Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Fatigue in hormone-naïve prostate cancer patients treated with radical prostatectomy or definitive radiotherapy

Prostate Cancer and Prostatic Diseases volume 13, pages 144–150 (2010)Cite this article

Subjects

Abstract

Chronic fatigue (CF) is a distressing symptom that follows cancer treatment; however, it has rarely been studied in hormone-naïve prostate cancer survivors after radical prostatectomy (RP) or definitive radiotherapy (RAD). We investigated CF in prostate cancer survivors after RP or RAD as monotherapy and explored associations between CF and medical and psychosocial variables. A population-based, cross-sectional postal survey in 2006 included Norwegian hormone-naïve survivors with the diagnosis of prostate cancer in 2004 who were treated with RP (n=337) or RAD (n=184). The primary outcome variable was prevalence of CF (defined as fatigue lasting 6 months or longer). Twelve to 32 months after RP and RAD, 13.4 and 26.1% of the patients after, respectively, RP and RAD reported CF inversely associated with pretreatment age (P=0.003). In multivariate analysis, high neuroticism, post-treatment co-morbidity, pain, urinary and intestinal dysfunction, but not sexual dysfunction, were positively associated with reporting CF. Further studies of CF in prostate cancer survivors should take into consideration the survivors’ pretreatment medical and psychosocial situation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Lu-yao GL, Yao SL . Population-based study of long-term survival in patients with clinically localized prostate cancer. Lancet 1997; 349: 906–910.

    Article  CAS  Google Scholar 

  2. Klein EA, Kupelian PA . Localized prostate cancer: radiation or surgery? Urol Clin North Am 2003; 30: 315–330.

    Article  Google Scholar 

  3. Zeliadt SB, Ramsey SD, Penson DF, Hall IJ, Ekwueme DU, Stroud L et al. Why do men choose one treatment over another? A review of patient decision making for localized prostate cancer. Cancer 2006; 106: 1865–1874.

    Article  Google Scholar 

  4. Sommers BD, Beard CJ, D’Amico AV, Dahl D, Kaplan I, Richie JP et al. Decision analysis using individual patient preferences to determine optimal treatment for localized prostate cancer. Cancer 2007; 110: 2210–2217.

    Article  Google Scholar 

  5. Radbruch L, Strasser F, Elsner F, Gonçalves JF, Loge J, Kaasa S et al. Fatigue in palliative care patients—an EAPC approach. Palliat Med 2008; 22: 13–32.

    Article  Google Scholar 

  6. Loge JH, Ekeberg Ø, Kaasa S . Fatigue in the general Norwegian population: normative data and associations. J Psychosom Res 1998; 45: 53–65.

    Article  CAS  Google Scholar 

  7. Orre IJ, Fosså SD, Murison R, Bremnes R, Dahl O, Klepp O et al. Chronic cancer-related fatigue in long-term survivors of testicular cancer. J Psychosom Res 2008; 64: 363–371.

    Article  Google Scholar 

  8. Hjermstad MJ, Fosså SD, Oldervoll L, Holte H, Jacobsen AB, Loge JH . Fatigue in long-term Hodgkin's disease survivors: a follow-up study. J Clin Oncol 2005; 23: 6587–6595.

    Article  Google Scholar 

  9. Hervouet S, Savard J, Simard S, Ivers H, Laverdière J, Vigneault E et al. Psychological functioning associated with prostate cancer: cross-sectional comparison of patients treated with radiotherapy, brachytherapy, or surgery. J Pain Symptom Manage 2005; 30: 474–484.

    Article  Google Scholar 

  10. Lilleby W, Fossa S, Waehre H, Olsen DR . Long-term morbidity and quality of life in patients with localized prostate cancer undergoing definitive radiotherapy or radical prostaectomy. Int J Radiat Oncol Biol Phys 1998; 43: 735–743.

