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Cancer-related fatigue

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Cancer-related fatigue is a symptom of fatigue that is experienced by nearly all cancer patients.[1]

Among patients receiving cancer treatment other than surgery, it is essentially universal. Fatigue is a normal and expected side effect of most forms of chemotherapy, radiation therapy, and biotherapy.[2] On average, cancer-related fatigue is "more severe, more distressing, and less likely to be relieved by rest" than fatigue experienced by healthy people.[2] It can range from mild to severe, and may be either temporary or a long-term effect.

Fatigue may be a symptom of the cancer, or it may be the result of treatments for the cancer.

Pathophysiology

[edit]

The pathophysiology of cancer-related fatigue is poorly understood. It may be caused by the cancer or the effects it has on the body, by the body's response to the cancer, or by the cancer treatments.

Fatigue is a common symptom of cancer.[3] One meta-analysis estimated that around 43% of individuals with cancer report experiencing fatigue.[4] The study also highlighted that fatigue levels can differ depending on factors like the type of cancer, the stage of treatment, and gender. Notably, women were found to experience more severe fatigue than men.[4]

Some fatigue is caused by cancer treatments. This may show a characteristic pattern. For example, people on many chemotherapy regimens often feel more fatigue in the week after treatments, and less fatigue as they recover from that round of medications. People receiving radiation therapy, by contrast, often find their fatigue steadily increases until the end of treatment.[3]

A systematic review and meta-analysis found that approximately 42% of working cancer survivors report experiencing cancer-related fatigue.[5] The analysis also identified emotional distress as a possible contributing factor to ongoing fatigue symptoms. These findings suggest that both physical and psychological factors may influence fatigue in working survivors, indicating the potential value of supportive workplace strategies [5]

Proposed mechanisms by which cancer can cause fatigue include an increase in pro-inflammatory cytokines, dysregulation of the hypothalamic-pituitary-adrenal axis, disruption of circadian rhythms, muscle loss and cancer wasting, and genetic problems.[2] Additionally, some forms of cancer may cause fatigue through more direct mechanisms, such as a leukemia that causes anemia by preventing the bone marrow from producing blood cells efficiently. A relationship between Interleukin 6 and fatigue has been observed in studies, albeit inconsistently. Increased markers of sympathetic nervous system activity are also associated with cancer related fatigue.[6]

Screening

[edit]

The National Comprehensive Cancer Network recommends that every cancer patient be systematically screened for fatigue at the first visit with an oncologist, throughout treatment, and afterwards.[2] Screening typically involves a simple question, like "On a scale of one to ten, how tired have you felt during the last week?"

More detailed information may be collected in a symptom journal.

Diagnosis

[edit]

Some causes of cancer-related fatigue are treatable, and evaluation is directed towards identifying these treatable causes. Treatable causes of cancer-related fatigue include: anemia, pain, emotional distress, sleep disturbances, nutritional disturbances, decreased physical fitness and activity, side effects from medications (e.g., sedatives), abuse of alcohol or other substances.[2] Additionally, other medical conditions, such as infections, heart disease, or endocrine dysfunction (e.g., hot flashes), can cause fatigue, and may also need treatment.

Definition

[edit]

The National Comprehensive Cancer Network defines cancer-related fatigue as "a distressing persistent, subjective sense of physical, emotional and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning".[2]

Cancer-related fatigue is a chronic fatigue (persistent fatigue not relieved by rest), but it is not related to chronic fatigue syndrome.[3] Cancer-related fatigue occurs in a significant proportion of cancer survivors, both during and after cancer treatment.[7] A review of current evidence indicates that exercise is the most effective way of ameliorating cancer-related fatigue.[7]

Prostate cancer

[edit]

Cancer related fatigue is common in patients undergoing treatment for prostate cancer.[8] A systematic review of the prevalence of cancer-related fatigue in men with prostate cancer was performed.[9] The analysis indicated that fatigue is a common symptom, occurring in about 40% of men with prostate cancer especially among those using hormone therapy.[9]

