Cancer-Related Fatigue Assessment and Management

Cancer-related fatigue is a persistent, distressing sense of tiredness or exhaustion that arises as a direct consequence of cancer or its treatment and is disproportionate to recent activity. It can compromise functional capacity, emotional wellbeing and overall quality of life throughout the cancer continuum, from diagnosis and active therapy to long-term survivorship. Accurate assessment relies on validated patient-reported outcome measures that capture multidimensional aspects of fatigue, including physical, cognitive and affective domains. Risk factors span biological (inflammation, anaemia, metabolic disturbance), psychological (depression, anxiety) and behavioural (sleep disruption, sedentary lifestyle) dimensions. Management is multimodal, encompassing exercise programmes, psychosocial interventions, nutritional support and pharmacological agents when indicated. Tailored exercise regimens combining aerobic and resistance training have demonstrated the greatest efficacy in both preventing and ameliorating fatigue. Cognitive–behavioural strategies, mindfulness and educational approaches address maladaptive beliefs and coping styles, while symptom-targeted pharmacotherapy may be considered for severe or refractory cases. Integrative supportive-care pathways increasingly emphasise early identification, ongoing monitoring and individualised intervention algorithms to promote optimal function and long-term wellbeing among patients and survivors worldwide.

Research from Nature Portfolio

Recent studies have reviewed long-term and delayed adverse effects of anticancer treatments, highlighting cancer-related fatigue as a predominant chronic concern. These analyses elucidate underlying biological mechanisms such as persistent inflammatory activation, neuroendocrine dysregulation and mitochondrial impairment. They critically evaluate existing pharmacological and non-pharmacological strategies, including exercise, behavioural therapies and nutritional modulation, and appraise clinical guidelines for fatigue management. Emerging supportive-care frameworks advocate for validated risk-assessment tools to identify patients at highest risk of severe or prolonged fatigue, enabling proactive and stratified intervention. Promising developments include integrative survivorship models that coordinate multidisciplinary teams to optimise symptom control and functional recovery over the long term.

Cancer-Related Fatigue Assessment and Management publication trend

The graph below shows the total number of articles in cancer-related fatigue assessment and management across all publications each year (not limited to Nature Index journals).

Technical terms

Cancer-Related Fatigue (CRF): A multidimensional, subjective experience of physical, emotional and cognitive exhaustion related to cancer or its treatment.

Patient-Reported Outcome Measures (PROMs): Standardised questionnaires completed by patients to assess symptoms, functional status and quality of life.

Growth Mixture Models: Statistical methods that identify distinct subgroups within longitudinal data, such as fatigue trajectories over time.

EORTC QLQ-FA12: A 12-item module of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire specifically measuring fatigue dimensions.

Cognitive–Behavioural Therapy (CBT): A structured psychological intervention targeting maladaptive thoughts and behaviours to alleviate symptoms such as fatigue.

References

1. Mitigating long-term and delayed adverse events associated with cancer treatment: implications for survivorship. Nature Reviews Clinical Oncology (2023).
2. Cancer-related fatigue trajectories up to 5 years after curative treatment for oesophageal cancer. British Journal of Cancer (2023).
3. Cancer-Related Fatigue: Causes and Current Treatment Options. Current Treatment Options in Oncology (2020).
4. A Narrative Review of Cancer-Related Fatigue (CRF) and Its Possible Pathogenesis. Cells (2019).
5. Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the “Fitter na kanker” Randomized Controlled Trial. Journal of Medical Internet Research (2017).
6. A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue. Current Oncology (2013).
7. The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials. Systematic Reviews (2019).