MedWire News: A significantly larger proportion of prostate cancer patients treated with definitive radiotherapy (RT) report chronic fatigue 1 year after treatment than their radical prostatectomy (RP)-treated counterparts, report researchers.
The team adds that factors including high levels of neuroticism, post-treatment comorbidity, pain, and urinary and intestinal dysfunction all increased the risk for chronic fatigue after RT.
“Further studies of chronic fatigue in prostate cancer survivors should take into consideration the survivors pretreatment medical and psychosocial situation,” suggest A Kyrdalen and colleagues from Oslo University Hospital in Norway in the journal Prostate Cancer and Prostatic Diseases.
The study aimed to assess the prevalence of chronic fatigue, at 1 year or more after RP or RT treatment in hormone-naïve patients, and determine any associations with medical and psychosocial variables.
In all, 337 RP patients and 184 RT patients were included in the study, and observed for a median of 23 months. Chronic fatigue was defined as clinically significant fatigue (tiredness, weakness, or a lack of energy) lasting more than 6 months.
The study is the first concerning post-treatment chronic fatigue in prostate cancer patients that excludes those treated with neoadjuvant androgen-deprivation therapy (ADT), which is itself highly associated with fatigue.
All patients completed The Fatigue Questionnaire (to evaluate physical and mental fatigue), the Brief Sexual Function Inventory, an abbreviated version of the Eysenck Personality Questionnaire (to assess neuroticism), and the International Prostate Symptom Score (to assess urinary and intestinal dysfunction). Characteristics such as age at diagnosis, pre-treatment comorbidity, and disease risk were also included in the analysis.
The researchers report that 17.9% of all patients experienced chronic fatigue at the time they completed the survey, significantly more of whom were treated with RT than RP, at 26.1% compared with 13.4%.
The difference in chronic fatigue prevalence between RP- and RT-treated patients was most prominent in survivors with the longest follow-up duration (up to 32 months), at 36% after RT versus 10% after RP.
After multivariate analysis, the researchers observed that RT patients were 2.29 times more likely to report chronic fatigue than RP patients, and that the presence of pain and neuroticism increased the risk for chronic fatigue by 3.29- and 5.01-fold, respectively, among all patients.
“Our observations… [show] that fatigue is a problem after local treatment even in patients without ADT,” conclude Kyrdalen and colleagues.
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