A Pilot Study of Proinflammatory Cytokines and Fatigue in Women With Breast Cancer During Chemotherapy
Fatigue remains a prevalent, persistent, and debilitating side effect of chemotherapy for stage I and II breast cancer patients. Severity of fatigue varies among patients. Evidence suggests that proinflammatory cytokines contribute to the development of fatigue.Objective:
The aim of this study is to investigate predictors of fatigue and cytokine levels in women undergoing chemotherapy for stage I or II breast cancer.Methods:
Piper Fatigue Scales and blood samples for interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were collected at baseline and days 7, 14, and 21 for each chemotherapy cycle. Descriptive statistics, general linear mixed models, and graphic analysis were used to analyze the data.Results:
The predominantly white convenience sample was composed of 11 women with stage I or II breast cancer who were 37 to 72 years old (mean, 52 years). Predictors of fatigue were type of chemotherapy drugs, time, and IL-6 levels. A predictor of IL-6 and TNF-α levels was whether chemotherapy was administered at the visit. Type of chemotherapy significantly predicted TNF-α levels. Fatigue patterns were characterized by chaotic pattern of peaks and troughs unique to each woman.Conclusions:
Women with stage I and II breast cancer experienced variability in the severity of fatigue and levels of IL-6 and TNF-α throughout their treatment trajectories. The presence and role of genetic variants related to cancer-related fatigue may explain the individual variation and warrant further research.Implications for Practice:
These findings highlight the importance of symptom assessments including fatigue at each clinic visit and individualized interventions throughout the cancer trajectory.