Breast cancer

[edit]

Cancer-related fatigue is a prevalent and significant symptom among breast cancer patients, often lasting for years after treatment.[10] An empirical study regarding cancer-related fatigue in breast cancer patients identified different groups of patients based on their fatigue levels, with nearly half (47.5%) falling into an "exhausted" group, characterized by high fatigue severity and interference in daily activities, along with elevated stress, anxiety, depression, and sleep disturbance, significantly impacting quality of life.[10]

Management

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Treatment depends on the patient's overall situation. A patient who is in active treatment may have different priorities than a person who has completed treatment, or who is at the end of life.

Some management strategies may help all patients and could be supported by the work of an Occupational Therapist. These include scheduling high-priority tasks during the patient's best time of day, using labor-saving devices, delegating tasks to caregivers, and avoiding unimportant activities, so that the patient will have more energy available for other activities.[11]

Patients who are not at the end of life may benefit from physical exercise or physical therapy.[12] Engaging in physical activity may reduce fatigue.[2][13][14][15] Forms of exercise that have been proven to be most effective are more aerobic exercise such as walking, running, cycling, and swimming.[16] These forms of activity can be done at various levels of intensity and have been proven as an effective way of improving quality of life for cancer patients.[17] A network meta-analysis evaluated the effectiveness of various exercise modalities in alleviating CRF among breast cancer patients. The findings indicated that yoga was the most effective, followed by combined aerobic and resistance exercises.[18] In addition to general exercise and yoga, other mind-body practices such as Qigong have demonstrated potential benefits in managing CRF.

Yoga

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With its focus on the integration of inner awareness, breathing, and body, yoga differs from general aerobic exercise.[19] Hatha yoga, a commonly practiced and accessible form of yoga, integrates physical postures (asanas) and breathwork (pranayama) and was featured in several interventions evaluated for their effectiveness in reducing cancer-related fatigue. Mixed types of yoga—those combining physical postures, breathing control, and mindfulness—were associated with increased patient adherence and improved fatigue outcomes.[19] Physical postures, often involving gentle stretching and movement, contributed to improved physical function, especially when paired with breathwork or meditative elements.[19] Breathing techniques alone, such as pranayama-based interventions, also demonstrated positive effects on fatigue management by potentially modulating stress and supporting emotional well-being. These interventions were most effective when delivered as part of a strategy that included both supervised group sessions and ongoing self-practice. As a low-intensity form of exercise, yoga practice of 150 minutes or greater per week is considered safe and effective for alleviating cancer-related fatigue.[19]

Qigong

[edit]

Qigong is a traditional Chinese practice that combines gentle movements, breathing exercises, and meditation to cultivate and maintain health and well-being. Research has consistently found that Qigong practice relieved cancer-related fatigue.[20] A systematic review and meta-analysis of randomized controlled trials found that Qigong practice is comparable to the effects of other intervention therapies for cancer-related fatigue, including Western exercise.[20] Mindful Exercises like Qigong may offer an alternative strategy for individuals who find it difficult to adhere to or adapt to medium or high-intensity aerobic exercise. Larger reductions in fatigue were observed among patients with higher baseline fatigue scores following Qigong intervention.[20] Different styles of Qigong, such as Taiichi Qigong, Badu Anjin Qigong, and Guolin Qigong, have been used in studies examining their effects on cancer-related fatigue.

Other Mindfulness-based Interventions

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In addition to yoga and Qigong, other mindfulness-based interventions (MBIs) have been studied for their potential in managing cancer-related fatigue. These interventions typically aim to help individuals become more aware of present-moment experiences, including physical sensations and thought processes, while adopting a nonjudgmental and accepting attitude.[21]

One of the most frequently studied MBIs is Mindfulness-Based Stress Reduction (MBSR), a structured program that uses practices such as body scanning, mindful breathing, and gentle movement to help individuals recognize and accept discomfort without judgment or avoidance. MBSR has been shown in multiple studies to reduce symptoms of fatigue and emotional distress in oncology populations.[21]

