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Evolving concepts in evaluation and treatment
Article first published online: 22 SEP 2003
Copyright © 2003 American Cancer Society
Volume 98, Issue 9, pages 1786–1801, 1 November 2003
How to Cite
Stasi, R., Abriani, L., Beccaglia, P., Terzoli, E. and Amadori, S. (2003), Cancer-related fatigue. Cancer, 98: 1786–1801. doi: 10.1002/cncr.11742
- Issue published online: 22 OCT 2003
- Article first published online: 22 SEP 2003
- Manuscript Accepted: 31 JUL 2003
- Manuscript Revised: 18 JUN 2003
- Manuscript Received: 7 APR 2003
- quality of life;
Although fatigue is one of the most common complaints of patients with cancer, it went unrecognized or overlooked for many years, until clinicians achieved better control over the more acute symptoms of nausea, emesis, and pain. A number of treatment-related and disease-related factors may contribute to the development of fatigue, but its physiologic basis remains poorly understood, and many proposed interventions have not been studied systematically. The lack of a standard of care for the assessment or treatment of fatigue in patients with cancer has limited research in this field. A critical appraisal of these issues is presented in this review.
The published literature was reviewed for definition, prevalence, causes, and means of managing cancer-related fatigue (CRF).
Fatigue was reportedly present at the time of diagnosis in approximately 50–75% of cancer patients. The prevalence of CRF increased to 80–96% in patients undergoing chemotherapy and to 60–93% in patients receiving radiotherapy. Two tested interventions that showed consistent effects to alleviate CRF were treatment of cancer-related anemia with erythropoietin agents (recombinant human erythropoietin and darbepotin α) and aerobic exercise.
Several lines of research are needed to bridge the specific gaps in the current knowledge of CRF. These involve the pathophysiology of the symptom, the validation of diagnostic criteria, and specific therapeutic interventions. Current practice guidelines are based on a combination of research and expert clinical judgment and should be used to guide care with the expectation that they will evolve to incorporate the results of studies currently underway. Cancer 2003. © 2003 American Cancer Society.