Fatigue, Weight Gain, and Altered Sexuality in Patients With Breast Cancer: Exploration of a Symptom Cluster

Margaret C. Wilmoth

Elizabeth Ann Coleman

Steven C. Smith

Carla Davis

ONF 2004, 31(6), 1069-1075. DOI: 10.1188/04.ONF.1069-1075

Purpose/Objectives: To identify the symptom cluster of fatigue, weight gain, and altered sexuality caused by treatment for breast cancer.

Jump to a section

    References

    Ahmadi, J., Samavatt, F., Sayyad, M., & Ghanizadeh, A. (2002). Various types of exercise and scores on the Beck Depression Inventory. Psychological Reports, 90(3, Pt. 1), 821-822.

    American Cancer Society. (2003). Detailed guide: Oral cavity and oropharyngeal cancer. Summary of side effects and complications of treatment. Retrieved February 15, 2003, from http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Summary_of_Side_Effects_and_Complications_of_Treatment_60.asp?sitearea

    Andersen, B.L. (1985). Sexual functioning morbidity among cancer survivors. Current status and future research directions. Cancer, 55, 1835-1842.

    Andersen, B.L. (1993). Predicting sexual and psychologic morbidity and improving the quality of life for women with gynecologic cancer. Cancer, 71 (4, Suppl.), 1678-1690.

    Andersen, B.L., Anderson, B., & deProsse, C. (1989). Controlled prospective longitudinal study of women with cancer: I. Sexual functioning outcomes. Journal of Consulting and Clinical Psychology, 57, 683-691.

    Andersen, B.L., Van der Does, J., & Anderson, B. (1992). Sexual outcomes following gynecologic cancer. In M. Coppelson, P. Morrow, & M. Tattersall (Eds.), Gynecologic oncology (pp. 1481-1497). Edinburgh, Scotland: Churchill Livingston.

    Barsevick, A.M., Whitmer, K., Sweeney, C., & Nail, L.M. (2002). A pilot study examining energy conservation for cancer treatment-related fatigue. Cancer Nursing, 25, 333-341.

    Barsevick, A.M., Whitmer, K., & Walker, L. (2001). In their own words: Using the Common Sense Model to analyze patient descriptions of cancer-related fatigue. Oncology Nursing Forum, 28, 1363-1369.

    Barton-Burke, M. (1997). The influence of fatigue on sexuality. In Dimensions of fatigue: A continuing education symposium. Bridgewater, NJ: Ortho Biotech Products, L.P.

    Berger, A.M., & Walker, S.N. (2001). An explanatory model of fatigue in women receiving adjuvant breast cancer chemotherapy. Nursing Research, 50, 42-52.

    Bower, J.E., Ganz, P.A., Desmond, K.A., Rowland, J.H., Meyerowitz, B.E., & Belin, T.R. (2000). Fatigue in breast cancer survivors: Occurrence, correlates, and impact on quality of life. Journal of Clinical Oncology, 18, 743-753.

    Bremer, B.A., Moore, C.T., Bourbon, B.M., Hess, D.R., & Bremer, K.L. (1997). Perceptions of control, physical exercise, and psychological adjustment to breast cancer in South African women. Annals of Behavioral Medicine, 19(1), 51-60.

    Bruner, D.W., & Boyd, C.P. (1999). Assessing women's sexuality after cancer therapy: Checking assumptions with the focus group technique. Cancer Nursing, 22, 438-447.

    Bullard, J., Bullard, D.G., Rosenbaum, E.H., & Rosenbaum, I.R. (2003). Cancer supportive care programs: Sexuality, intimacy and communications. Retrieved May 15, 2003, from http://www.cancersupportivecare.com/sexuality.html

    CancerSymptoms.org. (2002). Ways to manage your cancer symptoms: Fatigue. Retrieved September 15, 2004, from http://www.cancersymptoms.org/symptoms/fatigue/learn/key_points.php

    Cimprich, B. (1993). The oncology patient's experience of fatigue. Quality of Life—A Nursing Challenge, 1(1), 39-44.

    Coleman, E.A., Coon, S., Hall-Barrow, J., Richards, K., Gaylor, D., & Stewart, B. (2003). Feasibility of exercise during treatment for multiple myeloma. Cancer Nursing, 26, 410-419.

    Coleman, E.A., Hall-Barrow, J., Coon, S., & Stewart, C.B. (2003). Facilitating exercise adherence for patients with multiple myeloma. Clinical Journal of Oncology Nursing, 7, 529-534.