Mindfulness-Based Cognitive Therapy (MBCT) builds upon the MBSR model by incorporating elements of cognitive therapy, particularly techniques aimed at helping individuals identify and disengage from repetitive or negative thought patterns. MBCT interventions have been used to support patients in reducing cognitive reactivity, which may contribute to the emotional and psychological aspects of fatigue.[21]

Mindfulness-Based Cancer Recovery (MBCR) is an adaptation of MBSR specifically tailored for individuals with cancer. It focuses on addressing the unique psychological and physical challenges faced by cancer patients through mindfulness training. While fewer studies have evaluated MBCR compared to MBSR or MBCT, preliminary evidence suggests potential benefits in improving fatigue-related outcomes.[21]

Recent research has explored several complementary approaches for managing cancer-related fatigue (CRF), including microbiome-based therapies, nurse-led interventions, and melatonin supplementation. A systematic review examining the use of probiotics and synbiotics found preliminary evidence suggesting they may help reduce CRF symptoms, though the authors emphasized the need for more extensive clinical trials to confirm their effectiveness.[22] Another systematic review focusing on nurse-led interventions showed that multidisciplinary strategies—particularly those involving physical activity and psychological support—can be beneficial in easing fatigue among cancer patients.[23] Additionally, a meta-analysis on melatonin supplementation reported that taking melatonin, especially for periods of 13 weeks or longer, may lead to noticeable improvements in fatigue severity.[24]

While antidepressants are ineffective at reducing fatigue in non-depressed cancer patients, psychostimulants such as methylphenidate and amphetamines may reduce fatigue in some patients.[2][25][26][27][28] Methylphenidate may be effective in the management of cancer-related fatigue. If methylphenidate were to be used in patients with CRF, it would be prudent to restrict its use to patients with advanced disease or for short-term use in patients on active treatment. The clear advantage of methylphenidate in cancer is its rapid onset of action within 24–48 hours, and so the drug can be discontinued if ineffective.[29]

At the end of life, fatigue is usually associated with other symptoms, especially anemia, side effects from many medications and previous treatments, and poor nutritional status.[2] Pain, difficulty breathing, and fatigue form a common symptom cluster. Fatigue often increases as patients with advanced cancer approach death. As a result, people who are dying often sleep much more than a healthy person.[30][31]

Addressing specific causes

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If the fatigue is caused or exacerbated by a specific medical condition, such as anemia, then treatment of that medical condition should reduce the fatigue.

  • Anemia: Loss of oxygen-carrying red blood cells is a common cause of fatigue. Medications to improve blood production or blood transfusions frequently reduce fatigue.
  • Pain: A variety of approaches to managing cancer pain may be used, particularly analgesic medications.
  • Emotional distress: Anxiety and depression are strongly associated with fatigue in cancer patients. Psychosocial treatments directed at reducing stress and increasing coping skills may reduce fatigue. Additionally, some patients in active treatment worry that the fatigue indicates treatment failure, and this anxiety may increase their fatigue in a vicious cycle. Education about fatigue as a normal side effect can reassure the patient.[2] Up to 25% of cancer patients will experience depression.[3]
  • Sleep disturbances: Patients who do not sleep well are more tired than others. Cancer patients commonly experience insomnia or hypersomnia. Sleep disturbances may be caused by sleeping too much during the day, by restless leg syndrome, by pain, by anxiety, or by other medical conditions, like obstructive sleep apnea or menopause. Practicing good sleep hygiene may reduce fatigue by improving sleep quality.
  • Nutritional disturbances: Patients may have difficulty eating, may not be absorbing food well, or may have chosen an extreme diet as an alternative cancer treatment. Loss of appetite, diarrhea and vomiting may result in the patient consuming too few calories or becoming dehydrated.[3]
  • Lack of physical activity: Decreased physical activity can make fatigue worse by reducing endurance and muscle strength. Participating in regular aerobic[15] and muscle-strengthening[32] physical activity both during and after cancer treatment may reduce cancer-related fatigue. Current physical activity guidelines recommend adults with cancer to engage in at least 150 minutes per week of moderate- intensity or 75 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination. It is also recommended to perform muscle-strengthening physical activity two to three times a week, although there are studies showing that aerobic training is better at mitigating symptoms of cancer-related fatigue and reduces the risk of post exercise malaise.[33] Physical activities should be tailored to individual needs and physical abilities.[34]
  • Side effects from medications: Fatigue and sleepiness are known side effects with some kinds of medications. Sometimes a change of medication, the dose, or the timing of the medication may result in less fatigue. For example, an antihistamine might be taken shortly before sleep, rather than in the middle of the day.
  • Substance abuse: Alcohol, marijuana, and many other drugs can produce fatigue as a side effect.
  • Other medical conditions: Cancer and its treatment usually put intense physical stress on the body, which can exacerbate other medical conditions. Additionally, fatigue may result from an infection.[3]

