Fatigue and cancer: causes, prevalence and treatment approaches

Abstract

Fatigue is the most prevalent cancer-related symptom and has a significant adverse impact on patients' functional ability and quality of life. Hypotheses regarding the aetiology of cancer-related fatigue are discussed, and clinical practice guidelines for the evaluation and management of oncology patients with fatigue are reviewed. Both nonpharmacologic and pharmacologic strategies for the management of fatigue are summarised.

Feasibility and diagnostic accuracy of the Patient‐Reported Outcomes Measurement Information System (PROMIS) item banks for routine surveillance of sleep and fatigue problems in ambulatory cancer care

“…The latter was further divided into: 8-14 (sub-threshold insomnia or mild); [15][16][17][18][19][20][21] (moderate insomnia) and 22-28 (severe insomnia). 49 Savard et al 2005 adopted a ROC analysis to identify ISI's capacity to screen for insomnia and provided clinical cut-offs: ≥15 based on optimal sensitivity and specificity among cancer patients.…”

“…Moreover, only 67% of patients found results useful for clinicians (figure 1). [15][16][17][18][19][20] minutes per patient to complete all measures, feasibility survey and demographic data. We did not have separate data on time to completion of PROMIS items alone but other studies suggest an average of two minutes for completion of PROMIS CAT item banks for an average of 4-8 items, 36 which aligns with our average number of items to complete PROMIS CATs.…”

Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation

“…An overview of the treatment-related psychophysical problems of cancer patients is given by Courneya and Friedenreich 9 in their review 1999. The types of physical and psychosocial problems that are most relevant to the current review include: (a) loss of physical performance/fitness, [10][11][12][13][14] (b) fatigue, 8,10,[15][16][17][18][19] (c) distress, 20,21 (d) emotional problems (anxiety, depressions and so on) 10,21 and (e) immunological/hematological changes. 22 In addition, common somatic side effects (GVHD, infections, diarrhea, nausea, pain and so on 2,10,19,[23][24][25] ) likely exacerbated the physical and psychological problems.…”

Physical Activity and Cancer

“…For example, 53% of cancer survivors report that they are physically limited when it comes to exercise, compared with 21% of those with no history of cancer (Ness et al, 2006). One of the most prominent barriers, affecting at least 60% of cancer survivors (Alberg et al, 2003;Wagner & Cella, 2004), is cancer related fatigue (CRF). CRF is a debilitating sense of exhaustion which is disproportionate to energy expenditure (and therefore different from generally experienced tiredness), and is described by sufferers as "a complete shutdown", "unrelenting" and "uncontrollable" (Blaney et al, 2010).…”

“…One of the most common and debilitating symptoms experienced by cancer survivors, particularly those who are undergoing, or have undergone, chemotherapy and/or radiotherapy, is fatigue (Armes et al, 2005). Cancer related fatigue (CRF) is defined as "a persistent subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning" and is thought to affect anywhere between 60-100% of cancer patients (Alberg et al, 2003;Wagner & Cella, 2004). For many patients, this fatigue does not end with the cancer treatment, and has been found to continue for months, or even years, post-treatment (Andryowski et al, 1998;Minton & Stone, 2008).…”