early stage breast cancer
    Sean 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...
  13. ncbi Cognitive functioning in breast cancer survivors: a controlled comparison
    Heather 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...