Chronic Fatigue Highly Prevalent in Long-Term Cervical Cancer Survivors

Almost one quarter of long-term cervical cancer survivors reported experiencing chronic fatigue, according to a study conducted in Norway. Fatigue varied somewhat based on the treatment women underwent for their cancer.

“Chronic fatigue is a common and distressing symptom in several groups of cancer survivors,” wrote study authors led by Cecilie E. Kiserud, MD, PhD, of Oslo University Hospital in Norway. “However, chronic fatigue has not been extensively studied in survivors of cervical cancer.” Studies that have been done in this setting have been small.

For this new study, investigators sent a questionnaire to 822 survivors of cervical cancer who were treated between 2000 and 2007 in one part of Norway. All patients were cancer-free and aged 75 years or under by the end of 2013; of the full cohort, 461 completed the questionnaire (56%), and a total of 382 were included in the analysis. The results of the study were published online ahead of print in Gynecologic Oncology.

The overall prevalence of chronic fatigue in these women was 23%, which the authors reported is greater than that seen in the overall Norwegian population of Norwegian women aged 50 to 59 years (10.5%; P < .001).

Rates of chronic fatigue varied by treatment modality. Patients who were treated with neoadjuvant chemotherapy plus major surgery had a rate of 45.5% (10 of 22 patients), which was significantly higher than those treated with minimal invasive surgery (19%; P = .002) and those treated only with major surgery (18.8%; P = .011). Those treated with chemoradiation had a rate of 28.2%, and those treated with major surgery along with chemoradiation had a fatigue rate of 29.6%; these rates were not statistically significantly different from other chronic fatigue rates.

Compared with the survivors who reported no chronic fatigue, those with chronic fatigue were more likely to have had neurotoxic side effects of treatment (P = .001), more likely to have cardiovascular disease (P = .014), poor self-rated health (P < .001), engaged in less physical activity (P = .023), and were more likely to be obese (P = .001). On multivariate analysis, only increased depression (odds ratio [OR], 1.27; 95% CI, 1.16–1.38; P < .001) and poorer global quality of life (OR, 0.97; 95% CI, 0.95–0.99; P = .003) were significantly associated with chronic fatigue in these survivors.

“Close to one in four long-term survivors of cervical cancer report chronic fatigue at a median of 11 years after diagnosis,” the authors wrote, noting that the association between fatigue and certain variables may highlight a path toward intervention for this complication. “Identification and treatment of such factors could reduce the high prevalence of chronic fatigue in long-term survivors of cervical cancer.”