A Molecular Approach to Understanding the Role of Diet in Cancer-Related Fatigue: Challenges and Future Opportunities

Abstract

Cancer-related fatigue (CRF) is considered one of the most frequent and distressing symptoms for cancer survivors. Despite its high prevalence, factors that predispose, precipitate, and perpetuate CRF are poorly understood. Emerging research focuses on cancer and treatment-related nutritional complications, changes in body composition, and nutritional deficiencies that can compound CRF. Nutritional metabolomics, the novel study of diet-related metabolites in cells, tissues, and biofluids, offers a promising tool to further address these research gaps. In this position paper, we examine CRF risk factors, summarize metabolomics studies of CRF, outline dietary recommendations for the prevention and management of CRF in cancer survivorship, and identify knowledge gaps and challenges in applying nutritional metabolomics to understand dietary contributions to CRF over the cancer survivorship trajectory.

Fatigue and associated factors among adult cancer patients receiving cancer treatment at oncology unit in Amhara region, Ethiopia

“…Anxiety, which was supported by research from Australia [75], Netherland [76], and Nigeria [77] was the fourth factor in this study that had a significant association with CRF. This may be the result of biologically related processes; in particular, worry may lead to weariness via dysregulation of the hypothalamic-pituitary-adrenal axis [78]. As a result of internal and external stressors during therapy, the hypothalamic-pituitary-adrenal axis becomes dysregulated, depleting the body's supply of cortisol and impairing its ability to secrete it [79].…”

“…This could be as a result of the pathologic nature of cancer and its treatment, which could result in nutritional issues like altered taste, anorexia, diarrhea, and unintended weight loss that could then weaken the cancer survivor and modify their body composition [81]. Additionally, cancer treatments may worsen already-present symptoms or have unfavorable side effects like taste loss, xerostomia, inadequate nutritional intake, nausea, and vomiting, which can cause involuntary muscular atrophy and weakness and increase fatigue due to altered ATP metabolism [78,82].…”

Rosmarinic Acid and Related Dietary Supplements: Potential Applications in the Prevention and Treatment of Cancer

“…Potential challenges, long-term treatment, and repeated hospitalizations severely impact the quality of life, substantial financial burden, and psychological stress [ 2 ]. Studies showed that some dietary supplements, ethnic herbs, and teas are used for tumor prevention and treatment [ 3 , 4 , 5 ]. Some natural products from diets or plants are potential anti-tumor drugs and chemotherapy sensitizers [ 6 ].…”

Effects of mindfulness‐based interventions on fatigue and psychological wellbeing in women with cancer: A systematic review and meta‐analysis of randomised control trials

“…Furthermore, it seems that exercise alone may not successfully target all aspects of CRF, for example, emotional or cognitive fatigue, may actually hinder participants' engagement in interventions such as exercise 15–17 . Diet and sleep hygiene although have evidence that may impact CRF, there remains a lack of studies that incorporate the role of diet in the direct management of CRF or sleep interventions that improve sleep substantially 18 . This lack of improvement in sleep can directly or indirectly effect CRF, this is known as a phenomena called ‘cluster symptoms’ where more than one symptom cluster together and effect each other positively or negatively, for CRF the symptoms identified include sleep, anxiety and depression 19 .…”

“… 15 , 16 , 17 Diet and sleep hygiene although have evidence that may impact CRF, there remains a lack of studies that incorporate the role of diet in the direct management of CRF or sleep interventions that improve sleep substantially. 18 This lack of improvement in sleep can directly or indirectly effect CRF, this is known as a phenomena called ‘cluster symptoms’ where more than one symptom cluster together and effect each other positively or negatively, for CRF the symptoms identified include sleep, anxiety and depression. 19 The presence of these symptoms can lead to stress which may also lead to a further increase in the cluster symptoms.…”