Management of fatigue

Symptom control increasingly is recognized as an important component in the multidisciplinary management of cancer patients, as it allows for the successful completion of treatment and improves the quality of life throughout the course of the disease. Fatigue is one of the most common symptoms of cancer and cancer treatments. Cancer-related fatigue (CRF) is defined as a distressing, persistent, and subjective sense of tiredness or exhaustion that is not proportional to activity and that interferes with usual function. It is one of the most prevalent adverse side effects during and after therapy. CRF is exacerbated by co-occurring cancer-related side effects such as depression, anxiety, sleep disturbance, and pain. There is a wide range of fatigue occurrences among patients receiving radiation therapy, likely due to differences in type and stage of cancer, patient populations, types of radiotherapy, and assessment scales used. Severe subjective fatigue was reported by more than 75% of patients with advanced cancer in palliative care units, by 66% of patients with advanced cancer referred for palliative RT, and by 59% of patients with advanced lung cancer. There is limited research on CRF in patients receiving palliative radiation, and the available literature on fatigue is complicated by the multidisciplinary nature of cancer treatment. Furthermore, fatigue often is found as part of a cluster of symptoms, such as shortness of breath, anxiety, pain, and depression, which contributes to the difficulty of identifying the sensitivity and specificity of treatments targeting CRF.