Skip to main content

Advertisement

Log in

Fatigue in adolescent and adult survivors of non-CNS childhood cancer: a report from project REACH

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Studies of fatigue in childhood cancer survivors (CCS) are inconclusive, with some reporting increased fatigue prevalence in this population while others do not. Given the potentially significant consequences of unmanaged fatigue, we sought to estimate the prevalence of fatigue and to identify factors associated with fatigue in a population of non-CNS CCS ranging from adolescence to middle adulthood using a single fatigue measurement tool.

Methods

Two hundred sixty-eight CCS ages 12–49 years followed in a survivorship clinic at a single cancer center completed validated self-report measures of fatigue, depression, and quality of life. Demographic and current health data were collected by study questionnaire and chart review

Results

Based on age-adjusted population norms, the prevalence of fatigue was 13.8 %, which is not significantly different compared to results in healthy populations. Fatigue was independently associated with having ≥3 chronic health conditions (OR 4.27, 95 % CI 1.52–11.99). Fatigued participants reported lower overall quality of life scores (OR 0.86, 95 % CI 0.82–0.89) and were more likely to be depressed compared to non-fatigued patients (20.4 vs. 1.4 %, respectively, p < 0.0001). There were 41(78.8 %) survivors with fatigue in our population who did not report significant depression.

Conclusions

CCS did not demonstrate increased fatigue compared to age-matched normative data. Fatigued survivors were more likely to have multiple chronic conditions, depression, and decreased quality of life. Longitudinal study will promote better understanding of the relationship between fatigue and specific chronic conditions, thereby facilitating early identification of those individuals most at risk.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mariotto AB, Rowland JH, Yabroff KR, Scoppa S, Hachey M, Ries L, Feuer EJ (2009) Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomark Prev 18:1033–1040

    Article  Google Scholar 

  2. Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivvastave DK, Robison LL (2013) Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA 309:2371–2381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Armstrong GT, Kawashima T, Leisenring W, Stratton K, Stovall M, Hudson MM, Sklar CA, Robison LL, Oeffinger KC (2014) Aging and risk of severe, disabling, life-threatening, and fatal events in the childhood cancer survivor study. J Clin Oncol 32:1218–1227

    Article  PubMed  PubMed Central  Google Scholar 

  4. Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, Itri LM, Johnson DH, Scherr SL, Portenoy RK (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. Semin Hematol 34:4–12

    CAS  PubMed  Google Scholar 

  5. Andrykowski MA, Curran SL, Lightner R (1998) Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med 21:1–18

    Article  CAS  PubMed  Google Scholar 

  6. Loge JH, Abrahamsen AF, Ekeberg Ø, Kaasa S (1999) Hodgkin’s disease survivors more fatigued than the general population. J Clin Oncol 17:253–261

    CAS  PubMed  Google Scholar 

  7. Calaminus G, Dörffel W, Baust K, Teske C, Riepenhausen M, Brämswig J, Flechtner H-H, Singer S, Hinz A, Schellong G (2014) Quality of life in long-term survivors following treatment for Hodgkin’s disease during childhood and adolescence in the German multicentre studies between 1978 and 2002. Support Care Cancer 22:1519–1529

    Article  PubMed  Google Scholar 

  8. Jóhannsdóttir IMR, Hjermstad MJ, Moum T, Wesenberg F, Hjorth L, Schroder H, Mort S, Jonmundsson G, Loge JH (2012) Increased prevalence of chronic fatigue among survivors of childhood cancers : a population-based study. Pediatr Blood Cancer 58:415–420

    Article  PubMed  Google Scholar 

  9. Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK, Robison LL, Mertens AC (2008) Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS). Sleep 31:271–281

    PubMed  PubMed Central  Google Scholar 

  10. Langeveld NE, Grootenhuis M a, Voûte P a, de Haan RJ, van den Bos C (2003) No excess fatigue in young adult survivors of childhood cancer. Eur J Cancer 39:204–214.

