---
title: "Chemotherapy-related fatigue in breast cancer at high altitude: mechanisms and management"
id: "pubmed-42661012"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42661012"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42661012/"
doi: "10.1007/s00520-026-11151-6"
published_at: "2026-08-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Chemotherapy-related fatigue in breast cancer at high altitude: mechanisms and management
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42661012
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42661012/)
- **DOI:** [10.1007/s00520-026-11151-6](https://doi.org/10.1007%2Fs00520-026-11151-6)
- **Published At:** 2026-08-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Breast cancer (BC) patients frequently receive chemotherapy and commonly experience **chemotherapy-related fatigue (CRF)**, with a reported prevalence of about 30–60% during treatment. - A subset of patients develop persistent, long-term fatigue that impairs quality of life and may affect prognosis. - Patients living in **high-altitude** regions face additional environmental stressors — hypoxia, low atmospheric pressure, and temperature variation — that can exacerbate fatigue. - CRF is multifactorial: principal contributors include **chronic inflammation** and immune dysregulation; other implicated mechanisms are neuroendocrine abnormalities and **mitochondrial dysfunction**. - High-altitude hypoxia is not the primary cause but can amplify inflammatory and immune-readjustment pathways already involved in CRF. - Nonpharmacological interventions such as **physical activity**, cognitive behavioral therapy, and mindfulness have demonstrated effectiveness in reducing fatigue symptoms. - Pharmacological management of CRF remains inconclusive based on the review; however, clinicians should identify and correct reversible contributors (for example, anemia and sleep disorders). - The review calls for targeted future research on CRF pathophysiology in elevated areas and for development of customized treatment strategies to improve patient quality of life. - The article is a 2026 review published in Support Care Cancer (PMID: 42661012; DOI: 10.1007/s00520-026-11151-6) authored by Tao Wu et al. from Qinghai University–affiliated centers in Xining, China. - Authors declared no competing interests; ethics approval and consent statements were reported as not applicable in the publication.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China. * 2 Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China. qhdxlz@163.com. * PMID: **42661012** * DOI: [ 10.1007/s00520-026-11151-6 ](https://doi.org/10.1007/s00520-026-11151-6) Item in Clipboard Review # Recent advances in understanding chemotherapy-induced fatigue in BC patients residing in high-altitude regions: a review Tao Wu et al. Support Care Cancer. 2026. Show details Display options Display options Format Abstract PubMed PMID Support Care Cancer Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Support+Care+Cancer%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Support+Care+Cancer%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) . 2026 Aug 28;34(9):903. doi: 10.1007/s00520-026-11151-6. ### Authors [Tao Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+T&cauthor_id=42661012)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42661012/#short-view-affiliation-1 "Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China."), [Jinming Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+J&cauthor_id=42661012)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42661012/#short-view-affiliation-1 "Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China."), [Fuxing Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+F&cauthor_id=42661012)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42661012/#short-view-affiliation-1 "Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China."), [Zhen Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Z&cauthor_id=42661012)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42661012/#short-view-affiliation-2 "Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China. qhdxlz@163.com.") ### Affiliations * 1 Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China. * 2 Breast Disease Diagnosis and Treatment Center of Qinghai University Affiliated Hospital & Affliated Cancer Hospital of Qinghai University, Xining, China. qhdxlz@163.com. * PMID: **42661012** * DOI: [ 10.1007/s00520-026-11151-6 ](https://doi.org/10.1007/s00520-026-11151-6) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Breast cancer (BC) is a frequent women-specific malignancy, and one of the treatment options is chemotherapy. Chemotherapy-related fatigue (CRF) is however a common side effect with a prevalence of 30-60% of BC patients throughout the treatment process and some patients experience long-term fatigue which affects their quality of life and prognosis rates. Hypoxia, low atmospheric pressure, and temperature changes are some of the environmental factors that can worsen fatigue among BC patients in high-altitude zones. CRF mechanisms are multifactorial, which means they include chronic inflammation, immune dysregulation, neuroendocrine outliers, and mitochondrial dysfunction. The primary factors are inflammation and immune