CANCER-RELATED FATIGUE

Evidence-based recommendation for surveillance of cancer-related fatigue a (IGHG b)

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

On this page you can find:

Click here, to read this recommendation in PLAIN language.

Who is at risk for cancer-related fatigue?

All CAYA cancer survivors are at risk for cancer-related fatigue c

What surveillance modality should be used and at what frequency should it be performed?

All CAYA cancer survivors:

  • Medical history focused on survivors’ feelings of tiredness and exhaustion d
    regularly (at every long-term follow-up visit, or at general medical check-ups)

What should be done if there is an indication for cancer-related fatigue from the medical history?

  • Perform further testing with a validated fatigue measure e
  • Screen for physical problems that may cause fatigue f

What should be done if abnormalities are identified?

  • Refer to a specialist in fatigue (or more generic specialist such as a psychologist, physiotherapist, or other relevant specialist)
  • Discuss useful interventions g

Disclaimer

While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

a Cancer-related fatigue is defined as “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”.

b This recommendation reflects the recommendations of the preliminary evidence-based IGHG Fatigue guideline. The guideline will be published in a peer-reviewed journal soon.

c Main risk factors for cancer-related fatigue in CAYA cancer survivors are psychological distress, late effects or health problems, pain, older age at follow-up and radiotherapy.

d Questions to ask: “Do you get tired easily?”, or “Are you too tired or exhausted to enjoy the things you like to do?”

e Ideally, the PROMIS Pediatric Fatigue Measure or the PedsQL Multidimensional Fatigue Scale.

f For example other late effects like cardiac dysfunction, endocrine dysfunction, pulmonary dysfunction, and renal dysfunction (IGHG guidelines under development); and/or other general causes like anaemia, arthritis, neuromuscular complications, pain, fever and/or infection, and nutritional deficiencies (list not conclusive).

g Physical activity, education about cancer-related fatigue, relaxation and mindfulness, cognitive behavioural therapy, adventure-based training.