A new study has reported that radiation treatment for breast cancer results in persistent fatigue in some women, whether or not they also undergo chemotherapy. The study was designed to compare the impact on quality of life of radiation treatment alone compared to radiation treatment after adjuvant chemotherapy. Most patients with early stage breast cancer who are treated with chemotherapy have symptoms of fatigue and a decrease in quality of life during or after radiation treatment (radiotherapy). Both fatigue and cognitive impairment were evaluated in 161 chemotherapy + radiotherapy and 141 radiotherapy patients during radiation treatment and one year later.

Approximately 60% of the chemotherapy + radiotherapy patients expressed fatigue at baseline, compared to 33% of the radiotherapy only patients, consistent with previous findings that chemotherapy can cause fatigue. Corresponding rates at the end of radiation treatment were 61% and 53%. Fatigue was still reported after one year by over 40% of the study participants in both groups. Long term fatigue was associated with depression, which was less frequent in the radiotherapy only group at baseline but reached a similar value at the end of radiation treatment (25% in both groups). Initial mild cognitive impairment ("chemo brain") was reported by 34% of the radiotherapy only patients and 24% of the chemotherapy + radiotherapy patients and was still evident at the one-year mark for half of them. No evident biological disorders were found to be associated with fatigue or cognitive impairment. The authors conclude that fatigue is the main symptom in breast cancer patients treated with radiation treatment, whether they received chemotherapy previously or not. Persistent fatigue with more likely in women with depression at baseline, indicating that administering both medical and psychological programs for early stage breast cancer patients treated with chemotherapy and/or radiation treatment might be beneficial to manage fatigue.