The role of neuro‐immune interactions in cancer‐related fatigue: Biobehavioral risk factors and mechanisms

Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer‐related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer expe...

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Bibliographic Details
Published in:Cancer Vol. 125; no. 3; pp. 353 - 364
Main Author: Bower, Julienne E.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01.02.2019
Subjects:
Anxiety
Anxiety - etiology
Anxiety - immunology
Anxiety - psychology
Behavior - physiology
biobehavioral
Cancer
Cancer Survivors - psychology
Cancer Survivors - statistics & numerical data
Children
Depression - etiology
Depression - immunology
Depression - psychology
Fatigue
Fatigue - epidemiology
Fatigue - etiology
Health risks
Humans
inflammation
Mental depression
Neoplasms - complications
Neoplasms - epidemiology
Neuroimmunomodulation - physiology
neuro‐immune
Oncology
Physical activity
psychosocial
Quality of Life - psychology
Risk analysis
Risk Factors
Sleep
System effectiveness
neuro-immune
psychosocial
fatigue
inflammation
biobehavioral
ISSN:0008-543X, 1097-0142, 1097-0142
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Abstract Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer‐related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro‐immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer‐related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective. Neuro‐immune processes play a critical role in cancer‐related fatigue. In this review, biobehavioral risk factors and mechanisms for fatigue are examined with a focus on psychological, neural, neuroendocrine, and immune processes, and the implications for treatment are considered.
AbstractList Fatigue is a common and distressing symptom in cancer patients and survivors. There is substantial variability in the severity and persistence of cancer-related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro-immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer-related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biological systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue, though research is sparse. Identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective. Neuro-immune processes play a critical role in cancer-related fatigue. This review examines biobehavioral risk factors and mechanisms for fatigue with a focus on psychological, neural, neuroendocrine, and immune processes and considers implications for treatment.
Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer‐related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro‐immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer‐related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective. Neuro‐immune processes play a critical role in cancer‐related fatigue. In this review, biobehavioral risk factors and mechanisms for fatigue are examined with a focus on psychological, neural, neuroendocrine, and immune processes, and the implications for treatment are considered.
Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer-related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro-immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer-related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective.
Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer-related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro-immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer-related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective.Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer-related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro-immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer-related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective.
Author Bower, Julienne E.
AuthorAffiliation 1 UCLA Department of Psychology
3 Cousins Center for Psychoneuroimmunology
4 Jonsson Comprehensive Cancer Center
2 UCLA Department of Psychiatry and Biobehavioral Sciences
AuthorAffiliation_xml – name: 1 UCLA Department of Psychology
– name: 4 Jonsson Comprehensive Cancer Center
– name: 3 Cousins Center for Psychoneuroimmunology
– name: 2 UCLA Department of Psychiatry and Biobehavioral Sciences
Author_xml – sequence: 1
  givenname: Julienne E.
  surname: Bower
  fullname: Bower, Julienne E.
  email: jbower@ucla.edu
  organization: University of California
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30602059$$D View this record in MEDLINE/PubMed
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Issue 3
Keywords neuro-immune
psychosocial
fatigue
inflammation
biobehavioral
Language English
License 2019 American Cancer Society.
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Snippet Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence...
Fatigue is a common and distressing symptom in cancer patients and survivors. There is substantial variability in the severity and persistence of...
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StartPage 353
SubjectTerms Anxiety
Anxiety - etiology
Anxiety - immunology
Anxiety - psychology
Behavior - physiology
biobehavioral
Cancer
Cancer Survivors - psychology
Cancer Survivors - statistics & numerical data
Children
Depression - etiology
Depression - immunology
Depression - psychology
Fatigue
Fatigue - epidemiology
Fatigue - etiology
Health risks
Humans
inflammation
Mental depression
Neoplasms - complications
Neoplasms - epidemiology
Neuroimmunomodulation - physiology
neuro‐immune
Oncology
Physical activity
psychosocial
Quality of Life - psychology
Risk analysis
Risk Factors
Sleep
System effectiveness
Title The role of neuro‐immune interactions in cancer‐related fatigue: Biobehavioral risk factors and mechanisms
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fcncr.31790
https://www.ncbi.nlm.nih.gov/pubmed/30602059
https://www.proquest.com/docview/2169087046
https://www.proquest.com/docview/2163012004
https://pubmed.ncbi.nlm.nih.gov/PMC6502236
Volume 125
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