Cary Presant, MD, Oncology, Hematology/Oncology, 06:15PM Sep 9, 2013
Fatigue is the most common problem about which cancer patients complain. Therefore, it is important for us to consider anything that can alert us to which patients might be at greater risk of development of fatigue, and take time to discuss fatigue with them.
An interesting article by J. Bower and co-authors (J. Clinical Oncology 2013; 31:1656) discussed possible genetic correlations with fatigue. In over 170 early stage breast cancer patients, blood genotyping showed that polymorphisms in three genes related to cytokine expression were associated with fatigue (ILB-511C > T, IL6-174G > C and TNF-308G > A.) The patients who had a higher number of genes associated with increased production of cytokines developed greater degrees of fatigue (P=0.002). These genes were also associated with higher likelihood depression and more frequent occurrence of memory problems.
This information is of considerable interest. Hypothetically, it suggests that taking steps to reduce inflammation in patients who are having inflammatory disease or pain that can be treated with anti-inflammatory agents might be associated with better control of fatigue. It suggests ways in which anti-inflammatory interventions may be studied in future trials.
Although it is speculative, making certain that prompt treatment of fatigue includes advising primary care physicians to continue taking care of inflammatory diseases which may also be present might help with control of this challenging symptom.