Cancer-related fatigue in colorectal cancer survivors

Matty Weijenberg’s research study aims to unravel the biological mechanisms linking sedentary behaviour and physical activity with fatigue in colorectal cancer survivors

  • Topic: Colorectal cancer
  • Institution: Maastricht University
  • Country: Netherlands
  • Status: Completed
Researcher: Matty Weijenberg

Background

Cancer-related fatigue is one of the most common and distressing side effects in cancer survivors, however the biological mechanisms haven’t been yet understood.

Aims

Investigate the biological mechanisms linking sedentary behaviour and physical activity with overall fatigue and subdomains of fatigue in colorectal cancer survivors. Identify overlapping metabolites and anthropometric measures from the biological mechanisms involved.

How it was done

Data from the ongoing prospective cohort study in colorectal cancer survivors (EnCoRe) with repeated measurements at 6 weeks, 6 months, 1 year, and 2 years post-treatment were used. Information on sedentary behaviour, standing, moderate-to-vigorous physical activity, light-intensity physical activity, fatigue, subdomains of fatigue, and anropometric measures were collected. Targeted metabolomic analyses were conducted to determine the plasma concentration of 138 metabolites.

Findings

Levels of physical activity and sedentary behaviour were associated with several metabolites including amino acids and lipids. Many of these metabolites were also associated with fatigue, in particular with total fatigue and fatigue severity. These findings suggest that inflammation and impaired energy metabolism in muscles are underlying biological mechanisms linking sedentary behaviour and physical activity with fatigue. We observed that levels of sedentary behaviour, standing and physical activity were associated with handgrip strength, and physical activity also with obesity. Handgrip strength and obesity were also associated with fatigue. Further analyses suggested that the association of sedentary behaviour with fatigue may be partly mediated through changes in obesity.

Impact

The dataset generated through this study has been used to analyse multiple research questions related to this project – longitudinal associations of light-intensity physical activity with quality of life and fatigue, sedentary behaviour and physical activity with quality of life and fatigue, sleep quality with fatigue, inflammation with fatigue. Dr Van Roekel wrote an article on challenges and opportunities for early-career epidemiologists within the epidemiology field. Working on this project increased her experience in the field of biological mechanisms of fatigue after colorectal cancer which has led her to receive the Dutch Cancer Society’s Young Investigator Grant. Prof Weijenberg and Dr Van Roekel have also contributed as co-authors to other WCRF-funded projects.

Grant publications

Gielen AHC, Melenhorst J, Breukink SO, Weijenberg MP, Bours MJL. The Relation of Lifestyle with Inflammation at the Time of Diagnosis in Patients with Colorectal Cancer. Cancers (Basel). 2023 Aug 28;15(17):4307. doi: 10.3390/cancers15174307. PMID: 37686583; PMCID: PMC10486596.

van Roekel, E.H., Duchâteau, J., Bours, M.J.L. et al. Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer. Qual Life Res 29, 2987–2998 (2020). doi: 10.1007/s11136-020-02566-7.