    Demark-Wahnefried, W., Hars, V., Conaway, M.R., Havlin, K., Rimer, B.K., McElveen, G., et al. (1997). Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. American Journal of Clinical Nutrition, 65, 1495-1501.

    Demark-Wahnefried, W., Peterson, B.L., Winer, E.P., Marks, L., Aziz, N., Marcom, P.K., et al. (2001). Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. Journal of Clinical Oncology, 19, 2381-2389.

    Demark-Wahnefried, W., Rimer, B.K., & Winer, E.P. (1997). Weight gain in women diagnosed with breast cancer. Journal of the American Dietetic Association, 97, 519-526, 529.

    Demark-Wahnefried, W., Winer, E.P., & Rimer, B.K. (1993). Why women gain weight with adjuvant chemotherapy for breast cancer. Journal of Clinical Oncology, 11, 1418-1429.

    Dimeo, F., Bertz, H., Finke, J., Fetscher, S., Mertelsmann, R., & Keul, J. (1996). An aerobic exercise program for patients with haematological malignancies after bone marrow transplantation. Bone Marrow Transplantation, 18, 1157-1160.

    Dimeo, F., Stieglitz, R.D., Novelli-Fischer, U., Fetscher, S., Mertelsmann, R., & Keul, J. (1997). Correlation between physical performance and fatigue in cancer patients. Annals of Oncology, 8, 1251-1255.

    Dimeo, F.C. (2001). Effects of exercise on cancer-related fatigue. Cancer, 92(6, Suppl.), 1689-1693.

    Dodd, M., Janson, S., Facione, N., Faucett, J., Froelicher, E.S., Humphreys, J., et al. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33, 668-676.

    Dodd, M.J., Miaskowski, C., & Paul, S.M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28, 465-470.

    Evans, W.J. (2002). Physical function in men and women with cancer: Effects of anemia and conditioning. Oncology, 16(9, Suppl. 10), 109-115.

    Fawcett, J. (2000). Analysis and evaluation of contemporary nursing knowledge: Nursing models and theories. Philadelphia: F.A. Davis.

    Fleming, M.P., & Kleinbart, E. (2001). Breast cancer and sexuality. Journal of Sex Education and Therapy, 26, 215-224.

    Ganz, P.A., Greendale, G.A., Petersen, L., Zibecchi, L., Kahn, B., & Belin, T.R. (2000). Managing menopausal symptoms in breast cancer survivors: Results of a randomized controlled trial. Journal of the National Cancer Institute, 92, 1054-1064.

    Ganz, P.A., Rowland, J.H., Desmond, K., Meyerowitz, B.E., & Wyatt, G.E. (1998). Life after breast cancer: Understanding women's health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16, 501-514.

    Goodwin, P., Esplen, M.J., Butler, K., Winocur, J., Pritchard, K., Brazel, S., et al. (1998). Multidisciplinary weight management in locoregional breast cancer: Results of a phase II study. Breast Cancer Research and Treatment, 48, 53-64.

    Goodwin, P.J. (2001). Weight gain in early-stage breast cancer: Where do we go from here? Journal of Clinical Oncology, 19, 2367-2369.

    Goodwin, P.J., Skingley, P., Clark, R.M., Wilkinson, R., Lipa, M., & Levine, M.N. (1993). Prognostic effects of baseline weight and weight gain during the first year after diagnosis in node-negative breast cancer: An analysis of an Ontario Clinical Oncology Group study. Proceedings of the Seventh International Conference on the Adjuvant Therapy of Cancer, 41.

    Grant, M. (2000). Fatigue and quality of life with cancer. In M.L. Winningham & M. Barton-Burke (Eds.), Fatigue in cancer: A multidimensional approach (pp. 353-364.) Boston: Jones and Bartlett.

    Holmberg, S.K., Scott, L.L., Alexy, W., & Fife, B.L. (2001). Relationship issues of women with breast cancer. Cancer Nursing, 24, 53-60.

    Kaplan, H.S. (1992). A neglected issue: The sexual side effects of current treatments for breast cancer. Journal of Sex and Marital Therapy, 18(1), 3-19.

    Kawachi, I. (1999). Physical and psychological consequences of weight gain. Journal of Clinical Psychiatry, 60(Suppl. 21), 5-9.

    Knobf, M.T. (1998). Natural menopause and ovarian toxicity associated with breast cancer therapy. Oncology Nursing Forum, 25, 1519-1530.

    Knobf, M.T. (2001). The menopausal symptom experience in young mid-life women with breast cancer. Cancer Nursing, 24, 201-210.

    Knobf, M.T., Mullen, J.C., Xistris, D., & Moritz, D.A. (1983). Weight gain in women with breast cancer receiving adjuvant chemotherapy. Oncology Nursing Forum, 10(2), 28-33.

