Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms, and quality of life

Abstract

Purpose/objectives: To identify differences in fatigue, other physical symptoms, and psychological symptoms and their relationship to quality of life (QOL) during chemotherapy and as long as one year after.

Design: Longitudinal, descriptive design embedded in a pilot intervention study.

Setting: Midwestern urban oncology clinics and patient homes.

Sample: 25 Caucasian women, aged 40-65 years (-X = 54.3), with stage I or II breast cancer receiving doxorubicin-based chemotherapy.

Methods: The Piper Fatigue Scale, Hospital Anxiety and Depression Scale, Symptom Experience Scale, and Medical Outcomes Study Short-Form General Health Survey were completed before and after each treatment; 30, 60, and 90 days after the last treatment; and one year after the first treatment.

Main research variables: Fatigue, physical and psychological symptoms, and QOL.

Findings: Fatigue levels were moderately intense during treatments and decreased significantly over time. Sleep disturbances and pain were the most frequent, intense, and distressing other physical symptoms. Anxiety was highest at baseline, and depression was highest during the fourth chemotherapy treatment. Fatigue was correlated with other physical and psychological symptoms at some times during treatments and consistently following treatments. Higher fatigue was associated with lower QOL in several domains.

Conclusions: Fatigue is associated with other physical and psychological symptoms that fluctuate during and after treatment. Higher fatigue compromises QOL.

Implications for nursing: Interventions targeting primary or cluster symptoms can reduce the impact of adjuvant chemotherapy on fatigue, other symptoms, and QOL.