Pain, depression, and fatigue as a symptom cluster in advanced cancer

Barry J. A. Laird (Lead / Corresponding author), Angela C. Scott, Lesley A. Colvin, Amy Louise McKeon, Gordon D. Murray, Kenneth C. H. Fearon, Marie T. Fallon

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Context: Pain, depression, and fatigue are common symptoms in cancer populations. They often coexist and have been suggested as a specific symptom cluster. Systemic inflammation (SI) may be a possible common mechanism.

Objective: This study examined whether pain, depression, and fatigue exist as a symptom cluster in advanced cancer patients with cachexia and might be related to the presence of SI.

Methods: Secondary data analysis was undertaken of two clinical trials in patients with cancer cachexia (n = 654). Pain, depression, and fatigue were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. Plasma C-reactive protein (CRP) was measured as a marker of SI in a subgroup (n = 436). Multivariate analysis and a series of regression analyses were undertaken relating pain, depression, fatigue, and CRP.

Results: Pain, depression, and fatigue clustered, with between two and four times as many patients having all three symptoms as would be expected if the symptoms only coexist by chance (P < 0.001). CRP was not related to the symptom cluster. There was a strong relationship between the pattern of symptoms and physical functioning (P < 0.001).

Conclusion: Pain, depression, and fatigue is an identifiable symptom cluster in a cohort of cachexic cancer patients and is associated with reduced physical functioning.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalJournal of Pain and Symptom Management
Volume42
Issue number1
Early online date12 Mar 2011
DOIs
Publication statusPublished - Jul 2011

Keywords

  • cancer
  • cluster
  • depression
  • fatigue
  • inflammation
  • Pain

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  • Cite this

    Laird, B. J. A., Scott, A. C., Colvin, L. A., McKeon, A. L., Murray, G. D., Fearon, K. C. H., & Fallon, M. T. (2011). Pain, depression, and fatigue as a symptom cluster in advanced cancer. Journal of Pain and Symptom Management, 42(1), 1-11. https://doi.org/10.1016/j.jpainsymman.2010.10.261