Skip to main content

COVID-19 is an emerging, rapidly evolving situation.

What people with cancer should know:

Guidance for cancer researchers:

Get the latest public health information from CDC:

Get the latest research information from NIH:

Grant Details

Grant Number: 4R01CA160427-05 Interpret this number
Primary Investigator: Bower, Julienne
Organization: University Of California Los Angeles
Project Title: Biobehavioral Predictors of Fatigue in Newly-Diagnosed Breast Cancer Patients
Fiscal Year: 2016


DESCRIPTION (provided by applicant): Fatigue is one of the most common and distressing side effects of breast cancer treatment and may persist for months or years after successful treatment completion. Approximately one-third of breast cancer survivors report moderate to severe symptoms of fatigue, which has a negative impact on all aspects of quality of life. Although the prevalence and impact of cancer-related fatigue has now been well established, very little is known about predictors and mechanisms for the development and persistence of fatigue post-treatment. Accordingly, the primary goal of this prospective, longitudinal study is to identify biological and psychological risk factors for post-treatment fatigue, with intensive evaluation of mechanisms, in women newly diagnosed with early stage breast cancer. In particular, this application focuses on vulnerability factors that increase risk for inflammatory processes given evidence suggesting an inflammatory basis for cancer-related fatigue. Specific aims are to: 1) determine whether inflammatory risk genes, hypothalamic-pituitary-adrenal axis dysregulation, and body mass index at treatment onset predict post-treatment fatigue in breast cancer patients assessed longitudinally for 18 months after treatment completion; 2) evaluate whether history of depression and early life stress at treatment onset predict post-treatment fatigue in breast cancer patients assessed longitudinally for 18 months after treatment onset; 3) investigate the contribution of measured proinflammatory cytokine activity to the association between biological and psychological risk factors and post-treatment fatigue. We will recruit 360 women with newly-diagnosed, early-stage breast cancer before initiation of treatment with radiation, chemotherapy, trastuzumab or endocrine therapy. At baseline, participants will complete self-report questionnaires, diagnostic interview for depression, blood draw for cytokine gene polymorphisms and markers of inflammation, and saliva samples for diurnal cortisol slope. Follow-up assessments conducted at treatment completion and at 6, 12, and 18 months post-treatment will determine the trajectory of post-treatment fatigue and associated changes in inflammatory processes. This research is a critical next step in the early identification of patients who are at risk for persistent fatigue as a long term side effect of cancer treatment and for the development and implementation of targeted interventions to prevent and treat this disabling symptom.


Do all patients with cancer experience fatigue? A longitudinal study of fatigue trajectories in women with breast cancer.
Authors: Bower J.E. , Ganz P.A. , Irwin M.R. , Cole S.W. , Garet D. , Petersen L. , Asher A. , Hurvitz S.A. , Crespi C.M. .
Source: Cancer, 2021-02-19; , .
EPub date: 2021-02-19.
PMID: 33606273
Related Citations

Childhood maltreatment and monocyte gene expression among women with breast cancer.
Authors: Bower J.E. , Kuhlman K.R. , Ganz P.A. , Irwin M.R. , Crespi C.M. , Cole S.W. .
Source: Brain, behavior, and immunity, 2020 08; 88, p. 396-402.
EPub date: 2020-04-02.
PMID: 32247915
Related Citations

Inflammation and dimensions of reward processing following exposure to the influenza vaccine.
Authors: Boyle C.C. , Kuhlman K.R. , Dooley L.N. , Haydon M.D. , Robles T.F. , Ang Y.S. , Pizzagalli D.A. , Bower J.E. .
Source: Psychoneuroendocrinology, 2019 04; 102, p. 16-23.
EPub date: 2018-11-20.
PMID: 30496908
Related Citations

Testing a biobehavioral model of fatigue before adjuvant therapy in women with breast cancer.
Authors: Bower J.E. , Asher A. , Garet D. , Petersen L. , Ganz P.A. , Irwin M.R. , Cole S.W. , Hurvitz S.A. , Crespi C.M. .
Source: Cancer, 2019-02-15; 125(4), p. 633-641.
EPub date: 2018-12-18.
PMID: 30561795
Related Citations

The role of neuro-immune interactions in cancer-related fatigue: Biobehavioral risk factors and mechanisms.
Authors: Bower J.E. .
Source: Cancer, 2019-02-01; 125(3), p. 353-364.
EPub date: 2019-01-02.
PMID: 30602059
Related Citations

Communicating Risks of Adjuvant Chemotherapy for Breast Cancer: Getting Beyond the Laundry List.
Authors: Brauer E.R. , Long E.F. , Melnikow J. , Ravdin P.M. , Ganz P.A. .
Source: Journal of oncology practice, 2019 02; 15(2), p. e98-e109.
EPub date: 2018-12-14.
PMID: 30550372
Related Citations

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer.
Authors: Kuhlman K.R. , Boyle C.C. , Irwin M.R. , Ganz P.A. , Crespi C.M. , Asher A. , Petersen L. , Bower J.E. .
Source: Child abuse & neglect, 2017 Oct; 72, p. 360-369.
EPub date: 2017-09-07.
PMID: 28888809
Related Citations

Cortisol Awakening Response as a Prospective Risk Factor for Depressive Symptoms in Women After Treatment for Breast Cancer.
Authors: Kuhlman K.R. , Irwin M.R. , Ganz P.A. , Crespi C.M. , Petersen L. , Asher A. , Bower J.E. .
Source: Psychosomatic medicine, 2017 Sep; 79(7), p. 763-769.
PMID: 28570439
Related Citations

Val66Met BDNF polymorphism as a vulnerability factor for inflammation-associated depressive symptoms in women with breast cancer.
Authors: Dooley L.N. , Ganz P.A. , Cole S.W. , Crespi C.M. , Bower J.E. .
Source: Journal of affective disorders, 2016 Jun; 197, p. 43-50.
EPub date: 2016-03-02.
PMID: 26967918
Related Citations

Mind-body therapies and control of inflammatory biology: A descriptive review.
Authors: Bower J.E. , Irwin M.R. .
Source: Brain, behavior, and immunity, 2016 Jan; 51, p. 1-11.
EPub date: 2015-06-23.
PMID: 26116436
Related Citations

Cancer-related fatigue--mechanisms, risk factors, and treatments.
Authors: Bower J.E. .
Source: Nature reviews. Clinical oncology, 2014 Oct; 11(10), p. 597-609.
EPub date: 2014-08-12.
PMID: 25113839
Related Citations

Low heart rate variability and cancer-related fatigue in breast cancer survivors.
Authors: Crosswell A.D. , Lockwood K.G. , Ganz P.A. , Bower J.E. .
Source: Psychoneuroendocrinology, 2014 Jul; 45, p. 58-66.
EPub date: 2014-03-30.
PMID: 24845177
Related Citations

Childhood Adversity and Cumulative Life Stress: Risk Factors for Cancer-Related Fatigue.
Authors: Bower J.E. , Crosswell A.D. , Slavich G.M. .
Source: Clinical psychological science : a journal of the Association for Psychological Science, 2014 Jan; 2(1), .
PMID: 24377083
Related Citations

Inflammation and cancer-related fatigue: mechanisms, contributing factors, and treatment implications.
Authors: Bower J.E. , Lamkin D.M. .
Source: Brain, behavior, and immunity, 2013 Mar; 30 Suppl, p. S48-57.
EPub date: 2012-07-06.
PMID: 22776268
Related Citations

Back to Top