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Background. Few studies have explored fatigue in different groups of lymphoma survivors and the association with hormonal dysfunctions. The aims were to analyze associations between fatigue and thyroid and gonadal function in male lymphoma survivors. In addition, the impact of chronic fatigue on work situation and daily functioning were explored. Patients and methods. This cross-sectional study included male lymphoma survivors diagnosed in 1980-2002, aged ≤ 50 years at diagnosis and > 18 years at survey in 2007. The participants (n = 233, median age at survey: 48 years, median observation time: 15 years) completed questionnaires assessing levels of fatigue, chronic fatigue (duration ≥ 6 months), mental distress, daily functioning and work situation. Levels of thyroid and gonadal hormones were assessed. The participants were grouped according to diagnosis: Hodgkin lymphoma (HL, n = 131), aggressive/very aggressive non-Hodgkin lymphoma (NHL) (n = 67) and indolent NHL (n = 35). Thyroid hormones were categorized as normal (n = 174) or latent hypothyroidism (elevated thyroid stimulating hormone, n = 59). Gonadal hormones were categorized as normal (n = 111), elevated follicle stimulating hormone only (n = 45), primary (n = 35) or secondary hypogonadism (n = 42). Uni- and multivariate regression analyses were performed. A p value < 0.05 indicated the level of significance. Results. The survivors of HL and aggressive/very aggressive NHL had similar fatigue levels and similar prevalence of chronic fatigue (HL: 31%, aggressive/very aggressive; NHL: 27%). Survivors of indolent NHL had lower fatigue levels and prevalence of chronic fatigue (11%). Latent hypothyroidism was associated with increased fatigue levels (p = 0.042). Gonadal function was not associated with levels of fatigue or chronic fatigue. Mental distress was associated with increasing fatigue levels and chronic fatigue (p < 0.001). We found negative associations between chronic fatigue, daily functioning and work status. Conclusions. Fatigued lymphoma survivors should be investigated for thyroid function. The negative impact of chronic fatigue on daily functioning and work status emphasizes the importance of maintaining the effort in understanding the mechanisms behind fatigue. [ABSTRACT FROM AUTHOR]

Purpose. To investigate long-term development of sickness absence and disability pension among colorectal cancer (CRC) survivors compared to matched cancer-free controls, and to assess to what degree socio-demographic and disease characteristics influence these outcomes. Patients and methods. In a register-based cohort study with data from the Cancer Registry of Norway and longitudinal data from other national registries, 740 patients with CRC diagnosed 1992-1996 at the age 45-54 years were observed up to 14 years post-diagnosis. Also 740 matched controls were observed over the same time period. Results. During the first year after diagnosis, 85% of the CRC survivors were on sick-leave at some point, compared to 19% of the controls. Among survivors with localized cancer, 21% were on sick-leave 12 months after diagnosis, versus 33% with regional, and 52% with distant cancer. Survivors with rectum cancer were more likely than colon cancer survivors to be on sick-leave the first year after diagnosis (OR 2.53, 95% CI 1.61-3.98). CRC survivors were at higher risk for disability pension (DP) than controls, depending on extent of disease. Hazard ratios for DP were 1.67 (95% CI 1.13-2.46) for survivors with localized cancer, 3.12 (95% CI 2.06-4.72) for regional, and 10.13 (95% CI 4.17-24.62) for distant cancer, respectively. In survivors, distant cancer, low level of education, not having children < 18 years in the household, pre-diagnostic sick-leave and not being employed at diagnosis were associated with increased likelihood for DP. Conclusion. A considerable proportion of CRC survivors, for years after diagnosis, will experience reduced work ability compared to controls. Rehabilitation and workplace adjustment to reduce sickness absence and improve work ability should be a long-term concern. [ABSTRACT FROM AUTHOR]

Purpose. To examine cancer patients' needs for rehabilitation services and factors associated with such needs, and secondly identify unmet needs for rehabilitation services and related factors. Material and methods. In 2008 persons aged 25-60 years, diagnosed in 2005/2006 with the ten most prevalent cancers in Norway were identified through the Cancer Registry of Norway. These patients were contacted by their treating hospital receiving a mailed questionnaire. Main outcomes for the present study were measured by two questions assessing a) needs for rehabilitation services and b) rehabilitation services offered/used. For each question seven services were listed; physical therapy, physical training, psychological counseling, consultations with social worker, occupational therapy, supportive group sessions and admittance to a convalescent home. The respondents then rated to what extent they had experienced needs and if they had been offered and used each service. Those who reported need for a service that not had been offered were defined as having unmet need. Associations between demographic, health-related and outcome variables were analyzed by multivariate logistic and linear regression analyses. Results. Among the 1 325 respondents, the mean age was 52 years and 70% were women. Sixty-three percent reported need for at least one rehabilitation service. Need for physical therapy was most frequently reported (43%), followed by physical training (34%), psychological counseling (27%), supportive group sessions (24%), admittance to a convalescent home (24%), consultation with social worker (19%) and occupational therapy (6%). Changes in employment status and ongoing or previous chemotherapy were associated with reporting needs for all rehabilitation services. Forty percent reported unmet needs, which most frequently was reported among persons living alone, who had changed their employment status, receiving or had received chemotherapy or reported comorbidities. Conclusions. The majority reported need for at least one rehabilitation service, and 40% reported unmet needs. Prospective studies are recommended in order to better understand needs for rehabilitation services, such as needs in relation to time since treatment, extent of disease and treatment intensity. [ABSTRACT FROM AUTHOR]