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Expert Panel Issues Clinical Guidelines for Cancer-Related Fatigue

Several treatment options are available

Fatigue is a debilitating problem for cancer patients undergoing treatment; however, it also poses a huge detriment after treatment and can significantly affect quality of life. Approximately 30% of cancer patients experience persistent fatigue for several years after treatment, according to an American Society of Clinical Oncology (ASCO) expert panel.

ASCO created the panel to develop assessment, screening, and treatment guidelines for medical professionals to help patients who experience fatigue after completing primary cancer treatment. To create the new recommendations, the panel analyzed several national guidelines from the U.S. and Canada and reviewed published studies about cancer-related fatigue.

The panel recommends that all health care professions regularly screen for and measure fatigue and other associated problems in cancer patients through the patients’ health histories, physical examinations, and laboratory analyses.

Fatigue in cancer patients after treatment can be caused by other problems, such as depression, pain, anxiety, nutritional deficits, medications, or emotional distress. The panel recommends that all contributing factors should be identified and treated before the symptoms of fatigue are addressed.

Several treatment and care options are available for patients experiencing continued fatigue. “Studies show that initiating or maintaining adequate levels of physical activity can reduce cancer-related fatigue in post-treatment patients,” said panel co-chair Paul Jacobsen, PhD. “Physicians should actively encourage all patients to engage in a moderate level of physical activity after cancer treatment, dependent on risk of injury.”

Behavioral and psycho-educational therapies have reduced fatigue in cancer patients. The panel recommends that patients interested in these options be referred to psychosocial service providers who specialize in cancer. Some studies also suggest that yoga, acupuncture, and mindfulness-based approaches may be beneficial.

The panel does not recommend the use of medications to alleviate fatigue in cancer patients after treatment. While some data suggest that medications can help patients with fatigue who have advanced disease or are receiving cancer treatment, there is insufficient evidence that these medications relieve fatigue in patients after treatment, the panel says.

The new guidelines were published in the Journal of Clinical Oncology.

Sources: Moffitt Cancer Center; May 30, 2014; and JCO; April 14, 2014.

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