    Kutynec, C.L., McCargar, L., Barr, S.I., & Hislop, T.G. (1999). Energy balance in women with breast cancer during adjuvant treatment. Journal of the American Dietetic Association, 99, 1222-1227.

    Levine, E.G., Raczynski, J.M., & Carpenter, J.T. (1991). Weight gain with breast cancer adjuvant treatment. Cancer, 67, 1954-1959.

    Li, S., Holm, K., Gulanick, M., Lanuza, D., & Penckofer, S. (1999). The relationship between physical activity and perimenopause. Health Care for Women International, 20, 163-178.

    MacVicar, M.G., Winningham, M.L., & Nickel, J.L. (1989). Effects of aerobic interval training on cancer patients' functional capacity. Nursing Research, 38, 348-351.

    McInnes, J.A., & Knobf, M.T. (2001). Weight gain and quality of life in women treated with adjuvant chemotherapy for early-stage breast cancer. Oncology Nursing Forum, 28, 675-684.

    Meston, C.M. (2000). Sympathetic nervous system activity and female sexual arousal. American Journal of Cardiology, 86(Suppl. 2), 30F-34F.

    Mock, V., Atkinson, A., Barsevick, A., Cella, D., Cimprich, B., Cleeland, C., et al. (2000). NCCN practice guidelines for cancer-related fatigue. Oncology, 14(11A), 151-161.

    Mock, V., Burke, M.B., Sheehan, P., Creaton, E.M., Winningham, M.L., McKenney-Tedder, S., et al. (1994). A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncology Nursing Forum, 21, 899-907.

    Mock, V., Dow, K.H., Meares, C.J., Grimm, P.M., Dienemann, J.A., Haisfield-Wolfe, M.E., et al. (1997). Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncology Nursing Forum, 24, 991-1000.

    Mock, V., Pickett, M., Ropka, M.E., Muscari Lin, E., Stewart, K.J., Rhodes, V.A., et al. (2001). Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Practice, 9, 119-127.

    Mock, V., Ropka, M.E., Rhodes, V.A., Pickett, M., Grimm, P.M., McDaniel, R., et al. (1998). Establishing mechanisms to conduct multi-institutional research—Fatigue in patients with cancer: An exercise intervention. Oncology Nursing Forum, 25, 1391-1397.

    Nail, L.M. (2002). Fatigue in patients with cancer. Oncology Nursing Forum, 29, 537-545.

    National Comprehensive Cancer Network. (2003). Clinical practice guidelines in oncology: Cancer-related fatigue (Vol. 1). Retrieved September 15, 2004, from http://www.nccn.org/patients/patient_gls/_english/_fatigue/contents.asp

    Neidig, J.L., Smith, B.A., & Brashers, D.E. (2003). Aerobic exercise training for depressive symptom management in adults living with HIV infection. Journal of the Association of Nurses in AIDS Care, 14(2), 30-40.

    Nystedt, M., Berglund, G., Bolund, C., Fornander, T., & Rutqvist, L.E. (2003). Side effects of adjuvant endocrine treatment in premenopausal breast cancer patients: A prospective randomized study. Journal of Clinical Oncology, 21, 1836-1844.

    Okuyama, T., Akechi, T., Kugaya, A., Okamura, H., Imoto, S., Nakano, T., et al. (2000). Factors correlated with fatigue in disease-free breast cancer patients: Application of the Cancer Fatigue Scale. Supportive Care in Cancer, 8, 215-222.

    Payne, J.K. (2002). The trajectory of fatigue in adult patients with breast and ovarian cancer receiving chemotherapy. Oncology Nursing Forum, 29, 1334-1340.

    Pickett, M., Mock, V., Ropka, M.E., Cameron, L., Coleman, M., & Podewils, L. (2002). Adherence to moderate-intensity exercise during breast cancer therapy. Cancer Practice, 10, 284-292.

    Pinto, B.M., & Maruyama, N.C. (1999). Exercise in the rehabilitation of breast cancer survivors. Psycho-Oncology, 8, 191-206.

    Pinto, B.M., Trunzo, J.J., Reiss, P., & Shiu, S.Y. (2002). Exercise participation after diagnosis of breast cancer: Trends and effects on mood and quality of life. Psycho-Oncology, 11, 389-400.

    Portenoy, R.K. (2000). Cancer-related fatigue: An immense problem. Oncologist, 5, 350-352.

    Portenoy, R.K., & Itri, L.M. (1999). Cancer-related fatigue: Guidelines for evaluation and management. Oncologist, 4, 1-10.