    Article  Google Scholar 

  11. Vordermark D, Schwab M, Flentje M, Sailer M, Kölbl O . Chronic fatigue after radiotherapy for carcinoma of the prostate: correlation with anorectal and genitourinary function. Radiother Oncol 2002; 62: 293–297.

    Article  Google Scholar 

  12. Monga U, Kerrigan AJ, Thornby J, Monga TN, Zimmermann KP . Longitudinal study of quality of life in patients with localized prostate cancer undergoing radiotherapy. J Rehabil Res Dev 2005; 42: 391–399.

    Article  Google Scholar 

  13. Maliski SL, Kwan L, Orecklin JR, Saigal CS, Litwin MS . Predictors of fatigue after treatment for prostate cancer. Urology 2005; 65: 101–108.

    Article  Google Scholar 

  14. Larsen IK, Småstuen M, Parkin DM, Bray F . Data Quality at the Cancer Registry of Norway. Cancer in Norway 2006—Cancer Incidence, Mortality, Survival and Prevalence in Norway. Cancer Registry of Norway: Oslo, 2007.

  15. Hernes E, Kyrdalen A, Kvåle R, Hem E, Klepp O, Axcrona K et al. Initial management of prostate cancer: first year experience with the Norwegian National Prostate Cancer Registry. BJU Int 2009; e-pub ahead of print 4 Sept 2009; doi: 10.1111/j.1464-410X.2009.08834.x.

  16. Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D et al. Development of a fatigue scale. J Psychosom Res 1993; 37: 147–153.

    Article  CAS  Google Scholar 

  17. Fukuda KK, Straus SSE, Hickie II, Sharpe MMC, Dobbins JJG, Komaroff AA . The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med 1994; 121: 953–959.

    Article  CAS  Google Scholar 

  18. D’Amico AV, Whittington R, Malkowicz SB, Weinstein M, Tomaszewski JE, Schultz D et al. Predicting prostate specific antigen outcome preoperatively in the prostate specific antigen era. J Urol 2001; 166: 2185–2188.

    Article  Google Scholar 

  19. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982; 5: 649–655.

    Article  CAS  Google Scholar 

  20. O’Leary MP, Fowler FJ, Lenderking WR, Barber B, Sagnier PP, Guess HA et al. A brief male sexual function inventory for urology. Urology 1995; 46: 697–706.

    Article  Google Scholar 

  21. Mykletun A, Dahl AA, O’Leary MP, Fossa SD . Assessment of male sexual function by the Brief Sexual Function Inventory. BJU Int 2006; 97: 316–323.

    Article  Google Scholar 

  22. Eysenck HJ, Eysenck SBG . Manual of the EPQ. Hodder and Stoughton: London, UK, 1975.

    Google Scholar 

  23. Tambs K, Sundet JM, Eaves L, Solaas MH, Berg K . Pedigree analysis of Eysenck Personality Questionnaire (EPQ) scores in monozygotic (MZ) twin families. Behav Genet 1991; 21: 369–382.

    Article  CAS  Google Scholar 

  24. Eysenck SBG, Tambs K . Cross-cultural comparison of personality: Norway and England. Scand J Psychol 1990; 31: 191–197.

    Article  Google Scholar 

  25. Tambs K, Sundet JM, Eaves L, Berg K . Relations between EPQ and Jenkins Activity Survey. Pers Individ Differ 1989; 10: 1229.

    Article  Google Scholar 

  26. Grov EK, Fosså SD, Bremnes RM, Dahl O, Klepp O, Wist E . et al. The personality trait of neuroticism is strongly associated with long term morbidity in testicular cancer survivors. Acta Oncol 2009; 48: 842–849.

    Article  Google Scholar 

  27. Cockett AT, Aso Y, Denis L . Recommendations of the International Consensus Committee concerning: 1. Prostate symptoms score and quality of life assessment. I: Cockett AT, Aso Y, Denis L, Murphy G, Khoury S, Abrams P et al, red. Proceedings, the 2nd International Consultation on Benign Prostatic Hyperplasia (BPH), Paris, June 27.–30. 1993, Jersey, Channel Islands. Scientific Communication Internationally 1994, 553–555.