Prognosis

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Fatigue caused by the cancer or its treatment often resolves if treatment is successful. However, some patients experience long-term or chronic fatigue. When strict definitions are used, about 20% of long-term, disease-free cancer survivors report fatigue.[2] Under looser definitions, up to half of cancer survivors report fatigue.[2] However, these studies are largely limited to patients with breast cancer, or peripheral stem cell transplant or bone marrow transplant patients, and the incidence may be different for survivors of other cancers.

Experiencing fatigue before treatment, being depressed or anxious, getting too little exercise, and having other medical conditions are all associated with higher levels of fatigue in post-treatment cancer survivors.[2] Receiving multiple types of treatments, such as chemotherapy and radiation, is associated with more fatigue.[3] Older adults have a higher risk of long-term fatigue.[3]

[edit]

Cancer-related fatigue has consistently been found to be one of the most prevalent and distressing symptoms in childhood cancer survivors.[35] The International Late Effects of Childhood Cancer Guidelines Harmonization Group (IGHG) has published recommendations regarding the surveillance of fatigue in survivors of childhood cancer.[36] These recommendations include regular screenings of fatigue in survivors of childhood cancer. Survivors of pediatric brain tumors report more fatigue after end of treatment than survivors of acute lymphoblastic leukemia, but both groups experience more fatigue than healthy children and adolescents.[37] While considered a long-term effect of the treatment, children and adolescents experience fatigue already during the treatment for acute lymphoblastic leukemia and this side-effect of treatment remains in some patients after the treatment has ended.[38] Fatigue after treatment for pediatric brain tumors does not automatically resolve itself, but requires surveillance and interventions.[39]

[edit]

Cancer-related fatigue in older adults is the most distressing symptom of cancer, as described by those still undergoing treatment and survivors alike. This is especially distressing for older adults, as 60% of cancer diagnoses are in people 65 and up.[40] An issue with identifying the cause of cancer-related fatigue is the potential of comorbidities. Beyond cancer and treatment related fatigue, older adults may suffer from frailty syndrome or various age-related issues. Moreover, there is a rise in fatigue reported in older adults when compared to studies of the past.[41] Some existing methods of treating fatigue in older adults include exercise, education, and prescribing antidepressants.[42] Depression is especially prevalent in older adults with cancer. The existence of depressive symptoms in an already at risk group further exacerbates the decreased quality of life in this group. Due to the other comorbidities existing in this group, depression is often overlooked, which contributes to why older adults with cancer are one of the most at-risk groups for committing suicide.[43] Fatigue in older adults with cancer is a long lasting and dangerous symptom that requires surveillance and informed aid.

