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Fatigue in Adult Cancer Survivors

By Lisa Schulmeister, MN, RN, ACNS-BC, OCN, FAAN
A panel convened by the American Society of Clinical Oncology (ASCO) conducted a systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature on fatigue in adult cancer survivors. The group identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation.

The group recommends that all patients with cancer are evaluated for the presence of fatigue after completion of primary treatment and are offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. Physical activity interventions, psychosocial interventions (e.g. cognitive behavioral therapy, educational therapies), and mind-body interventions (e.g. yoga, mindfulness) may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psycho-stimulants in the management of fatigue in patients who are disease free after active treatment. The panel concluded that multiple factors cause or contribute to fatigue and interventions should be tailored to each patient’s specific needs.

Bower JE, Bak K, Berger A, et al. Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation. J Clin Oncol, published online before print April 14, 2014, doi: 10.1200/JCO.2013.53.4495.
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