Depression and cancer

Cancer related fatigue could be caused by depression and poor physical performance, says report.

A study conducted by a team of German researchers from the Chariti University Medical Center in Berlin, has indicated that cancer related fatigue could be caused by depression and poor physical performance and not due to physiological reasons.

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According to the report, published in this month's issue of the medical journal Annals of Oncology, researchers studied more than 70 cancer patients who had been free of cancer related treatment for at least three months.

They found that although fatigue is a common problem in patients who are recovering from haematological cancers like leukaemia, lymphoma, myeloma, it is not caused by a weakened immune system or other physiological conditions.

Cancer related fatigue - defined as an unusual and persistent sense of tiredness that can occur during or after treatment, may affect physical and mental ability and is not relieved by rest.

Although researchers were not able to zero in on the exact reason behind the fatigue, they have listed various cancer related problems like anaemia, impaired nutritional status, sleep disturbances, changes in the concentrations of cytokines (small proteins released by cells that affect the behaviour of other cells) due to the interaction between the tumour and the immune system and impaired thyroid, as possible causes behind the fatigue.

Researchers are now planning on conducting further studies to decide if depression is caused by poor physical performance or vice versa.

"Impaired physical performance and depression seem to be critical components in cancer-related fatigue although we have not yet clarified the association between the two factors. Impaired performance can result in increased dependence, lower self-esteem, reduced social activities, restricted family life and a pessimistic mood. The patient can also interpret poor performance as a sign of poor health and this increases psychological distress," said the lead researcher Dr Fernando Dimeo.