From the Guidelines
Cancer fatigue is a persistent, often overwhelming feeling of physical, mental, and/or emotional exhaustion that differs from fatigue caused by exertion as it is not necessarily relieved by rest or sleep. This condition is characterized by a debilitating sense of tiredness or weakness throughout the entire body, which can be described as much more intense than normal fatigue 1. Patients with cancer fatigue typically experience a range of symptoms, including:
- A heavy feeling in their limbs
- Difficulty concentrating
- Emotional drain
- A complete lack of energy that makes even simple tasks like showering or preparing meals feel impossible This fatigue can come on suddenly, may worsen during cancer treatment, and can persist for months or even years after treatment ends 1. Unlike normal tiredness, cancer fatigue often isn't proportional to activity level and doesn't resolve with a good night's sleep. The causes of cancer fatigue are multifactorial, including the cancer itself, effects of cancer treatments, physical and psychological comorbidities, other physical symptoms, physical inactivity and deconditioning, and cognitive, emotional, and behavioral responses to diagnosis and treatment 1.
According to the most recent guideline update on the management of fatigue in adult survivors of cancer, the management of cancer fatigue requires a comprehensive approach that addresses the physical, emotional, and social aspects of the condition 1. This may include energy conservation techniques, light exercise as tolerated, good nutrition, treating underlying conditions like anemia or depression, and sometimes medications like modafinil or methylphenidate in severe cases. It is essential to recognize that cancer fatigue is not an inevitable and unavoidable consequence of cancer and its treatment, and that effective management can significantly improve the quality of life for patients with cancer 1.
From the Research
Description of Cancer Fatigue
- Cancer-related fatigue is a disabling and distressing symptom that is highly prevalent across the cancer continuum from a patient's diagnosis and treatment through survivorship and end of life 2
- It has a multifactorial etiology and significant individual variability in its clinical expression, determinants, and sequelae 2
- Fatigue is a common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness 3
Characteristics of Cancer Fatigue
- Cancer-related fatigue can have profound effects on quality-of-life and physical functioning 4
- It is often underdiagnosed, and management is frequently suboptimal 2
- The prevalence of fatigue can be assessed by looking critically at the evidence of fatigue and the factors that affect it 3
Treatment and Management of Cancer Fatigue
- Exercise, psycho-educational interventions, and cognitive-behavioral therapy for insomnia are effective in the treatment of cancer-related fatigue 2
- Cognitive behavioral therapy (CBT) is an individualized intervention that empowers patients and caregivers to actively participate in the treatment process and has been shown to significantly reduce fatigue scores among cancer patients 5
- Aerobic exercise, yoga, and psycho-educational interventions also have benefits in patients with earlier stage disease, those undergoing active treatment, and in cancer survivors 4