Background: 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.
Author Affiliations: College of Nursing and Health Innovation (Dr Raudonis) and Office of Information Technology, University of Texas at Arlington (Dr Rowe); Baylor Scott and White Health, Dallas, Texas (Ms Kelley); and Texas Health Harris Methodist Hospital, Fort Worth (Ms Ellis).
Presented in part as a poster at the 11th National Conference on Cancer Nursing Research, Los Angeles, California, February 10 to 12, 2011, and at the 25th Annual Conference of the Southern Nursing Research Society, Jacksonville, Florida, February 16 to 19, 2011.
Presented as a podium presentation at the 26th Annual Conference of the Southern Nursing Research Society, New Orleans, Louisiana, February 22 to 25, 2012.
The study was funded by a small grant from the Texas Health Research and Education Institute.
The authors have no conflicts of interest to disclose.
Correspondence: Ingrid H. Kelley, BSN, RN, 902 Belemeade St. Arlington, TX 76014, Attn: B. Raudonis, PhD (ingii@sbcglobal.net).
Accepted for publication April 21, 2016.
