I'm so tired: Biological and genetic mechanisms of cancer-related fatigue

Andrea Barsevick, Marlene Frost, Aeilko Zwinderman, Per Hall, Michele Halyard

Research output: Contribution to journalArticlepeer-review

110 Scopus citations

Abstract

Objective: The goal of this paper is to discuss cancer-related fatigue (CRF) and address issues related to the investigation into potential biological and genetic causal mechanisms. The objectives are to: (1) describe CRF as a component of quality of life (QOL); (2) address measurement issues that have slowed progress toward an understanding of mechanisms underlying this symptom; (3) review biological pathways and genetic approaches that have promise for the exploration of causal mechanisms of CRF; and (4) offer directions for future research. Methods: Review, synthesis, and interpretation of the literature. Results: Until recently, CRF and QOL have been understood primarily as subjective patient-reported experiences. With increased understanding of human genetics, theories and research are being expanded to incorporate biological and genetic understandings of these subjective experiences. Proposed biological and genetic mechanisms of CRF that have been examined include cytokine dysregulation, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, five hydroxy tryptophan (5-HT) neurotransmitter dysregulation, circadian rhythm disruption, alterations in adenosine triphosphate (ATP) and muscle metabolism, and vagal afferent activation. Approaches to the study of genetic mechanisms have also been addressed including candidate genes, genome-wide scanning, and gene expression. Based on the review and synthesis of the literature, directions for future research are proposed. Conclusions: Understanding the biological and genetic basis of CRF has the potential to contribute to a more complete understanding of the genetic determinants of QOL.

Original languageEnglish (US)
Pages (from-to)1419-1427
Number of pages9
JournalQuality of Life Research
Volume19
Issue number10
DOIs
StatePublished - Dec 2010

Keywords

  • Biological mechanisms
  • Cancer-related fatigue
  • Genetic variables
  • Patient-reported outcomes
  • Quality of life

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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