Skip to main content

Advertisement

SpringerLink
Log in

The association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

The causes of cancer-related fatigue, which can influence patients’ activities, are multidimensional; however, little is known about the cognitive dimension. We examined the association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients after primary treatment.

Methods

This descriptive, cross-sectional study recruited 20–64-year-old breast cancer patients in an outpatient setting. The patients (N = 93; mean age = 53 years) were divided into low (L-CogF) and high-cognitive fatigue (H-CogF) groups according to their scores on the cognitive fatigue subscale of the Cancer Fatigue Scale. We compared the groups on their sociodemographic and medical characteristics and scores on the Functional Assessment of Cancer Therapy-Breast (FACT-B) [a measure of quality of life (QOL)], Simplified Menopausal Index (SMI), and Self-Rating Questionnaire for Depression (SRQ-D).

Results

The L-CogF (n = 55) and H-CogF (n = 38) patients did not differ in age, years since diagnosis, marital status, educational background, or treatment history. Total and subscale FACT-B scores, except for physical well-being, were significantly lower in H-CogF participants than in L-CogF participants. SMI and SRQ-D scores were significantly higher in H-CogF participants. Employed H-CogF participants were concerned about keeping their jobs (p < 0.05).

Conclusions

Breast cancer patients with high-cognitive fatigue suffer from severe menopause and depressive symptoms, and deteriorating QOL. Cognitive fatigue should be considered when interpreting patients’ cognitive complaints.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Matsuda A, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H, The Japan Cancer Surveillance Research Group. Cancer incidence and incidence rates in Japan in 2007: a study of 21 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) Project. Jpn J Clin Oncol. 2013;43:328–36.

    Article  PubMed  Google Scholar 

  2. Matsuda T, Ajiki W, Marugame T, Ioka A, Tsukuma H, Sobue T, Research Group of Population-Based Cancer Registries of Japan. Population-based survival of cancer patients diagnosed between 1993 and 1999 in Japan: a chronological and international comparative study. Jpn J Clin Oncol. 2011;41:40–51.

    Article  PubMed  Google Scholar 

  3. Janz NK, Mujahid M, Chung LK, Lantz PM, Hawley ST, Morrow M, et al. Symptom experience and quality of life of women following breast cancer treatment. J Womens Health. 2007;16(9):1348–61.

    Article  Google Scholar 

  4. Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12(Suppl 1):4–10.

    Article  PubMed  Google Scholar 

  5. Bower JE, Ganz PA, Desmond KA, Bernaards C, Rowland JH, Meyerowitz BE, et al. Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer. 2006;106(4):751–8.

    Article  PubMed  Google Scholar 

  6. Berger AM, Pickar Abernethy A, Atkinson A, Barsevick AM, Breitbart WS, Cella D, et al. Cancer-related fatigue version I. 2012. NCCN clinical practice guidelines in oncology; 2012. FT-1.

  7. Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol. 2000;18(4):743–53.

    CAS  PubMed  Google Scholar 

  8. Brown LF, Kroenke K. Cancer-related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics. 2009;50(5):440–7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Glaus A, Boehme Ch, Thürlimann B, Ruhstaller T, Hsu Schmitz SF, Morant R, et al. Fatigue and menopausal symptoms in women with breast cancer undergoing hormonal cancer treatment. Ann Oncol. 2006;17(5):801–6.

    Article  CAS  PubMed  Google Scholar 

  10. Glaus A, Crow R, Hammond S. A qualitative study to explore the concept of fatigue/tiredness in cancer patients and in healthy individuals. Support Care Cancer. 1996;4(2):82–96.

    Article  CAS  PubMed  Google Scholar 

  11. Okuyama T, Akechi T, Kugaya A, Okamura H, Shima Y, Maruguchi M, et al. Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage. 2000;19(1):5–14.

    Article  CAS  PubMed  Google Scholar 

  12. Seruga B, Zhang H, Bernstein LJ, Tannock IF. Cytokines and their relationship to the symptoms and outcome of cancer. Nat Rev Cancer. 2008;8(11):887–99.

    Article  CAS  PubMed  Google Scholar 

  13. Ferguson RJ, McDonald BC, Saykin AJ, Ahles TA. Brain structure and function differences in monozygotic twins: possible effects of breast cancer chemotherapy. J Clin Oncol. 2007;25(25):3866–70.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M. Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med. 2010;52(2):219–27.

    Article  PubMed  Google Scholar 

  15. Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77(2):109–30.

    Article  PubMed  Google Scholar 

  16. Okuyama T, Tanaka K, Akechi T, Kugaya A, Okamura H, Nishiwaki Y, et al. Fatigue in ambulatory patients with advanced lung cancer: prevalence, correlated factors, and screening. J Pain Symptom Manage. 2001;22(1):554–64.

    Article  CAS  PubMed  Google Scholar 

  17. Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, et al. Reliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument. J Clin Oncol. 1997;15(3):974–86.

    CAS  PubMed  Google Scholar 

  18. Koyama T, Aso T. Konenkifujin ni okeru kanporyoho–Kanryakuka sita konenki shisu niyoru hyoka. Sanhujinka Kanpokenkyu no Ayumi (Recent progress of kampo medicine in obstetrics and gynecology) (in Japanese). 1992;9:30–4.

  19. Abe T, Tsutsui S, Namba T, Nishida K, Nozawa A, Kato G, et al. Studies on the self-rating questionnaire for the screening test of masked depression (SRQ-D). J Jpn Psychosom Soc. 1972;12(4):243–7 (in Japanese with English abstract).

