Predictors of Fatigue After Treatment for Prostate Cancer
Published in: Urology, v. 65, no. 1, Jan. 2005, p. 101-108
Posted on RAND.org on January 01, 2005
OBJECTIVES: To investigate whether post-treatment fatigue among men treated for prostate cancer varies by treatment, demographics, or pretreatment general and disease-specific health-related quality of life. The authors also sought to describe the baseline characteristics of men who were fatigued at follow-up to allow for interventions in those at greatest risk. METHODS: The authors conducted a secondary analysis on data gathered from men with prostate cancer at biopsy and after treatment by examining factors that predicted for post-treatment fatigue. RESULTS: Univariate and multivariate analysis results demonstrated that post-treatment fatigue was associated with baseline fatigue, role limitations due to emotional problems, treatment type, and treatment location. RESULTS: Univariate analysis showed that those who were fatigued at follow-up were more likely to have been treated at a public facility (P = 0.0017), be nonwhite (Latino, African American, or Asian Pacific-Islander; P = 0.0362), be married (P = 0.0413), be not employed at least part-time (P = 0.0327), to have one or more comorbidities (P = 0.0005), and to have scored lower in all domains of the RAND 36-Item Health Survey and UCLA Prostate Cancer Index at baseline (all P =0.05) than those not fatigued at follow-up. Those who declined from baseline energy levels were more likely to have had lower baseline energy scores (P <0.0001), to have been treated in a public facility (P = 0.0578), and to have had a baseline prostate-specific antigen level of 10 ng/mL or greater (P = 0.059) than those who remained at their baseline energy level. Lower baseline role-emotional scores were associated with both fatigue at follow-up and a decline from baseline at follow-up. CONCLUSIONS: Men with lower pretreatment quality-of-life measures may be at increased risk of fatigue after prostate cancer treatment.