Cancer-related fatigue

Fatigue is a common and debilitating symptom experienced by patients with cancer. Cancer-related fatigue (CRF) is characterized by feelings of physical and mental tiredness, weakness, and lack of energy and is not changed by rest or sleep. CRF is distinct from the normal tiredness experienced by healthy individuals, e. g., after physical activity. CRF occurs both as a consequence of the disease itself and as a side effect of cancer treatment, although the precise pathophysiology is largely unknown. CRF is reported by as many as 40% of patients at diagnosis, and nearly all patients expect fatigue from cancer therapy. Up to 90% of patients treated with radiation and 80% of those treated with chemotherapy experience fatigue. CRF continues for months or even years following treatment in approximately one-third of cancer patients with cancer. The impact of CRF on daily living and patient's quality of life is remarkable. In addition, CRF is associated with considerable psychological distress and can lead to a significant financial burden by limiting a patient's ability to work. Despite its high relevance for patients and practitioners, research in the area of cancer-related fatigue lags behind attention that has been given to other cancer-related symptoms. This paper seeks to give a systematic overview of cancer-related fatigue and non-pharmacological interventions for the effective clinical management of CRF.