    Ream, E., & Richardson, A. (1996). Fatigue: A concept analysis. International Journal of Nursing Studies, 33, 519-529.

    Rock, C.L., Flatt, S.W., Newman, V., Caan, B.J., Haan, M.N., Stefanick, M.L., et al. (1999). Factors associated with weight gain in women after diagnosis of breast cancer. Journal of the American Dietetic Association, 99, 1212-1221.

    Rowland, J.H., Desmond, K.A., Meyerowitz, B.E., Belin, T.R., Wyatt, G.E., & Ganz, P.A. (2000). Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. Journal of the National Cancer Institute, 92, 1422-1429.

    Rumpel, C., Ingram, D.D., Harris, T.B., & Madans, J. (1994). The association between weight change and psychological well-being in women. International Journal of Obesity and Related Metabolic Disorders, 18, 179-183.

    Schnipper, H.H. (2003). Life after breast cancer. Journal of Clinical Oncology, 21(9, Suppl.), 104-107.

    Schover, L.R. (1991). The impact of breast cancer on sexuality, body image, and intimate relationships. CA: A Cancer Journal for Clinicians, 41, 112-120.

    Schover, L.R., Yetman, R.J., Tuason, L.J., Meisler, E., Esselstyn, C.B., Hermann, R.E., et al. (1995). Partial mastectomy and breast reconstruction: A comaprison of their effects on psychosocial adjustment, body image, and sexuality. Cancer, 75, 54-64.

    Schwartz, A.L. (1998). Patterns of exercise and fatigue in physically active cancer survivors. Oncology Nursing Forum, 25, 485-491.

    Schwartz, A.L. (2000a). Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Practice, 8, 16-24.

    Schwartz, A.L. (2000b). Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Practice, 8, 231-237.

    Shell, J.A. (2002). Evidence-based practice for symptom management in adults with cancer: Sexual dysfunction. Oncology Nursing Forum, 29, 53-66.

    Shimozuma, K., Ganz, P.A., Petersen, L., & Hirji, K. (1999). Quality of life in the first year after breast cancer surgery: Rehabilitation needs and patterns of recovery. Breast Cancer Research and Treatment, 56, 45-57.

    Stead, M.L. (2003). Sexual dysfunction after treatment for gynaecologic and breast malignancies. Current Opinion in Obstetrics and Gynecology, 15, 57-61.

    Stone, P. (2002). The measurement, causes and effective management of cancer-related fatigue. International Journal of Palliative Nursing, 8, 120-128.

    Stone, P., Richards, M., A'Hern, R., & Hardy, J. (2000). A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Annals of Oncology, 11, 561-567.

    Suh, M.R., Jung, H.H., Kim, S.B., Park, J.S., & Yang, W.S. (2002). Effects of regular exercise on anxiety, depression, and quality of life in maintenance hemodialysis patients. Renal Failure, 24, 337-345.

    Swain, S.W. (1996). Endocrine therapies of cancer. In B.A. Chabner & D.L. Longo (Eds.), Cancer chemotherapy and biotherapy: Principles and practice (pp. 59-108). Philadelphia: Lippincott-Raven.

    Tavio, M., Milan, I., & Tirelli, U. (2002). Cancer-related fatigue. International Journal of Oncology, 21, 1093-1099.

    Wilmoth, M.C. (2001). The aftermath of breast cancer: An altered sexual self. Cancer Nursing, 24, 278-286.

    Wilmoth, M.C., & Ross, J.A. (1997). Women's perception. Breast cancer treatment and sexuality. Cancer Practice, 5, 353-359.

    Wilmoth, M.C., & Sanders, L.D. (2001). Accept me for myself: African American women's issues after breast cancer. Oncology Nursing Forum, 28, 875-879.

    Wilmoth, M.C., & Tingle, L.R. (2001). Development and psychometric testing of the Wilmoth Sexual Behaviors Questionnaire-Female. Canadian Journal of Nursing Research, 32, 135-151.

    Wilmoth, M.C., & Townsend, J. (1995). A comparison of the effects of lumpectomy versus mastectomy on sexual behaviors. Cancer Practice, 3, 279-285.

    Winningham, M.L., MacVicar, M.G., Bondoc, M., Anderson, J.I., & Minton, J.P. (1989). Effect of aerobic exercise on body weight and composition in patients with breast cancer on adjuvant chemotherapy. Oncology Nursing Forum, 16, 683-689.

    Yurek, D., Farrar, W., & Andersen, B.L. (2000). Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. Journal of Consulting and Clinical Psychology, 68, 697-709.