title: Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment.
abstract: BACKGROUND
  To understand the pathogenesis of fatigue in cancer, we conducted a cross-sectional study using Brief Fatigue Inventory (BFI) and Functional Assessment of Cancer Therapy-Fatigue (FACT-F) instruments to measure fatigue and assessed laboratory studies.
  
  
  METHODS
  174 patients with cancer, who had undergone treatment within the last six months, answered the questionnaires and the Brief Version Zung Self-Rating Depression Scale (BZSDS). Blood samples were drawn for hemoglobin, albumin, thyroid stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEAS) and tumor necrosis factor-alpha (TNF- alpha). Testosterone levels were checked in male patients.
  
  
  RESULTS
  Clinically significant fatigue with BFI > or =4 was present in 52.0% of patients. Measurement of laboratory parameters revealed the following: DHEAS levels <80 mcg/dl in males and <36 mcg/dl in females=54.1%; BZSDS scores > or =27=20.1%; testosterone levels <200 ng/dl=26.4% of male patients. Significant correlations were noted between BFI and FACT-F, albumin levels, hemoglobin levels and BZSDS scores. In addition, for male patients BFI correlated with DHEAS and testosterone levels. In multiple linear regression, hemoglobin, BZSDS scores and current opioid use were associated with response BFI. For male patients, DHEAS <80 mcg/dl, increased BZSDS and testosterone <200 ng/dl were associated with increased BFI.
  
  
  CONCLUSIONS
  Fatigue is common in this population and BFI correlates with more extensive measurements. Abnormalities such as decreased testosterone and DHEAS may lead to interventions that can be therapeutically exploited.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: A
authors.initials: A
authors.lastname: Shafqat
authors.forename: L H
authors.initials: LH
authors.lastname: Einhorn
authors.forename: N
authors.initials: N
authors.lastname: Hanna
authors.forename: G W
authors.initials: GW
authors.lastname: Sledge
authors.forename: A
authors.initials: A
authors.lastname: Hanna
authors.forename: B E
authors.initials: BE
authors.lastname: Juliar
authors.forename: P
authors.initials: P
authors.lastname: Monahan
authors.forename: S
authors.initials: S
authors.lastname: Bhatia
mesh_terms: D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005221:Fatigue / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000628:therapy; D012709:Serum Albumin / Q000032:analysis; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin; D014409:Tumor Necrosis Factor-alpha; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D013972:Thyrotropin