Lange termijn effecten van curatieve behandeling van borstkanker: vermoeidheid en depressie

Engeland, M. van (Marianne) (2013) Lange termijn effecten van curatieve behandeling van borstkanker: vermoeidheid en depressie. thesis, Medicine.

Text EngelandvanM.pdf Restricted to Registered users only Download (944kB)

Abstract

Aim: The aim of this report is to gain better understanding of fatigue and depression as long term effects of curative treatment for breast cancer. There are two key questions: 1) Is there an increased risk of fatigue after curative treatment for breast cancer compared to an unselected control population? And is there an influence of the type of treatment on fatigue after breast cancer? 2) Does getting adjuvant therapy cause more use of antidepressants for depressive symptoms in the long term after breast cancer than surgery alone? Material and Methods: 1) Systematic review: a predetermined search strategy was used to search for articles with information about fatigue after breast cancer. By screening reference lists of read articles, suitable articles were sought. Titles and abstracts were screened by the use of previously determined inclusion and exclusion criteria. 2) Retrospective cohort-study: data from 221 patients treated with surgery and 390 patients treated with adjuvant therapy was used from an existing database. All the patients had a history of breast cancer and had been treated after 1970 and were younger than 80 at the time of diagnosis. The prescription of antidepressants for depressive symptoms after breast cancer was used as measurement for depressive symptoms. Patients who received adjuvant therapy where compared to patients who only underwent surgery with a cox-regression. Results: 1) 1320 titles were found with the search strategy and 33 titles in the reference lists. After screening, 33 articles were included. 18 articles compared fatigue in breast cancer patients with fatigue in a healthy control population. 15 articles had a follow-up period of 5 years or less and three articles had a follow-up period of more than five years. 27 articles investigated the influence of one or more treatment types and their influence on fatigue. There are strong indications in the literature that breast cancer survivors experience more fatigue than healthy individuals up to five years after the diagnosis. There is no influence of treatment on fatigue except chemotherapy. There is weak evidence for an influence of chemotherapy on fatigue in breast cancer survivors. 2) After a median follow-up of nine years the women who received adjuvant therapy found to have a 1.7 fold risk of using antidepressants for depressive symptoms after breast cancer compared to surgically treated women HR 1,708 (95%BI; 1,026-2,843). The HR is corrected for age at time of diagnosis and antidepressant use before diagnosis of breast cancer. Conclusion: 1) Breast cancer survivors are more fatigued then healthy individuals up to five years after the diagnosis 2) Women who besides surgery also underwent adjuvant therapy have a statistically significant higher risk for use of antidepressant for depressive symptoms in the long term after breast cancer.

Item Type:	Thesis (Thesis)
Supervisor name:	Berendsen, Dr. A.J. and Bock, Prof. Dr. G.H. de
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:45
Last Modified:	25 Jun 2020 10:45
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/673

Actions (login required)

View Item