Management Of Fatigue In Adult Survivors Of Cancer

Publication Date: May 16, 2024
Last Updated: May 16, 2024

Treatment

Summary of Recommendations During Active Cancer Treatment

General Note: The following recommendations (strong or conditional) represent reasonable options for patients depending on clinical circumstances and in the context of individual patient preferences.
Recommended care should be accessible to patients whenever possible.

Recommendation 1.1

Clinicians should recommend exercise (aerobic, resistance, or a combination) to reduce the severity of fatigue during cancer treatment. Exercise should be tailored according to the individual patient’s abilities and may be either supervised or unsupervised. (M, S)
Note: Benefits for fatigue have consistently been seen with interventions that combine aerobic and resistance training, as well as resistance-only interventions. The choice of exercise modality, intensity, and duration should be based on several important considerations, including patient preference, availability, accessibility, likelihood of adherence, safety, and cost.
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Recommendation 1.2

Clinicians should recommend cognitive behavioral therapy (CBT) with or without hypnosis to reduce the severity of cancer-related fatigue in adults undergoing cancer treatment. (M, S)
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Recommendation 1.3

Clinicians should recommend mindfulness-based programs to reduce the severity of cancer-related fatigue in adults undergoing cancer treatment. Mindfulness-based programs may include mindfulness-based stress reduction (MBSR). (M, S)
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Recommendation 1.4

Clinicians should recommend tai chi or qigong, practiced at a low to moderate intensity, to reduce the severity of cancer-related fatigue in adults undergoing cancer treatment. (M, S)
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Recommendation 1.5

Clinicians may recommend psychoeducation to reduce the severity of cancer-related fatigue in adults undergoing cancer treatment. (M, C)
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Recommendation 1.6

Clinicians may recommend American ginseng (Panax quinquefolius) at a dose of 2000 mg daily to manage symptoms of cancer-related fatigue in adults undergoing cancer treatment. (L, C)
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Recommendation 1.7

Clinicians should not recommend wakefulness agents, such as modafinil or armodafinil, to manage symptoms of cancer-related fatigue in adults undergoing cancer treatment. (M, S)
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Recommendation 1.8

Clinicians should not recommend L-carnitine to manage symptoms of cancer-related fatigue in adults undergoing cancer treatment. (L, C)
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Recommendation 1.9

Clinicians should not routinely recommend psychostimulants, such as methylphenidate, to manage symptoms of cancer-related fatigue in adults undergoing cancer treatment. (M, C)
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Recommendation 1.10

Clinicians should not recommend antidepressants, such as paroxetine, to manage symptoms of cancer-related fatigue in adults undergoing cancer treatment. (M, C)
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No Recommendation

There is insufficient evidence to make recommendations for or against acupressure, coenzyme Q10, guarana, brain wave vibration meditation, minocycline, music or music therapy, progressive muscle relaxation, reflexology, solution-focused therapy, or yoga to reduce the severity of cancer-related fatigue in adults undergoing cancer treatment. (No recommendation for or against; Ins)

Overview

Title

Management Of Fatigue In Adult Survivors Of Cancer

Authoring Organizations

American Society of Clinical Oncology

Society for Integrative Oncology