Severity, Implications, And Understanding Of Cancer Related Fatigue In Cancer Survivors Of South Asian Ethnicity.

JOURNAL OF CLINICAL ONCOLOGY(2019)

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Abstract
e23177 Background: Cancer Related Fatigue (CRF) is a common debilitating symptom among cancer survivors that interferes with their Quality of Life (QOL). We evaluated incidence, severity, perception and implications of CRF on QOL among cancer survivors of South Asian ethnicity. Methods: Between July & December 2018, cancer survivors who visited cancer follow up clinic were asked to participate in this study by filling CRF questionnaire which focused on evaluating an individual’s assessment of severity, perception of causes and implications of CRF on their QOL as well as the measures taken to overcome CRF. Results: 160 cancer survivors, median age 52 years, 125 female & 34 male with most common diagnosis of breast cancer(60%) participated in the study. All survivors had received ≥2 treatment modalities. Overall, 133(84%) underwent surgery, 144(91%) received chemotherapy, 103(65%) received radiation therapy, 60(38%) received hormonal therapy & 34(21%) received targeted therapy. 36(23%) experienced weight loss and 26(16%) required blood transfusion. 148(93%) survivors reported CRF of any grade. 82(52%) reported moderate intensity CRF(affecting work but not activities of daily living) while 33(21%) reported severe intensity CRF (affecting activities of daily living). CRF was perceived as generalized weakness by 137(86.2%), emotional labiality by 42(26%), diminished concentration/attention span by 36(23%) and decreased motivation/interest in usual activities by 29(18%) survivors. CRF was attributed to treatment of cancer by 137(86%), psychological and social factors by 50(31%), cancer itself by 34(21%) and environmental /genetic factors by 16(10%) survivors. CRF adversely affected various aspects of QOL including activities of daily living in 79(50%), mood in 74(47%), professional work in 46(29%) and interpersonal relationships in 36(23%) survivors. To overcome CRF, 70(44%) survivors increased physical activity, 61(38%) resorted to mind-body interventions, 29 (18%) took pharmacological intervention and 25 (16%) resorted to psychosocial interventions. CRF resolved within 3 months after completion of therapy in 29(18%), 3-6 months in 23(15%), 6-12 months in 23(15%) and > 12 months in 1 survivor. CRF persisted in 78(49%) survivors. Conclusions: Incidence & severity of CRF is high in cancer survivors of South Asian ethnicity. Persistence of CRF beyond treatment completion significantly affects QOL and remains a poorly understood & incompletely addressed health issue among cancer survivors. More research is warranted in this field.
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Key words
cancer survivors,fatigue,south asian ethnicity
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