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Annals of Oncology 13:589-598, 2002
© 2002 European Society for Medical Oncology


Original Paper

Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study

P. Servaes1,+, S. Verhagen2 and G. Bleijenberg1

Netherlands Fatigue Research Group, Departments of 1Medical Psychology and 2Medical Oncology, University Medical Centre Nijmegen, The Netherlands

Received 15 June 2001; revised 12 September 2001; accepted 25 September 2001.

Background

Quality of life after cancer treatment becomes more important as the number of long-term survivors increases. This study aimed to investigate complaints of fatigue after treatment for breast cancer.

Patients and methods

The study patients were 150 women who had finished curative treatment for breast cancer by a mean of 29 months before commencement of this study. Measurements included computerised questionnaires and a daily Self-Observation List.

Results

Thirty-eight per cent of the sample were severely fatigued, compared with 11% in a matched sample of women without a history of cancer. No association was found between fatigue and former treatment. The ‘severely fatigued disease-free breast cancer patient’ scored more ‘problematic’ on psychological well-being, functional impairment, sleep disturbance, physical activity, social support, neuropsychological and social functioning compared with the ‘non-severely fatigued disease-free breast cancer patient’. Furthermore, the severely fatigued patients had a lower sense of control with respect to their fatigue complaints and stronger breast cancer- and psychologically-related attributions with regard to the causes of fatigue compared with the non-severely fatigued patients. Regression analyses indicated that sleep disturbance, physical activity and causal attributions contributed significantly to the subjective experience of fatigue.

Conclusions

Severe fatigue is a problem for almost 40% of the sample of breast cancer survivors. Severe fatigue is related to physical, psychological, social, cognitive and behavioural factors.

Key words: breast cancer, fatigue, multidimensional measurement, post-treatment


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