Association between cancer-related fatigue and traditional Chinese medicine body constitution in female patients with breast cancer

Sheuh-Mei Deng; Aih-Fung Chiu; Shin-Chung Wu; Yu-Chuen Huang; Shu-Chuan Huang; Shih-Yu Chen; Ming-Yen Tsai

doi:10.1016/j.jtcme.2020.08.005

Association between cancer-related fatigue and traditional Chinese medicine body constitution in female patients with breast cancer

J Tradit Complement Med. 2020 Aug 31;11(1):62-67. doi: 10.1016/j.jtcme.2020.08.005. eCollection 2021 Jan.

Authors

Sheuh-Mei Deng^{1

2}, Aih-Fung Chiu³, Shin-Chung Wu⁴, Yu-Chuen Huang⁵, Shu-Chuan Huang¹, Shih-Yu Chen⁶, Ming-Yen Tsai⁷

Affiliations

¹ Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan.
² Department of Nursing, Fooyin University, Kaohsiung, 83102, Taiwan.
³ Department of Nursing, Meiho University, Pingtung, 91202, Taiwan.
⁴ Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan.
⁵ Department of Medical Research, China Medical University Hospital and School of Chinese Medicine, China Medical University, Taichung, 41354, Taiwan.
⁶ Department of Pediatrics, E-Da Hospital and I-Shou University, Kaohsiung, 82445, Taiwan.
⁷ Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan.

Abstract

Background: Cancer-related fatigue (CRF) is a common psychosomatic problem in breast cancer patients. Traditional Chinese medicine (TCM) has been used to address symptoms in patients with CRF. Identification of the specific constitution in TCM is essential for personalized care.

Aim: To explore the relationship between fatigue and specific constitutions in breast cancer.

Experimental procedure: We conducted a cross-sectional study in all breast cancer patients at Kaohsiung Chang Gung Memorial Hospital in Taiwan. The severity of fatigue was determined using the Brief Fatigue Inventory-Taiwanese (BFI-T) form. TCM patterns were determined using the Body Constitution Questionnaire (BCQ). The relationship between constitution and fatigue was analyzed using logistic regression.

Results: We recruited 110 breast cancer patients with fatigue (mean age: 55 ± 11 years). The mean duration of breast cancer was 17.4 months. The major constitution among these patients with fatigue was Yang-Qi deficiency (50%). Phlegm-Stasis syndrome was correlated with a duration of breast cancer of more than 18 months (p = 0.02). Out of all participants, 42.7% (n = 47) reported clinically significant fatigue (BFI-T score ≥4). According to logistic regression, the score of Yang-Qi deficiency [odds ratio (OR): 3.5, 95% confidence interval (CI): 1.49-8.21, p < 0.01] was also associated with clinically significant fatigue.

Conclusion: Yang-Qi deficiency is associated with clinically significant fatigue in breast cancer patients. However, the association of Phlegm-Stasis syndrome and fatigue as disease duration increases cannot be ignored. Further studies are needed to determine whether treating both constitutions integrating TCM treatment can alleviate patients' fatigue symptoms.

Keywords: BCQ, Body Constitution Questionnaire; BFI-T, Brief Fatigue Inventory–Taiwan; BMI, body mass index; Breast cancer; CAM, complementary and alternative medicine; CI, confidence interval; CRF, Cancer-related fatigue; Chemotherapy; Constitution; Fatigue; Hb, hemoglobin; OR, odds ratio; TCM, traditional Chinese medicine; Traditional Chinese medicine; VAS, visual analogue scale; WBC, white blood cell.