References

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  1. ^ Hofman, Maarten; Ryan, Julie L.; Figueroa-Moseley, Colmar D.; Jean-Pierre, Pascal; Morrow, Gary R. (2007-05-01). "Cancer-Related Fatigue: The Scale of the Problem". The Oncologist. 12 (S1): 4–10. doi:10.1634/theoncologist.12-s1-4. ISSN 1083-7159. PMID 17573451.
  2. ^ a b c d e f g h i j k l m "NCCN Clinical Practice Guidelines in Oncology: Cancer-Related Fatigue" (PDF) (Version 1.2010 ed.). National Comprehensive Cancer Network. 22 January 2010.
  3. ^ a b c d e f g h "Fatigue". National Cancer Institute. 1980-01-01. Retrieved 6 October 2010.
  4. ^ a b Kang, Ye-Eun; Yoon, Ji-Hae; Park, Na-Hyun; Ahn, Yo-Chan; Lee, Eun-Jung; Son, Chang-Gue (2023-08-07). "Prevalence of cancer-related fatigue based on severity: a systematic review and meta-analysis". Scientific Reports. 13 (1): 12815. Bibcode:2023NatSR..1312815K. doi:10.1038/s41598-023-39046-0. ISSN 2045-2322. PMC 10406927. PMID 37550326.
  5. ^ a b Matsunaga, Masaaki; He, Yupeng; Khine, May Thet; Shi, Xuliang; Okegawa, Ryusei; Li, Yuanying; Yatsuya, Hiroshi; Ota, Atsuhiko (2024-02-28). "Prevalence, severity, and risk factors of cancer-related fatigue among working cancer survivors: a systematic review and meta-analysis". Journal of Cancer Survivorship: Research and Practice. doi:10.1007/s11764-024-01557-8. ISSN 1932-2267. PMID 38418754.
  6. ^ Saligan LN, Olson K, Filler K, Larkin D, Cramp F, Yennurajalingam S, et al. (August 2015). "The biology of cancer-related fatigue: a review of the literature". Supportive Care in Cancer. 23 (8): 2461–2478. doi:10.1007/s00520-015-2763-0. PMC 4484308. PMID 25975676.
  7. ^ a b Thong MS, van Noorden CJ, Steindorf K, Arndt V (February 2020). "Cancer-Related Fatigue: Causes and Current Treatment Options". Curr Treat Options Oncol. 21 (2): 17. doi:10.1007/s11864-020-0707-5. PMC 8660748. PMID 32025928.
  8. ^ Randall J, Haque W, Butler EB, Teh BS (March 2019). "Cancer related fatigue in prostate cancer". Translational Andrology and Urology. 8 (Suppl 1): S106 – S108. doi:10.21037/tau.2018.12.06. PMC 6511691. PMID 31143682.
  9. ^ a b Luo YH, Yang YW, Wu CF, Wang C, Li WJ, Zhang HC (July 2021). "Fatigue prevalence in men treated for prostate cancer: A systematic review and meta-analysis". World J Clin Cases. 9 (21): 5932–5942. doi:10.12998/wjcc.v9.i21.5932. PMC 8316927. PMID 34368311.
  10. ^ a b Ho, Rainbow T. H.; Fong, Ted C. T.; Cheung, Irene K. M. (December 2014). "Cancer-related fatigue in breast cancer patients: factor mixture models with continuous non-normal distributions". Quality of Life Research. 23 (10): 2909–2916. doi:10.1007/s11136-014-0731-7. ISSN 0962-9343. PMID 24899547.
  11. ^ Wallis, Amy; Meredith, Pamela; Stanley, Mandy (April 2020). "Cancer care and occupational therapy: A scoping review". Australian Occupational Therapy Journal. 67 (2): 172–194. doi:10.1111/1440-1630.12633. ISSN 0045-0766. PMID 31957031.
  12. ^ Zhang, Ya-Bin; Zhong, Xue-Mei; Han, Ni; Tang, Huang; Wang, Shui-Yu; Lin, Wen-Xuan (2023-02-07). "Effectiveness of exercise interventions in the management of cancer-related fatigue: a systematic review of systematic reviews". Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 31 (3): 153. doi:10.1007/s00520-023-07619-4. ISSN 1433-7339. PMID 36746815.
