Cancer-Related Fatigue

Cancer-related fatigue (CRF) is abundantly represented in most cancer populations and is highly distressing, causing significant psychological and functional morbidity. It does not receive enough attention from cancer clinicians as a certain amount of fatigue is expected from cancer and treatments. However, CRF is a distinct entity and category of fatigue that does not respond to usual restorative measures. This chapter reviews its definition, prevalence, pathophysiology, and assessment including unique contributory causes and distinguishing CRF from other symptoms such as depression and pain. Measurement tools are discussed. Strategies for the management of CRF including pharmacologic and nonpharmacologic interventions are reviewed and tips are provided. Evidence is presented for the use of psychostimulants and other drug therapy as well as exercise, psychotherapies, and mind-body interventions (e.g., yoga, acupuncture). CRF is a distinct entity with significant consequences for patients. Its assessment should be thorough and treatment directed toward underlying causes.