title: The trajectory of fatigue in adult patients with breast and ovarian cancer receiving chemotherapy.
abstract: OBJECTIVE
  To describe the trajectory of fatigue and determine the feasibility of exploring physiologic mechanisms of fatigue in adult patients receiving chemotherapy for breast and ovarian cancer.
  
  
  METHODS
  Descriptive, longitudinal, repeated measures.
  
  
  METHODS
  Outpatient ambulatory cancer centers within two large, academic, teaching hospitals with overnight hospital stays in general clinical research centers.
  
  
  METHODS
  Seventeen adult participants with either early-stage breast or ovarian cancer receiving chemotherapy for the first time.
  
  
  METHODS
  Demographic questionnaire; Piper Fatigue Scale (PFS); hemoglobin, bilirubin, melatonin, and weight change were measured at baseline, three months, and approximately six months. PFS also was collected at three additional two-week nadir, post-treatment, measurement points. Descriptive statistics and repeated analysis of variance measures were used to analyze data.
  
  
  METHODS
  Fatigue, hemoglobin, bilirubin, melatonin, and presence of other comorbid disease.
  
  
  RESULTS
  Subjective fatigue was experienced by the majority of patients receiving chemotherapy. It was irregular over time, intensified at three months, and continued after treatment ended. The physiologic trajectory of fatigue from baseline to three months indicated a significant change over time in hemoglobin in the breast cancer group (p = 0.02) and in nighttime melatonin levels for both breast and ovarian cancer groups (p = 0.03). Although not significant, daytime melatonin levels changed over time from baseline to six months.
  
  
  CONCLUSIONS
  Fatigue fluctuates during the course of chemotherapy treatment and does not cease after treatment ends. Preliminary findings suggest that fatigue mechanisms may have an undetermined physiologic basis.
  
  
  CONCLUSIONS
  Assessment of cancer treatment-related fatigue must be ongoing, even after treatment ends. Findings suggest an awareness of the importance of understanding fatigue mechanisms to enable future testing of research-based interventions.
authors.affiliation: College of Nursing, Wayne State University, Detroit, MI, USA. jkpayne@salud.unm.edu
authors.forename: Judith K
authors.initials: JK
authors.lastname: Payne
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy / Q000451:nursing*; D015400:Clinical Nursing Research; D005221:Fatigue / Q000139:chemically induced / Q000451:nursing*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009859:Oncology Nursing; D010045:Outpatients; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy / Q000451:nursing*; D012107:Research Design; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep; D011795:Surveys and Questionnaires