Laurent Zelek, CHU Avicenne, BOBIGNY - Tao … · AMGEN “regards croisés” study • 77% of...
Transcript of Laurent Zelek, CHU Avicenne, BOBIGNY - Tao … · AMGEN “regards croisés” study • 77% of...
AMGEN “regards croisés” study
• 77% of patients reported fatigue as most common symptom– 67% patients reported that fatigue had a major impact on their
QoL
• 93% of physicians and 100% of nurses felt it was important to treat fatigue
• 85% of patients felt treatment of fatigue was important
Patients’ Perception of Fatigue by Cancer Type
Mitry E et al. Oncologie 2010;12:709–717
10 point scale of fatigue: 1 (not intense at all) – 10 (very intense); this is the total of patients who answered from 6–10 on the scale
Fatigue is Attributable to Several Causes
Patients (n=300)
Physicians (n=250)
Nurses (n=109)
Chemotherapy treatment (%) 78 84a 82
Cancer (%) 68 77b 65
Secondary effects of chemotherapy (%) 31 46a 55a
Anaemia (%) 27 79a 79a
ND (%) 6 1 0aSignificant difference based on the 95% confidence interval for the patient groupbSignificant difference based on the 95% confidence interval for the group of physiciansND: Data not provided. The question posed to the patients was: ‘what, according to you, is the cause of your fatigue?’ The data posed to health professionals was: ‘what, according to you, is the cause of the fatigue experienced by your patients (who have non-myeloid malignancy, are receiving chemotherapy, and have an Hb <11 g/dL)?’
Mitry E et al. Oncologie 2010;12:709–717
Adverse Effects of Chemotherapy that Most Impact Daily Life
All patients (n=300)
Tumour type Age group
Breast cancer (n=70)
Lung cancer (n=73)
Colorectal cancer(n=72)
Haematological malignancyb
(n=82)
<70 years of age
(n=230)
≥70 years of age (n=70)
Fatigue (%) 67 63 71 63 72 68 63
Skin/ aesthetic effectsa (%)
39 69 25* 24* 38 44 21*
Nausea/ vomiting (%)
34 26 36 39 34 36 27
Anaemia (%) 18 9* 16 13 32* 17 21
Pain (%) 17 9* 25 14 20 18 14
Patients were questioned on 30 possible adverse effects, five categories of which are presented above (totals are more than 100% – more than one response possible)aPatients with alopecia, loss of fingernails, aesthetic effects, skin toxicity and/ or long-term cutaneous signsbNon-myeloid haematological malignancy*Significant difference vs. total population of patients
Mitry E et al. Oncologie 2010;12:709–717
Fatigue: Risk factors and mechanisms
• Cytokines (TNFa and IL6)• Genetic polymorphisms• BMI • Pretreatment fatigue
• Fatigue, depression and cognitive disorders are linked
Physical activity and fatigue: what do weknow?
• Physical activity is decereased in pts with fatigue• Deconditionning ? • After therapy low PA is correlated to fatigue• Is AP lowering BMI ?
• Coping
Association between physical activity and markers o f quality of life (measured by SF-36) in patients with cancer.
Fong D Y T et al. BMJ 2012;344:bmj.e70
©2012 by British Medical Journal Publishing Group
Association between physical activity and fatigue a nd depression in patients with cancer .
Fong D Y T et al. BMJ 2012;344:bmj.e70
©2012 by British Medical Journal Publishing Group