Fatigue in Patients With Advanced Terminal Cancer Correlates With Inflammation, Poor Quality of Life and Sleep, and Anxiety/Depression

Am J Hosp Palliat Care. 2016 Dec;33(10):942-947. doi: 10.1177/1049909115603055. Epub 2015 Aug 30.

Abstract

Purpose: To assess which laboratory and clinical factors are associated with fatigue in patients with terminal cancer.

Methods: We evaluated 51 patients with advanced incurable solid tumors using the Chalder Fatigue Questionnaire (CFQ) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale for fatigue; the Pittsburgh Sleep Quality Index (PSQI-BR) for sleep quality; the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression; the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire, Version 3.0 (QLQ C-30); and Functional Assessment of Cancer Therapy (FACT) for quality of life. We also analyzed several inflammatory markers and the modified Glasgow prognostic score (mGPS).

Results: We observed severe fatigue in 19 (38%) patients (FACIT-F score >36). There was a significant correlation between fatigue as evaluated by the CFQ and quality of sleep and between the CFQ mental fatigue subscale scores and TNF-α level. When fatigue was evaluated using the FACIT-F scale, we observed a significant association between fatigue and anxiety/depression, quality of sleep, mGPS, and hemoglobin levels. Fatigue measured both with the CFQ and FACIT-F scale correlated with poor quality of life according to the EORTC QLQ C-30.

Conclusion: In patients with advanced cancer, fatigue is a common symptom associated with the presence of inflammation, poor quality of sleep, depression/anxiety, and poor quality of life.

Keywords: depression; fatigue; inflammation; neoplasm; palliative care; quality of life.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / etiology
  • Anxiety / psychology
  • Biomarkers
  • Depression / etiology
  • Depression / psychology
  • Fatigue / blood
  • Fatigue / etiology*
  • Fatigue / physiopathology*
  • Female
  • Health Status
  • Humans
  • Inflammation / blood
  • Inflammation / etiology*
  • Inflammation / metabolism*
  • Inflammation Mediators / metabolism
  • Male
  • Mental Health
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / complications*
  • Neoplasms / physiopathology*
  • Neoplasms / psychology
  • Prognosis
  • Quality of Life
  • Severity of Illness Index
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / psychology

Substances

  • Biomarkers
  • Inflammation Mediators