  13. ^ Jose Stephy, Diwan Sanjay Kumar. Effect of standardized exercise program on reported fatigue in patients of cancer receiving chemotherapy. Clinical Cancer Investigation Journal 3(5): 373-376
  14. ^ Mishra, Shiraz I.; Scherer, Roberta W.; Geigle, Paula M.; Berlanstein, Debra R.; Topaloglu, Ozlem; Gotay, Carolyn C.; Snyder, Claire (2012-08-15). "Exercise interventions on health-related quality of life for cancer survivors". The Cochrane Database of Systematic Reviews. 2012 (8): CD007566. doi:10.1002/14651858.CD007566.pub2. ISSN 1469-493X. PMC 7387117. PMID 22895961.
  15. ^ a b Cramp F, Byron-Daniel J (November 2012). "Exercise for the management of cancer-related fatigue in adults". The Cochrane Database of Systematic Reviews. 11 (11): CD006145. doi:10.1002/14651858.CD006145.pub3. PMC 8480137. PMID 23152233.
  16. ^ Chen, Xiaoli; Li, Juejin; Chen, Chongcheng; Zhang, Yalin; Zhang, Shu; Zhang, Yun; Zhou, Lin; Hu, Xiaolin (2023-06-13). "Effects of exercise interventions on cancer-related fatigue and quality of life among cancer patients: a meta-analysis". BMC Nursing. 22 (1): 200. doi:10.1186/s12912-023-01363-0. ISSN 1472-6955. PMC 10261838. PMID 37312185.
  17. ^ Thompson, Paul D.; Arena, Ross; Riebe, Deborah; Pescatello, Linda S. (July–August 2013). "ACSM's New Preparticipation Health Screening Recommendations from ACSM's Guidelines for Exercise Testing and Prescription". Current Sports Medicine Reports. 12 (4) (Ninth ed.): 215–217. doi:10.1249/JSR.0b013e31829a68cf. ISSN 1537-8918. PMID 23851406.
  18. ^ Wu, Tong; Yan, Fanghong; Wei, Yuanyuan; Yuan, Chenlu; Jiao, Yanxia; Pan, Yayan; Zhang, Yilin; Zhang, Hongyan; Ma, Yuxia; Han, Lin (2023-12-01). "Effect of Exercise Therapy on Cancer-Related Fatigue in Patients With Breast Cancer: A Systematic Review and Network Meta-analysis". American Journal of Physical Medicine & Rehabilitation. 102 (12): 1055–1062. doi:10.1097/PHM.0000000000002277. ISSN 1537-7385. PMID 37204936.
  19. ^ a b c d Song, Jihong; Wang, Tao; Wang, Yujie; Li, Rong; Niu, Sitian; Zhuo, Litao; Guo, Qian; Li, Xiaomei (2021-03-01). "The Effectiveness of Yoga on Cancer-Related Fatigue: A Systematic Review and Meta-Analysis". Oncology Nursing Forum. 48 (2): 207–228. doi:10.1188/21.onf.207-228. ISSN 0190-535X. PMID 33600394.
  20. ^ a b c Yin, Jianchun; Tang, Lijun; Dishman, Rodney K. (2020-10-01). "The efficacy of Qigong practice for cancer-related fatigue: A systematic review and meta-analysis of randomized controlled trials". Mental Health and Physical Activity. 19: 100347. doi:10.1016/j.mhpa.2020.100347. ISSN 1755-2966.
  21. ^ a b c d Chayadi, Ellentika; Baes, Naomi; Kiropoulos, Litza (2022-07-14). "The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis". PLOS ONE. 17 (7): e0269519. Bibcode:2022PLoSO..1769519C. doi:10.1371/journal.pone.0269519. ISSN 1932-6203. PMC 9282451. PMID 35834503.
  22. ^ Belloni, Silvia; Caruso, Rosario; Giacon, Chiara; Baroni, Irene; Conte, Gianluca; Magon, Arianna; Arrigoni, Cristina (2024-04-01). "Microbiome-Modifiers for Cancer-Related Fatigue Management: A Systematic Review". Seminars in Oncology Nursing. Patient Navigation. 40 (2): 151619. doi:10.1016/j.soncn.2024.151619. hdl:2434/1040369. ISSN 0749-2081. PMID 38503656.
