Literature DB >> 17103445

The impact of hypogonadism and autonomic dysfunction on fatigue, emotional function, and sexual desire in male patients with advanced cancer: a pilot study.

Florian Strasser1, J Lynn Palmer, Leslie R Schover, S Wamique Yusuf, Katherine Pisters, Rena Vassilopoulou-Sellin, Beth DeGracia, Jie S Willey, Eduardo Bruera.   

Abstract

BACKGROUND: The objective of this study was to determine whether hypogonadism and autonomic dysfunction contribute substantially to cancer-related fatigue, decreased sexual desire, and depression in male patients with advanced, incurable cancer.
METHODS: Forty-eight patients who had received no major antineoplastic intervention for at least 2 weeks were tested for autonomic dysfunction by using Ewing tests. Total and free testosterone levels were measured. Multivariate analyses were performed to test the relation of these factors with the Functional Assessment of Cancer Therapy (FACT) (the Functional Assessment of Anorexia/Cachexia Therapy [FAACT] scale and the Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-F] subscale), the Hospital Anxiety and Depression Scale (HADS), the Edmonton Symptom Assessment Scale, the Sexual Desire Inventory, and sexual function (Cancer Rehabilitation Evaluation System subscale). Common causes for fatigue (anemia, depression, malnutrition, symptom distress, and medications) also were considered.
RESULTS: Thirty-eight of 47 patients (81%) had autonomic dysfunction, although it was not associated significantly with the other variables examined. Twenty-nine of 45 patients (64%) had a low level of free testosterone (hypogonadism), which was correlated with the HADS Anxiety score (P = .002), the FACT Emotional Well-Being score (P = .02), and the HADS Depression score (P = .04). Hypogonadal men also had lower scores on the FACT Functional Well-Being scale (P = .01) and the FACIT-F subscale (P = .05). Men who reported symptoms related to weight loss (FAACT scale) had significantly lower levels of free testosterone (r = 0.34; P = .02) but did not differ from the other group in actual weight loss (P = .22). The total testosterone level was not appropriate for screening of hypogonadism unless the patients had values <100 ng/ mL. Logistic regression analysis failed to reveal a distinct multivariate model of autonomic dysfunction or hypogonadism that predicted clinical outcomes.
CONCLUSIONS: Hypogonadism is a frequent condition in patients with advanced, incurable cancer and is associated with negative mood, fatigue, and symptoms related to anorexia/cachexia. Copyright 2006 American Cancer Society.

Entities:  

Mesh:

Year:  2006        PMID: 17103445     DOI: 10.1002/cncr.22339

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  28 in total

1.  Prognostic Value of Heart Rate Variability in Patients With Cancer.

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2.  Testosterone replacement for fatigue in hypogonadal ambulatory males with advanced cancer: a preliminary double-blind placebo-controlled trial.

Authors:  E Del Fabbro; J M Garcia; R Dev; D Hui; J Williams; D Engineer; J L Palmer; L Schover; E Bruera
Journal:  Support Care Cancer       Date:  2013-05-08       Impact factor: 3.603

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Review 4.  A systematic review of opioid effects on the hypogonadal axis of cancer patients.

Authors:  Kerry McWilliams; Claribel Simmons; Barry J Laird; Marie T Fallon
Journal:  Support Care Cancer       Date:  2014-03-15       Impact factor: 3.603

Review 5.  When and when not to use testosterone for palliation in cancer care.

Authors:  Rony Dev; Eduardo Bruera; Egidio Del Fabbro
Journal:  Curr Oncol Rep       Date:  2014-04       Impact factor: 5.075

6.  Heart rate variability as a measure of autonomic dysfunction in men with advanced cancer.

Authors:  Y Guo; J L Palmer; F Strasser; S W Yusuf; E Bruera
Journal:  Eur J Cancer Care (Engl)       Date:  2013-04-30       Impact factor: 2.520

7.  Clinical outcomes and contributors to weight loss in a cancer cachexia clinic.

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8.  Cancer-Related Fatigue, Version 2.2015.

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Journal:  J Natl Compr Canc Netw       Date:  2015-08       Impact factor: 11.908

9.  A Chinese Decoction, Kuan-Sin-Yin, Improves Autonomic Function and Cancer-Related Symptoms of Metastatic Colon Cancer.

Authors:  Tsai-Ju Chien; Chia-Yu Liu; Pin-Hao Ko; Chung-Hua Hsu
Journal:  Integr Cancer Ther       Date:  2015-11-25       Impact factor: 3.279

10.  Association between hypogonadism, symptom burden, and survival in male patients with advanced cancer.

Authors:  Rony Dev; David Hui; Egidio Del Fabbro; Marvin O Delgado-Guay; Nikhil Sobti; Shalini Dalal; Eduardo Bruera
Journal:  Cancer       Date:  2014-02-27       Impact factor: 6.860

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