Thyroid function in the etiology of fatigue in breast cancer

Nagi B. Kumar, Angelina Fink, Silvina Levis, Ping Xu, Roy Tamura, Jeffrey Krischer

Research output: Contribution to journalReview article

Abstract

Background: Cancer related fatigue (CRF), reported in about 90% of breast cancer patients receiving chemotherapy, and has a profound impact on physical function, psychological distress and quality of life. Although several etiological factors such as anemia, depression, chronic inflammation, neurological pathology and alterations in metabolism have been proposed, the mechanisms of CRF are largely unknown. Methods: We conducted a pilot, prospective, case-control study to estimate the magnitude of change in thyroid function in breast cancer patients from baseline to 24 months, compared to cancer-free, age-matched controls. Secondary objectives were to correlate changes in thyroid function and obesity over time with fatigue symptoms scores in this patient population. Results: The proportion of women with breast cancer who developed subclinical or overt hypothyroidism (TSH > 4.0 mIU/L) from baseline to year 1 was significantly greater compared to controls (9.6% vs. 5%; p=0.02). Subjects with breast cancer reported significantly worse fatigue symptoms than age-matched controls, as indicated by higher disruption indices (p < 0.001 at baseline, p=0.02 at year 1, p=0.09 at year 2). Additionally, a significant interaction effect on disruption index score (p=0.019), general level of activity over time (p=0.006) and normal work activity (p= 0.002) was observed in the subgroup of women with BMI > 30. Conclusion: Screening breast cancer patients for thyroid function status at baseline and serially post-treatment to evaluate the need for thyroid hormone replacement may provide for a novel strategy for treating chemotherapy-induced fatigue.

Original languageEnglish (US)
Pages (from-to)25723-25737
Number of pages15
JournalOncotarget
Volume9
Issue number39
DOIs
StatePublished - May 22 2018
Externally publishedYes

Fingerprint

Fatigue
Thyroid Gland
Breast Neoplasms
Drug Therapy
Neoplasms
Hypothyroidism
Thyroid Hormones
Thyroid Neoplasms
Case-Control Studies
Anemia
Obesity
Quality of Life
Pathology
Psychology
Inflammation
Population
Therapeutics

Keywords

  • Breast cancer
  • Fatigue
  • Hypothyroidism
  • Subclinical hypothyroidism
  • Thyroid function

ASJC Scopus subject areas

  • Oncology

Cite this

Kumar, N. B., Fink, A., Levis, S., Xu, P., Tamura, R., & Krischer, J. (2018). Thyroid function in the etiology of fatigue in breast cancer. Oncotarget, 9(39), 25723-25737. https://doi.org/10.18632/oncotarget.25438

Thyroid function in the etiology of fatigue in breast cancer. / Kumar, Nagi B.; Fink, Angelina; Levis, Silvina; Xu, Ping; Tamura, Roy; Krischer, Jeffrey.

In: Oncotarget, Vol. 9, No. 39, 22.05.2018, p. 25723-25737.

Research output: Contribution to journalReview article

Kumar, NB, Fink, A, Levis, S, Xu, P, Tamura, R & Krischer, J 2018, 'Thyroid function in the etiology of fatigue in breast cancer', Oncotarget, vol. 9, no. 39, pp. 25723-25737. https://doi.org/10.18632/oncotarget.25438
Kumar NB, Fink A, Levis S, Xu P, Tamura R, Krischer J. Thyroid function in the etiology of fatigue in breast cancer. Oncotarget. 2018 May 22;9(39):25723-25737. https://doi.org/10.18632/oncotarget.25438
Kumar, Nagi B. ; Fink, Angelina ; Levis, Silvina ; Xu, Ping ; Tamura, Roy ; Krischer, Jeffrey. / Thyroid function in the etiology of fatigue in breast cancer. In: Oncotarget. 2018 ; Vol. 9, No. 39. pp. 25723-25737.
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