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


CONCLUSIONS
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.
Faculdade de Medicina do ABC, Santo André, Brazil.
Alex Rua
AR
Rodrigues
Faculdade de Medicina do ABC, Santo André, Brazil.
Damila Cristina
DC
Trufelli
Faculdade de Medicina do ABC, Santo André, Brazil.
Fernando
F
Fonseca
Faculdade de Medicina do ABC, Santo André, Brazil.
Larissa Carvalho
LC
de Paula
Faculdade de Medicina do ABC, Santo André, Brazil aurodelgiglio@gmail.com.
Auro Del
AD
Giglio
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D015415:Biomarkers; D003863:Depression / Q000209:etiology / Q000523:psychology; D005221:Fatigue / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006304:Health Status; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000378:metabolism*; D018836:Inflammation Mediators / Q000378:metabolism; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology
D015415:Biomarkers; D018836:Inflammation Mediators
depression; fatigue; inflammation; neoplasm; palliative care; quality of life