readjustment, and high-altitude hypoxia only adds to the processes. Nondpharmacological treatments such as physical activity, cognitive behavioral therapy, and mindfulness have been effective in the control of fatigue. Treatment is yet to be conclusive on the pharmacological side but reversible factors (e.g., anemia, sleep disorders) should be managed. Future studies are to consider CRF mechanisms in elevated areas and devise the customized treatments to enhance patient quality of life. **Keywords:** Breast cancer; Chemotherapy-related fatigue; Patient quality of life. © 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Ethics approval and consent to participate: No applicable. Consent for publication: No applicable. Competing interests: The authors declare no competing interests. ## Similar articles * [ Cancer-related fatigue: prevalence, assessment and treatment strategies. ](https://pubmed.ncbi.nlm.nih.gov/21831025/) Weis J.Weis J.Expert Rev Pharmacoecon Outcomes Res. 2011 Aug;11(4):441-6. doi: 10.1586/erp.11.44.Expert Rev Pharmacoecon Outcomes Res. 2011.PMID: 21831025Review. * [ Impact of a combined multimodal-aerobic and multimodal intervention compared to standard aerobic treatment in breast cancer survivors with chronic cancer-related fatigue - results of a three-armed pragmatic trial in a comprehensive cohort design. ](https://pubmed.ncbi.nlm.nih.gov/28253845/) Kröz M, Reif M, Glinz A, Berger B, Nikolaou A, Zerm R, Brinkhaus B, Girke M, Büssing A, Gutenbrunner C; CRF-2 study group.Kröz M, et al.BMC Cancer. 2017 Mar 2;17(1):166. doi: 10.1186/s12885-017-3142-7.BMC Cancer. 2017.PMID: 28253845Free PMC article.Clinical Trial. * [ Effect of a Pedometer-based Exercise Program on Cancer Related Fatigue and Quality of Life amongst Patients with Breast Cancer Receiving Chemotherapy. ](https://pubmed.ncbi.nlm.nih.gov/32592382/) Gandhi A, Samuel SR, Kumar KV, Saxena PP, Mithra P.Gandhi A, et al.Asian Pac J Cancer Prev. 2020 Jun 1;21(6):1813-1818. doi: 10.31557/APJCP.2020.21.6.1813.Asian Pac J Cancer Prev. 2020.PMID: 32592382Free PMC article. * [ Long-Term Fatigue After Treatment for Breast Cancer. ](https://pubmed.ncbi.nlm.nih.gov/42611514/) Avis NE, O'Connell NS, Mihalko SL, Jordan JH, Ladd AC, Lesser GJ, Olson KC, Weaver KE, Dressler EV, Grizzard PJ, Levine B, Moore TL, Ky B, Hackney MH, Brubaker P, Reding KW, Lucas AR, Bellissimo MP, Moeller FG, Kitzman DW, Hamilton CA, Klepin HD, Yeboah J, Ntim W, Zaha VG, D'Agostino R Jr, Hundley WG.Avis NE, et al.JAMA Netw Open. 2026 Aug 3;9(8):e2629862. doi: 10.1001/jamanetworkopen.2026.29862.JAMA Netw Open. 2026.PMID: 42611514Free PMC article. * [ Cancer-related Fatigue in Breast Cancer Survivors: A Review. ](https://pubmed.ncbi.nlm.nih.gov/32819836/) Ruiz-Casado A, Álvarez-Bustos A, de Pedro CG, Méndez-Otero M, Romero-Elías M.Ruiz-Casado A, et al.Clin Breast Cancer. 2021 Feb;21(1):10-25. doi: 10.1016/j.clbc.2020.07.011. 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High Alt Med Biol 19:116–123. - [DOI](https://doi.org/10.1089/ham.2017.0061) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/29389240/) Show all 73 references ## Publication types * Review Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Review%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Review) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) ## MeSH terms * Altitude* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Altitude%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Altitude) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Antineoplastic Agents* / adverse effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antineoplastic+Agents%2Fadverse+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Antineoplastic+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Antineoplastic Agents* / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antineoplastic+Agents%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Antineoplastic+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Breast Neoplasms* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Breast+Neoplasms%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Breast+Neoplasms) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Fatigue* / chemically induced Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Fatigue%2Fchemically+induced%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Fatigue) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Fatigue* / epidemiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Fatigue%2Fepidemiology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Fatigue) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Fatigue* / etiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Fatigue%2Fetiology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Fatigue) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Fatigue* / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Fatigue%2Ftherapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Fatigue) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Hypoxia / complications Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hypoxia%2Fcomplications%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Hypoxia) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661012/) * Quality of Life Actions
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