  23. ^ Mazlan, Ain Noor Farieha; Tuan Rusli, Nabila Afiqah; Wee, Lei Hum; Ahmad, Mahadir; Chan, Caryn Mei Hsien (2024-11-20). "Nurse-Led Interventions in Managing Cancer-Related Fatigue: A Systematic Review". Cancer Nursing: 10.1097/NCC.0000000000001409. doi:10.1097/NCC.0000000000001409. ISSN 0162-220X. PMID 39259694.
  24. ^ Li, Yongchao; Zhang, Wencai; Zeng, Xiaochun; Zhou, Lu; He, Wenjuan; Peng, Yadong (2024-12-29). "Influence of melatonin supplementation on cancer-related fatigue: a meta-analysis of randomized controlled trials". Clinical and Translational Oncology. doi:10.1007/s12094-024-03824-7. ISSN 1699-3055. PMID 39733381.
  25. ^ Breitbart W, Alici Y (August 2010). "Psychostimulants for cancer-related fatigue". Journal of the National Comprehensive Cancer Network. 8 (8): 933–942. doi:10.6004/jnccn.2010.0068. PMID 20870637.
  26. ^ Minton O, Richardson A, Sharpe M, Hotopf M, Stone PC (April 2011). "Psychostimulants for the management of cancer-related fatigue: a systematic review and meta-analysis". Journal of Pain and Symptom Management. 41 (4): 761–767. doi:10.1016/j.jpainsymman.2010.06.020. PMID 21251796.
  27. ^ Gong S, Sheng P, Jin H, He H, Qi E, Chen W, et al. (2014). "Effect of methylphenidate in patients with cancer-related fatigue: a systematic review and meta-analysis". PLOS ONE. 9 (1): e84391. Bibcode:2014PLoSO...984391G. doi:10.1371/journal.pone.0084391. PMC 3885551. PMID 24416225.
  28. ^ Yennurajalingam S, Bruera E (2014). "Review of clinical trials of pharmacologic interventions for cancer-related fatigue: focus on psychostimulants and steroids". Cancer Journal. 20 (5): 319–324. doi:10.1097/PPO.0000000000000069. PMID 25299141. S2CID 29351114.
  29. ^ Minton, Ollie; Richardson, Alison; Sharpe, Michael; Hotopf, Matthew; Stone, Patrick C. (April 2011). "Psychostimulants for the Management of Cancer-Related Fatigue: A Systematic Review and Meta-Analysis". Journal of Pain and Symptom Management. 41 (4): 761–767. doi:10.1016/j.jpainsymman.2010.06.020. ISSN 0885-3924. PMID 21251796.
  30. ^ Lin, Shuanglan; Chen, Yanhan; Yang, Liu; Zhou, Jianrong (May 2013). "Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients". Journal of Clinical Nursing. 22 (9–10): 1281–1290. doi:10.1111/jocn.12228. ISSN 0962-1067. PMID 23574291.
  31. ^ Klasson, Caritha; Helde Frankling, Maria; Lundh Hagelin, Carina; Björkhem-Bergman, Linda (January 2021). "Fatigue in Cancer Patients in Palliative Care—A Review on Pharmacological Interventions". Cancers. 13 (5): 985. doi:10.3390/cancers13050985. ISSN 2072-6694. PMC 7956665. PMID 33652866.
  32. ^ Brown JC, Huedo-Medina TB, Pescatello LS, Pescatello SM, Ferrer RA, Johnson BT (January 2011). "Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis". Cancer Epidemiology, Biomarkers & Prevention. 20 (1): 123–133. doi:10.1158/1055-9965.epi-10-0988. PMID 21051654.
  33. ^ Kessels E, Husson O, van der Feltz-Cornelis CM (2018). "The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis". Neuropsychiatric Disease and Treatment. 14 (14): 479–494. doi:10.2147/ndt.s150464. PMC 5810532. PMID 29445285.
