From a Clustering of Adverse Symptoms after Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis with 3 Months of Follow-Up.

Simple Summary: After getting treated for colorectal cancer, many people feel fatigue, stress, and pain and face other challenges that can make daily activities and work tough. Our research explored how these issues group together and if they are connected to fatigue and difficulties in work. We gathered data from the MIRANDA study, where patients shared their experiences after colorectal cancer treatment before the start of the rehabilitation and three months after. Using data from their questionnaire responses, we identified six main problem groups: fatigue, digestive troubles, pain, feelings of stress or anxiety, urinary issues, and side effects from chemotherapy. Our findings reveal that experiencing even a single symptom from these categories can be a precursor to feeling more fatigued or having a decreased ability to work. Our findings shed light on colorectal cancer survivors' various challenges and how they might impact their daily lives and work. In colorectal cancer (CRC) patients, apart from fatigue, psychological and physical symptoms often converge, affecting their quality of life and ability to work. Our objective was to ascertain symptom clusters within a year following CRC treatment and their longitudinal association with persistent fatigue and reduced work ability at the 3-month follow-up. We used data from MIRANDA, a multicenter cohort study enrolling adult CRC patients who are starting a 3-week in-patient rehabilitation within a year post-curative CRC treatment. Participants completed questionnaires evaluating symptoms at the start of rehabilitation (baseline) and after three months. We performed an exploratory factor analysis to analyze the clustering of symptoms at baseline. Longitudinal analysis was performed using a multivariable linear regression model with dichotomized symptoms at baseline as independent variables, and the change in fatigue and ability to work from baseline to 3-month-follow-up as separate outcomes, adjusted for covariates. We identified six symptom clusters: fatigue, gastrointestinal symptoms, pain, psychosocial symptoms, urinary symptoms, and chemotherapy side effects. At least one symptom from each factor was associated with higher fatigue or reduced ability to work at the 3-month follow-up. This study highlights the interplay of multiple symptoms in influencing fatigue and work ability among CRC patients post-rehabilitation. [ABSTRACT FROM AUTHOR]