Cancer-related Fatigue

Prevalence, Assessment and Treatment Strategies

Joachim Weis


Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(4):441-446. 

In This Article

Five-year View

Although CRF is one of the most common symptoms in cancer patients and has been investigated within the last three decades, there is still a lack of understanding of the complexity of this syndrome and the various interactions between psychological and somatic factors. Although many factors associated with CRF have been identified, a comprehensive theoretical model for understanding the causes of CRF is still missing. Some standardized instruments have been developed which allow systematic assessment of CRF in clinical trials. Nevertheless, there is no gold standard for assessing CRF. The European Organisation for Research and Treatment of Cancer Quality of Life study group has developed a cross-cultural multidimensional fatigue module which may be regarded as a promising measurement tool for the future. Most treatment approaches are addressing supportive strategies or relieve of symptoms. Causal therapies are only possible in those cases where the causes of CRF are known (e.g., anemia). Among the supportive interventions, exercise and physical training show the best evidence and therefore are recommended in most clinical practice guidelines. In terms of pharmacologic treatment, no clear recommendation can be given. In particular, the relative benefits and side-effect profiles must be evaluated via randomized trials. In addition, the combination of various treatment approaches, including medication, should be addressed by future research. Although there has been substantial progress in research activities on CRF, this syndrome is still to be regarded as a great challenge for basic research, treatment and rehabilitation of cancer patients.


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