  34. ^ Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, et al. (July 2010). "American College of Sports Medicine roundtable on exercise guidelines for cancer survivors". Medicine and Science in Sports and Exercise. 42 (7): 1409–1426. doi:10.1249/MSS.0b013e3181e0c112. PMID 20559064. S2CID 43598402.
  35. ^ Spathis A, Booth S, Grove S, Hatcher H, Kuhn I, Barclay S (March 2015). "Teenage and Young Adult Cancer-Related Fatigue Is Prevalent, Distressing, and Neglected: It Is Time to Intervene. A Systematic Literature Review and Narrative Synthesis". Journal of Adolescent and Young Adult Oncology. 4 (1): 3–17. doi:10.1089/jayao.2014.0023. PMC 4365509. PMID 25852970.
  36. ^ Christen S, Roser K, Mulder RL, Ilic A, Lie HC, Loonen JJ, et al. (December 2020). "Recommendations for the surveillance of cancer-related fatigue in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group". Journal of Cancer Survivorship. 14 (6): 923–938. doi:10.1007/s11764-020-00904-9. PMC 7572340. PMID 32839902.
  37. ^ Irestorm E, Tonning Olsson I, Johansson B, Øra I (April 2020). "Cognitive fatigue in relation to depressive symptoms after treatment for childhood cancer". BMC Psychology. 8 (1): 31. doi:10.1186/s40359-020-00398-1. PMC 7146960. PMID 32272971.
  38. ^ Irestorm E, Steur LM, Kaspers GJ, Van Eijkelenburg NK, Van der Sluis IM, Dors N, et al. (December 2022). "Fatigue trajectories during pediatric ALL therapy are associated with fatigue after treatment: a national longitudinal cohort study". Supportive Care in Cancer. 31 (1): 1. doi:10.1007/s00520-022-07456-x. PMC 9747814. PMID 36512099.
  39. ^ Irestorm, Elin; van Gorp, Marloes; Twisk, Jos; Nijhof, Sanne; de Bont, Judith; Grootenhuis, Martha; van Litsenburg, Raphaele (2023-09-07). "Longitudinal development of fatigue after treatment for childhood cancer: a national cohort study". Acta Oncologica. 62 (10): 1309–1321. doi:10.1080/0284186X.2023.2254477. ISSN 0284-186X. PMID 37676687.
  40. ^ Giacalone, A.; Quitadamo, D.; Zanet, E.; Berretta, M.; Spina, M.; Tirelli, U. (2013-10-01). "Cancer-related fatigue in the elderly". Supportive Care in Cancer. 21 (10): 2899–2911. doi:10.1007/s00520-013-1897-1. ISSN 1433-7339. PMID 23852408.
  41. ^ Louise, André; Gabriel, Antherieu; Amélie, Boinet; Judith, Bret; Thomas, Gilbert; Rabia, Boulahssass; Claire, Falandry (January 2022). "Oncological Treatment-Related Fatigue in Oncogeriatrics: A Scoping Review". Cancers. 14 (10). doi:10.3390/cancer (inactive 24 April 2025). ISSN 2072-6694. Archived from the original on 2025-03-21.{{cite journal}}: CS1 maint: DOI inactive as of April 2025 (link)
  42. ^ Rao, Arati; Cohen, Harvey Jay (2004-07-01). "Symptom Management in the Elderly Cancer Patient: Fatigue, Pain, and Depression". JNCI Monographs. 2004 (32): 150–157. doi:10.1093/jncimonographs/lgh031. ISSN 1052-6773. PMID 15263059.
  43. ^ Saracino, Rebecca M.; Nelson, Christian J. (2019-09-01). "Identification and treatment of depressive disorders in older adults with cancer". Journal of Geriatric Oncology. 10 (5): 680–684. doi:10.1016/j.jgo.2019.02.005. ISSN 1879-4068. PMC 7457378. PMID 30797709.
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