EVALUATING THE BURDEN OF FATIGUE ON HEALTH AND WELL-BEING IN GYNAECOLOGICAL CANCER SURVIVORS: A CROSS-SECTIONAL PUBLIC HEALTH ANALYSIS
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Keywords
anxiety, depression, fatigue, gynaecological cancers, quality of life.
Abstract
In Pakistan, as cancer treatment options continue to evolve, more people are surviving the disease. However, many survivors face long-term challenges, including persistent side effects that can last for years after treatment. Cancer-related fatigue is one of the most common side effect reported by survivors, regardless of the type or stage of cancer they had. This ongoing exhaustion can significantly impact their daily lives and overall well-being.
Objective: This study investigated cancer-related fatigue in gynaecological cancer survivors, focusing on its prevalence and relationship to distress, quality of life, demographics and treatment factors.
Methodology: The cross sectional study was conducted in Abbasi Shaheed hospital, Karachi from July 2023 to June 2024, using a detail short form (SF-36) questionnaire. The study involved 120 women treated for gynaecological cancers, who completed questionnaires assessing fatigue, psychological distress, health-related quality of life and demographics. Additionally, their medical records were reviewed to gather information on disease and treatment characteristics.
Results: The study revealed that cancer-related fatigue affected 53% of women treated for gynecological cancers, with cervical cancer patients experiencing it most frequently followed by ovarian cancer patients. Younger women were more likely to report fatigue than older women. However, when age was taken into account, the type of cancer had minimal impact on fatigue risk. Women with fatigue reported higher levels of anxiety and depression and their quality of life was also affected, as shown by lower scores in various SF-36 domains.
Conclusion: The study highlighted the need for routine screening, patient education and effective symptom management for fatigue. This should be a standard part of treatment and follow-up care, addressing both the physical and psychological aspects of fatigue to provide comprehensive support.
References
2. Rosenbloom SK & Cella D (2019) Age-associated differences in fatigue among patients with cancer. Journal of Pain and Symptom Management 40, 217–223.
3. Arriba LN, Fader AN, Frasure HE & von Gruenigen VE (2020) A review of issues surrounding quality of life among women with ovarian cancer. Gynecologic Oncology 119, 390–396.
4. Ballinger RS & Fallowfield LJ (2019) Quality of life and patient-reported outcomes in life in gynecological cancer survivors. Current Opinion in Obstetrics and Gynecology 22, 30–35.
5. Jacobsen PB, Donovan KA, Vadaparampil ST & Small BJ (2017) Systematic review and meta-analysis of psycho- logical and activity-based interventions
6. Greimel ER, Winter R, Kapp KS & Haas J (2019) Quality of life and sexual func- tioning after cervical cancer treatment: a long-term follow-up study. Psycho- Oncology 18, 476–482.
7. Holzner B, Kemmler G, Meraner V, Mai- slinger A, Kopp M, Bodner T, Nguyen- Van-Tam D, Zeimet AG, Fleischhacker WW & Sperner-Unterweger B (2023) Fatigue in ovarian carcinoma patients. Cancer 97, 1564–1572.
8. Cella M & Chalder T (2020) Measuring fatigue in clinical and community set- tings. Journal of Psychosomatic Research ł9, 17–22.
9. Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P & Morrow GR (2019) Cancer-related fatigue: the scale of the problem. The Oncologist 12(Suppl. 1), 4–10.
10. Bjelland I, Dahl AA, Haug TT & Neckel- mann D (2022) The validity of the Hospital Anxiety and Depression Scale: an updated literature52, 69–77.
11. Harrington CB, Hansen JA, Moskowitz M & Todd BL (2020) It’s not over when it’s over: long-term symptoms in can- cer survivors – a systematic review. International Journal of Psychiatry in Medicine 40, 163–181.
12. Geue K, Sender A, Schmidt R, Richter D, Hinz A, Schulte T, Br€ahler E & Sto€bel-Richter Y (2024) Gender-spe- cific quality of life after cancer in young adulthood: a comparison with the general population. Quality of Life Research 23, 1377–1386.
13. Gershenson DM & Bodurka DC (2019) Quality of life and sexual func- tioning in cervical cancer survivors. Journal of Clinical Oncology 23, 7428–7436.
14. Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D & Wallace EP (2023) Development of a fatigue scale. Journal of Psychoso- matic Research 37, 147–153.
15. Brown LF & Kroenke K (2019) Cancer- related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics 50, 440–447.
16. Cella D, Lai J-S, Chang C-H, Peterman A & Slavin M (2022) Fatigue in cancer patients compared with fatigue in the general United States population. Cancer 94, 528–538.
17. Ahlberg K, Ekman T, Gaston-Johansson F & Mock V (2023) Assessment and management of cancer-related fatigue in adults. The Lancet 3ł2, 640–650.
18. & Stanton AL (2022) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. Journal of the National Cancer Insti- tute 104, 386–405.
19. Carlsson M, Strang P & Bjurstro€m C (2020) Treatment modality affects long-term quality of life in gynaeco- logical cancer. Anticancer Research 20, 563–568.
20. Ahlberg K, Ekman T & Gaston-Johansson F (2021) Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer. Oncology Nursing Forum 32, 633–640.
21. Bjelic-Radisic V, Jensen PT, Vlasic KK, Waldenstrom A-C, Singer S, Chie W, Nordin A & Greimel E (2021) Quality of life characteristics inpatients with cervical cancer. European Journal of Cancer 48, 3009–3018.
22. Carlsson M, Strang P & Bjurstro€m C (2020) Treatment modality affects long-term quality of life in gynaeco- logical cancer. Anticancer Research 20, 563–568.
23. Bifulco G, De Rosa N, Tornesello ML, Piccoli R, Bertrando A, Lavitola G, Morra I, Sardo A, Buonagur FM & Nappi C (2022) Quality of life, life- style behavior and employment experi- ence: a comparison between young and midlife survivors of gynecology early stage cancers. Gynecologic Oncology 124, 444–451.
24. Arndt V, Merx H, Stu€rmer T, Stegmaier C,Ziegler H & Brenner H (2024) Age- specific detriments to quality of life among breast cancer patients one year after diagnosis. European Journal of Cancer 40, 673–680.
25. Beesley V, Eakin E, Steginga S, Aitken J, Dunn J & Battistutta D (2018) Unmet needs of gynaecological cancer survi- vors: implications for developing community support services. Psycho- Oncology 17, 392–400.
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Sodee Kirshan
Senior Registrar, Department of Gynae & Obs, Sindh Institute of Child and Maternal Health, Karachi, Pakistan
Shazia Gul
Assistant District Health Officer, District Health Office Kamber - Shahdadkot, Pakistan
Samina
Professor, Department of Gynaecology & Obstetrics, Jinnah Medical College, Peshawar KPK, Pakistan
Perah Khadim
Research Officer, Indus Hospital and Health Network, Karachi, Pakistan
Yousra Batool
Postgraduate Trainee, Zia Uddin Medical College, Karachi, Pakistan
Nusrat Lakho
Associate Professor, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Sahiba Hakro
Postgraduate Trainee, Zia Uddin Medical College, Karachi, Pakistan
Jaweria Soomro
Female Medical Officer, Experimental Dispensary Junjhar Colony, PPHI Sindh, Pakistan
Sania Tufail
Postgraduate Trainee, Zia Uddin Medical College, Karachi, Pakistan