Late medical complications disease and fatigue in Hodgkin's disease survivors

Purpose: Long-term medical complications, such as cardiac, pulmonary, and t hyroid dysfunction, are frequent among Hodgkin's disease survivors (HDSs), Chronic fatigue is also highly prevalent among HDSs, Few studies have explo red possible etiologic explanations for fatigue, The aim of this study was to explore whether late cardiac, pulmonary, and thyroid complications after curative treatment for Hodgkin's disease (HD) may explain the high level o f fatigue among HDSs, Patients and Methods: Four-hundred fifty-nine patients treated for HD at th e Norwegian Radium Hospital from 1971 to 1991 were included in a cross-sect ional, follow-up study of subjective health status. Fatigue (physical [PF] and mental], was measured by the Fatigue Questionnaire. A subcohort of the HDSs (116 patients) treated from 1980 to 1988 were included in a separate s tudy in which long-term cardiac, pulmonary, and thyroid complications were assessed. All patients had received radiotherapy, and 63 patients had recei ved additional chemotherapy. The present study comprised 92 patients (mean age, 37 years; range, 23 to 56 years) who participated in both studies. Results: HDSs with pulmonary dysfunction were more fatigued than HDSs with normal pulmonary function (PF 10.9 v 8.9; P < .05). Gas transfer impairment was the most prevalent pulmonary dysfunction, and three times as many pati ents with gas transfer impairment reported chronic fatigue (duration, 6 mon ths or longer), compared with patients without pulmonary dysfunction (48% v 17%, P < .01). No associations were found between cardiac sequelae or hypo thyroidism and fatigue. Conclusion: Pulmonary dysfunction is associated with fatigue in HI)Ss, Card iac sequelae was not. associated with fatigue in HDSs. We question the abse nce of an association between thyroid complications and fatigue. (C) 2001 b y American Society of Clinical Oncology