Title:Cancer-Related Fatigue: Still an Enigma to be Solved Quickly
VOLUME: 9 ISSUE: 4
Author(s):Fausto Meriggi
Affiliation:ESMO designated Center of Integrated Oncology and Palliative Care, Oncology Department, Poliambulanza Foundation, Via Leonida Bissolati 57, Brescia, Italy.
Keywords:Cancer survivors, cancer-related fatigue, multidimensional syndrome, pharmacological treatment.
Abstract:Fatigue is the most common symptom in patients with advanced cancer and its prevalence
ranges between 50% to 90% overall. In cancer survivors, approximately 30% of patients will experience
persistent fatigue for a number of years after treatment. This complex, multidimensional symptom causes
disruption in many aspects of quality of life and becomes particularly problematic in the frail and elderly
patients. However, cancer-related fatigue is still less investigated and undertreated by the clinicians. Recent
guidelines focus on the importance to investigate this distressing symptom at the baseline visit and
then at regular intervals. There is no certainty on aetiology and pathogenesis, but it seems that proinflammatory
cytokine network is involved both during or after a therapy for cancer. After addressing reversible
or treatable contributing risk factors, the treatment can be pharmacologic and non-pharmacologic or combined but
it is still largely inadequate especially in case of moderate-severe cancer-related fatigue. Interventions should be tailored
to each patient’s specific needs. Finally, cancer-related fatigue has societal and economic costs with increased cancer care.
