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Management of Fatigue in Patients with Advanced Cancer



Stone, Patrick;

Candelmi, Diego Ezequiel;

Kandola, Kerran;

Montero, Ligia;

Smetham, Dom;

Suleman, Sahil;

Fernando, Asanga;

Stone, Patrick;

Candelmi, Diego Ezequiel;

Kandola, Kerran;

Montero, Ligia;

Smetham, Dom;

Suleman, Sahil;

Fernando, Asanga;

Rojí, Rocío;

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(2023)

Management of Fatigue in Patients with Advanced Cancer.

Current Treatment Options in Oncology


10.1007/s11864-022-01045-0.

Abstract

Opinion statement
Fatigue is a common and distressing symptom experienced by patients with cancer. It is most common in patients with locally advanced or metastatic incurable disease. It can have profound effects on quality-of-life and physical functioning. In addition to general supportive measures (directed at tackling contributory conditions and comorbidities), a variety of specific interventions have been developed which can be broadly categorised as physical therapies, psychological therapies or medication. There is some evidence that each of these approaches can have benefits in patients with earlier stage disease, those undergoing active treatment and in cancer survivors. The best evidence is for aerobic exercise, yoga, cognitive-behavioural therapy (CBT) and psycho-educational interventions. Less strong evidence supports the use of medications such as methylphenidate or ginseng. In patients with advanced disease, it is likely that the mechanisms of fatigue or the factors contributing to fatigue maintenance may be different. Relatively fewer studies have been undertaken in this group and the evidence is correspondingly weaker. The authors recommend the cautious use of aerobic exercise (e.g. walking) in those who are still mobile. The authors advise considering the use of psycho-educational approaches or CBT in those patients who are able to engage in such forms of therapy. In patients near the end-of-life, the authors advise use of dexamethasone (short-term use) and other pharmacological treatments only on the basis of a clinical trial.

Type: Article

Title: Management of Fatigue in Patients with Advanced Cancer
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11864-022-01045-0
Publisher version: https://doi.org/10.1007/s11864-022-01045-0
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Fatigue, Neoplasm, Palliative care, Therapeutics, Exercise, Psychotherapy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Marie Curie Palliative Care
URI: https://discovery.ucl.ac.uk/id/eprint/10163753
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