  28. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39: 1423–1434.

    Article  Google Scholar 

  29. Stone P, Hardy J, Huddart R, A’Hern R, Richards M . Fatigue in patients with prostate cancer receiving hormone therapy. Eur J Cancer 2000; 36: 1134–1141.

    Article  CAS  Google Scholar 

  30. Herr HW, O’Sullivan M . Quality of life of asymptomatic men with nonmetastatic prostate cancer on androgen deprivation therapy. J Urol 2000; 163: 1743–1746.

    Article  CAS  Google Scholar 

  31. Waldmann A, Rohde V, Bremner K, Krahn M, Kuechler T, Katalinic A . Measuring prostate-specific quality of life in prostate cancer patients scheduled for radiotherapy or radical prostatectomy and reference men in Germany and Canada using the Patient Oriented Prostate Utility Scale-Psychometric (PORPUS-P). BMC Cancer 2009; 9: 295.

    Article  Google Scholar 

  32. Harvey S, Wessely S, Kuh D, Hotopf M . The relationship between fatigue and psychiatric disorders: evidence for the concept of neurasthenia. J Psychosom Res 2009; 66: 445–454.

    Article  Google Scholar 

  33. Kato K, Sullivan PF, Evengård B, Pedersen NL . Premorbid predictors of chronic fatigue. Arch Gen Psychiatry 2006; 63: 1267–1272.

    Article  Google Scholar 

  34. Van den Bergh RC, Essink-Bot ML, Roobol MJ, Wolters T, Schröder FH, Bangma CH et al. Anxiety and distress during active surveillance for early prostate cancer. Cancer 2009; 115: 3868–3878.

    Article  Google Scholar 

  35. Litwin MS, Lubeck DP, Spitalny GM, Henning JM, Carroll PR . Mental health in men treated for early stage prostate carcinoma. Cancer 2002; 95: 54–60.

    Article  Google Scholar 

  36. Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR . Mechanisms of cancer-related fatigue. Oncologist 2007; 12: 22–34.

    Article  CAS  Google Scholar 

  37. Denham JW, Hauer-Jensen M . The radiotherapeutic injury—a complex ‘wound’. Radiother Oncol 2002; 63: 129–145.

    Article  Google Scholar 

  38. Monga U, Jaweed M, Kerrigan AJ, Lawhon L, Johnson J, Vallbona C et al. Neuromuscular fatigue in prostate cancer patients undergoing radiation therapy. Arch Phys Med Rehabil 1997; 78: 961–966.

    Article  CAS  Google Scholar 

  39. Gillette EL, Mahler PA, Powers BE, Gillette SM, Vujaskovic Z . Late radiation injury to muscle and peripheral nerves. Int J Radiat Oncol Biol Phys 1995; 31: 1309–1318.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This project has been financed with the aid of EXTRA funds from the Norwegian Foundation for Health and Rehabilitation.

Author information

Authors and Affiliations

  1. Department of Clinical Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    A E Kyrdalen, A A Dahl, M Cvancarova & S D Fosså

  2. Faculty Division, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway

    A A Dahl & S D Fosså

  3. Cancer Registry of Norway, Oslo, Norway

    E Hernes & M Cvancarova

Authors
  1. A E Kyrdalen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A A Dahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E Hernes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Cvancarova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S D Fosså
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A E Kyrdalen.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kyrdalen, A., Dahl, A., Hernes, E. et al. Fatigue in hormone-naïve prostate cancer patients treated with radical prostatectomy or definitive radiotherapy. Prostate Cancer Prostatic Dis 13, 144–150 (2010). https://doi.org/10.1038/pcan.2009.61

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/pcan.2009.61

Keywords

This article is cited by

Search

Advanced search

Quick links