How Can We Improve Our Approach to Cancer-Related Fatigue?

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Cancer-related fatigue is one of the most underestimated and least researched side effects, said an oncology consultant who spoke at the European Society for Medical Oncology's 2023 Conference.

Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit.MADRID — Cancer-related fatigue is common but often undertreated. Similarly, its impact is underestimated. These were the messages delivered by speakers at the European Society for Medical Oncology's 2023 Conference during a session titled"The Multiple Faces of Fatigue in the Cancer Ecosystem.

What exactly is this fatigue? According to the definition set out in the ESMO 2020 recommendations and repeated word for word in the latest recommendations issued by the National Comprehensive Cancer Network published on October 6, cancer-related fatigue is"a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.

There are several tools available to enable this screening, she noted. The EORTC Core Quality of Life Questionnaire is a three-item subscale evaluating the symptoms of fatigue, weakness, and lack of energy. The MD Anderson Symptom Inventory assesses fatigue, sleep disorders, and drowsiness. The numeric rating scale for fatigue is an 11-point visual self-assessment scale comprising a single element, with 0 representing no fatigue and 10 representing intense fatigue.

In addition, to assess fatigue, the diagnostic process consists of documenting the start, type, and duration of the fatigue, as well as the presence of attenuating factors and interference with activities of daily living and leisure activities. The ESMO recommendations indicate that, according to the results of randomized clinical trials and systematic literature reviews, physical exercise can be recommended in patients with cancer who do not have cachexia .

Finally, psychosocial interventions in the form of information, advice, psychoeducation, and cognitive-behavioral therapy are useful tools .

 

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