Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment

Background: To understand the pathogenesis of fatigue in cancer, we conducted a cross-sectional study using Brief Fatigue Inventory (BFI) and Functional Assessment of Cancer Therapy-Fatigue (FACT-F) instruments to measure fatigue and assessed laboratory studies. Patients and methods: 174 patients with cancer, who had undergone treatment within the last six months, answered the questionnaires and the Brief Version Zung Self-Rating Depression Scale (BZSDS). Blood samples were drawn for hemoglobin, albumin, thyroid stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEAS) and tumor necrosis factor-alpha (TNF-alpha). Testosterone levels were checked in male patients. Results: Clinically significant fatigue with BFI >= 4 was present in 52.0% of patients. Measurement of laboratory parameters revealed the following: DHEAS levels < 80 mcg/dl in males and < 36mcg/dl in females=54.1%; BZSDS scores >= 27=20.1%; testosterone levels < 200ng/dl=26.4% of male patients. Significant correlations were noted between BFI and FACT-F, albumin levels, hemoglobin levels and BZSDS scores. In addition, for male patients BFI correlated with DHEAS and testosterone levels. In multiple linear regression, hemoglobin, BZSDS scores and current opioid use were associated with response BFI. For male patients, DHEAS < 80mcg/dl, increased BZSDS and testosterone < 200ng/dl were associated with increased BFI. Conclusion: Fatigue is common in this population and BFI correlates with more extensive measurements. Abnormalities such as decreased testosterone and DHEAS may lead to interventions that can be therapeutically exploited.