    Google Scholar 

  20. Rockliff BW. A brief self-rating questionnaire for depression (SRQ-D). Psychosomatics. 1969;10(4):236–43.

    Article  CAS  PubMed  Google Scholar 

  21. Sugawara Y, Akechi T, Okuyama T, Matsuoka Y, Nakano T, Inagaki M, et al. Occurrence of fatigue and associated factors in disease-free breast cancer patients without depression. Support Care Cancer. 2005;13(8):628–36.

    Article  PubMed  Google Scholar 

  22. Penttinen HM, Saarto T, Kellokumpu-Lehtinen P, Blomqvist C, Huovinen R, Kautiainen H, et al. Quality of life and physical performance and activity of breast cancer patients after adjuvant treatments. Psychooncology. 2011;20(11):1211–20.

    Article  CAS  PubMed  Google Scholar 

  23. Schultz PN, Klein MJ, Beck ML, Stava C, Sellin RV. Breast cancer: relationship between menopausal symptoms, physiologic health effects of cancer treatment and physical constraints on quality of life in long-term survivors. J Clin Nurs. 2005;14(2):204–11.

    Article  PubMed  Google Scholar 

  24. Kamezaki A, Saito H. Study on the sexuality of menopausal women and related factors. Kawasaki J Med Welfare. 2006;11(2):77–83.

    Google Scholar 

  25. Mar Fan HG, Houédé-Tchen N, Chemerynsky I, Yi QL, Xu W, Harvey B, et al. Menopausal symptoms in women undergoing chemotherapy-induced and natural menopause: a prospective controlled study. Ann Oncol. 2010;21(5):983–7.

    Article  CAS  PubMed  Google Scholar 

  26. Goodwin PJ, Ennis M, Pritchard KI, Trudeau M, Hood N. Risk of menopause during the first year after breast cancer diagnosis. J Clin Oncol. 1999;17(8):2365–70.

    CAS  PubMed  Google Scholar 

  27. Takamatsu K, Kasuga M, Makita K, Nozawa S. Evaluation of depressive conditions among Japanese patients at a menopause clinic. J Obstet Gynaecol Res. 2004;30(1):42–7.

    Article  PubMed  Google Scholar 

  28. Jenkins V, Shilling V, Deutsch G, Bloomfield D, Morris R, Allan S, et al. A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer. 2006;94:828–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C. Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev. 2012;38:926–34.

    Article  PubMed  Google Scholar 

  30. Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiat Res. 1975;12:189–98.

    Article  CAS  PubMed  Google Scholar 

  31. Ganz PA, Kwan L, Castellon SA, Oppenheim A, Bower JE, Silverman DH, et al. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance. J Natl Cancer Inst. 2013;105:791–801.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Berent-Spillson A, Persad CC, Love T, Sowers M, Randolph JF, Zubieta JK, et al. Hormonal environment affects cognition independent of age during the menopause transition. J Clin Endocrinol Metab. 2012;97(9):E1686–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Ahles TA, Root JC, Ryan EL. Cancer- and cancer treatment-associated cognitive change: an update on the state of the science. J Clin Oncol. 2012;30(30):3675–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Janz NK, Mujahid M, Chung LK, Lantz PM, Hawley ST, Morrow M, et al. Symptom experience and quality of life of women following breast cancer treatment. J Womens Health (Larchmt). 2007;16(9):1348–61.

    Article  Google Scholar 

  35. Maytal G, Peteet J. The meaning of work. In: Feuerstein M, editor. Work and cancer survivors. New York: Springer; 2008. p. 105–19.

    Google Scholar 

  36. Bouknight RR, Bradley CJ, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol. 2006;24(3):345–53.

    Article  PubMed  Google Scholar 

  37. Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van der Lelie J, de Reijke TM, et al. Cancer, fatigue and the return of patients to work-a prospective cohort study. Eur J Cancer. 2003;39(11):1562–7.

    Article  CAS  PubMed  Google Scholar 

  38. Lindbohm ML, Kuosma E, Taskila T, Hietanen P, Carlsen K, Gudbergsson S, et al. Cancer as the cause of changes in work situation (a NOCWO study). Psychooncology. 2011;20(8):805–12.

    Article  PubMed  Google Scholar 

  39. Maunsell E, Brisson C, Dubois L, Lauzier S, Fraser A. Work problems after breast cancer: an exploratory qualitative study. Psychooncology. 1999;8(6):467–73.

    Article  CAS  PubMed  Google Scholar 

  40. Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer. 2013;119(Suppl 11):2151–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Special thanks to all breast cancer patients who participated in this study. We would also like to thank Dr. Toyone Kikumori, Dr. Nobuyuki Tsunoda, Dr. Shigenori Sato, Dr. Hironori Hayashi, Dr. Hiroki Uchida, Dr. Sumiyo Noda, and Dr. Ai Idota, who were willing to support the recruitment of patients in their practices.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daikominami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan

    Kiyoko Miura & Shoko Ando

  2. Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan

    Tsuneo Imai

Authors
  1. Kiyoko Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shoko Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tsuneo Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kiyoko Miura.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miura, K., Ando, S. & Imai, T. The association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients. Breast Cancer 23, 407–414 (2016). https://doi.org/10.1007/s12282-014-0578-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-014-0578-3

Keywords

Search

Navigation