  11. Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L (2005) Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:5501–5510

    Article  PubMed  Google Scholar 

  12. Arnett JJ (2000) Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol 55:469–480

    Article  CAS  PubMed  Google Scholar 

  13. Bober SL, Zhou ES, Chen B, Manley PE, Kenney LB, Recklitis CJ (2013) Sexual function in childhood cancer survivors: a report from project REACH. J Sex Med 10:2084–2093

    Article  PubMed  Google Scholar 

  14. Varni JW, Ph D, Burwinkle TM, Katz ER, Meeske K, Dickinson P, Pedsql T (2002) The PedsQL ™ in pediatric cancer reliability and validity of the pediatric quality of life inventory ™ generic Core. Cancer 94:2090–2106

    Article  PubMed  Google Scholar 

  15. Varni JW, Limbers CA (2008) The PedsQL multidimensional fatigue scale in young adults: feasibility, reliability and validity in a university student population. Qual Life Res 17:105–114

    Article  PubMed  Google Scholar 

  16. Robert RS, Paxton RJ, Palla SL, Yang G, Askins M, Joy SE, Ater JL (2012) Feasibility, reliability, and validity of the pediatric quality of life inventory generic Core Scales, cancer module, and multidimensional fatigue scale in long-term adult survivors of pediatric cancer. Pediatr Blood Cancer 59:703–707

    Article  PubMed  PubMed Central  Google Scholar 

  17. Derogatis L (2000) BSI 18: brief symptom inventory 18. National Computer Systems, Inc., Minneapolis

    Google Scholar 

  18. Zabora J, Brintzenhofseszoc K, Jacobsen P, Curbow B, Piantadosi S, Hooker C, Owens A, Derogatis L (2001) A new psychosocial screening instrument for use with cancer patients. Psychosomatics 42:241–246

    Article  CAS  PubMed  Google Scholar 

  19. Recklitis CJ, Parsons SK, Shih M-C, Mertens A, Robison LL, Zeltzer L (2006) Factor structure of the brief symptom inventory-18 in adult survivors of childhood cancer: results from the childhood cancer survivor study. Psychol Assess 18:22–32

    Article  PubMed  Google Scholar 

  20. Beck JS, Beck AT, Jolly JB, Steer RA (2005) Manual for Beck youth inventories, second edi. Harcourt Assessment, Oxford

    Google Scholar 

  21. Kenney LB, Nancarrow CM, Najita J, Vrooman LM, Rothwell M, Recklitis C, Li FP, Diller L (2010) Health status of the oldest adult survivors of cancer during childhood. Cancer 116:497–505

    Article  PubMed  Google Scholar 

  22. Gordijn MS, van Litsenburg RR, Gemke RJ, Huisman J, Bierings MB, Hoogerbrugge PM, Kaspers GJL (2013) Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 60:479–485

    Article  PubMed  Google Scholar 

  23. Langeveld NE, Stam H, Grootenhuis M, Last BF (2002) Quality of life in young adult survivors of childhood cancer. Support Care Cancer 10:579–600

    Article  CAS  PubMed  Google Scholar 

  24. Armstrong GT, Pan Z, Ness KK, Srivastava D, Robison LL (2010) Temporal trends in cause-specific late mortality among 5-year survivors of childhood cancer. J Clin Oncol 28:1224–1231

    Article  PubMed  PubMed Central  Google Scholar 

  25. Krischer JP, Epstein S, Cuthbertson DD, Goorin AM, Epstein ML, Lipshultz SE (1997) Clinical cardiotoxicity following anthracycline treatment for childhood cancer: the pediatric oncology group experience. J Clin Oncol 15:1544–1552

    CAS  PubMed  Google Scholar 

  26. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kaden-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582

    Article  CAS  PubMed  Google Scholar 

  27. Visser MR, Smets EM (1998) Fatigue, depression and quality of life in cancer patients: how are they related? Support Care Cancer 6:101–108

    Article  CAS  PubMed  Google Scholar 

  28. Kanellopoulos A, Hamre HM, Dahl AA, Ruud E, Fossa SD (2013) Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma. Pediatr Blood Cancer 60(5):849–855

  29. Clanton NR, Klosky JL, Li C, Jain N, Srivastava DK, Mulrooney D, Zeltzer L, Stovall M, Robison LL, Krull KR (2011) Fatigue, vitality, sleep, and neurocognitive functioning in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Cancer 117:2559–2568

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Natasha N. Frederick.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Frederick, N.N., Kenney, L., Vrooman, L. et al. Fatigue in adolescent and adult survivors of non-CNS childhood cancer: a report from project REACH. Support Care Cancer 24, 3951–3959 (2016). https://doi.org/10.1007/s00520-016-3230-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3230-2

Keywords

Navigation