Dynamic monitoring and risk assessment of chronic fatigue in survivors of childhood cancer

As survival rates have increased tremendously in children and adolescents treated for cancer, the long-term sequelae of the childhood cancer treatment play an increasingly important role in their daily life quality. A frequently experienced symptom is a chronic feeling of fatigue, of which the prevalence reaches up to 85% in childhood cancer survivors. Although this has a large negative impact on daily life functioning of the patient, to date there is no standard of care to monitor this, or even to reduce it, given that there is insufficient knowledge about the specific risk groups, the times and duration of these complaints, and associated physical and psychological complaints. Since cancer-related fatigue is a fluctuating symptom, it is required to determine the dynamic risk factors in detail. Therefore, this project focuses on the identification of patient- and time-related risk factors for developing long-term fatigue. We will closely monitor the dynamics of psychological experiences (e.g. fatigue, anxiety, depression), as well as the physiological, environmental and stress-related parameters (heart rhythm variability, physical activity, sleep patterns) through innovative measurements in daily life of 150 childhood cancer survivors (i.e. ecological momentary assessments via app-driven questions & objective monitoring of physical activity and sleep patterns with multisensor wearables). This way, we can address the dynamic associations between fatigue, stress, worrying behavior, insomnia, decreased physical activity, and biological changes, which is necessary for indications of suitable interventions to reduce fatigue and thus optimize the daily quality of life after cancer treatment in children and adolescents.