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Cited by 438Cancer survivorship and careCancer-related cognitive impairment studiesChildhood Cancer Survivors' Quality of Life

Cancer-Related Fatigue: Causes and Current Treatment Options

Open access
Thong, Melissa S.Y., van Noorden, Cornelis J. F., Steindorf, Karen, Arndt, Volker·2020·Current Treatment Options in Oncology
DOI 10.1007/s11864-020-0707-5PMC PMC8660748
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Abstract

Opinion statement: Cancer-related fatigue (CRF) is a problem for a significant proportion of cancer survivors during and after active cancer treatment. However, CRF is underdiagnosed and undertreated. Interventions are available for CRF although there is no gold standard. Based on current level of evidence, exercise seems to be most effective in preventing or ameliorating CRF during the active- and posttreatment phases.

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Crossref · 10.1007/s11864-020-0707-5

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  • Cancer-related fatigue (CRF) is a multi-factorial condition arising from a complex interplay of clinical, physiological, environmental, and psychosocial factors.

    “CRF is a multi-factorial condition affected by several interrelated protective and perpetuating factors.”

    From Exploring the dynamic interconnectedness of protective and perpetuating factors of cancer-related fatigue (2023) · cites this paper as [10]

    The “Mechanisms underlying CRF” section describes CRF as involving complex multifactorial processes linked to molecular/physiological, clinical, and psychological factors. It does not identify environmental factors or characterize those factors collectively as protective and perpetuating; the citing sentence is therefore more specific than the source supports. No page number is available in our copy. (LLM, conf=0.83)

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  • Physical activity training has proven effective and is recommended in guidelines for treating CRF.

    “Physical activity training has proven effective and is recommended in guidelines for treating CRF.10,42”

    From Exploring the dynamic interconnectedness of protective and perpetuating factors of cancer-related fatigue (2023) · cites this paper as [10]

    The Exercise/physical activity section reports that exercise interventions reduce CRF, and the Discussion recommends them as first-line treatment. However, the paper describes their efficacy as moderate and acknowledges uncertainty about exercise’s benefits in general; it does not explicitly say that guidelines recommend physical activity training. Thus, “proven effective” and “recommended in guidelines” overstate what this copy establishes. (LLM, conf=0.86)

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  • Rumination may be more important for fear of cancer recurrence, depression, and anxiety, perhaps because these outcomes are characterized by maladaptive cognitive coping styles, whereas fatigue can be understood more physiologically than cognitively.

    “Results suggest rumination may be more important for FCR, depression, and anxiety, perhaps because these outcomes are characterized by maladaptive cognitive coping styles, whereas fatigue can be understood more physiologically than cognitively.1,70”

    From Mindfulness and Psychosocial Symptoms in People with Cancer: Testing Rumination and Experiential Avoidance as Mediators, and Sex as a Moderator. (2025) · cites this paper as [70]

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  • Cancer-related fatigue mechanisms are not well understood but are thought to include multifactorial contributions from both the central and peripheral nervous systems, the hypothalamic-pituitary-adrenal axis, inflammatory cytokines, and energy metabolism.

    “CRF is particularly difficult to define, as its mechanisms are not well understood, but is thought to include multifactorial contributions from both the central and peripheral nervous systems, the hypothalamic-pituitary-adrenal (HPA) axis, inflammatory cytokines, and energy metabolism [reviewed by Thong et al. (2020)].”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Thong et al. 2020

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Authors
Thong, M. S. Y., van Noorden, C. J. F., Steindorf, K., & Arndt, V.
Affiliations
German Cancer Research Center (DE)
Corresponding author
Thong, Melissa S.Y.
ORCID
Venue
Current Treatment Options in Oncology
Publisher
Springer Science and Business Media LLC
Published
2020-02
Volume
21
Issue
2
Pages
17-17
ISSN
  • 1527-2729 (ISSN-L)
  • 1534-6277
DOI
10.1007/s11864-020-0707-5
PMC
PMC8660748
OpenAlex
W3004472565
Cited by
438
References
137
Citations by year
2026: 58 · 2025: 100 · 2024: 85 · 2023: 92 · 2022: 61 · 2021: 27 · 2020: 14 · 2018: 1
FWCI
5.21
Type
journal article
Language
en
Update notices
correction (2022-03-01)
Open access
Licence
Locations
  • Current Treatment Options in Oncology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Pfizer
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
Keywords
cancer-related fatigue, cancer survivors, exercise intervention, fatigue etiology, underdiagnosis, undertreatment, fatigue prevention
MeSH terms
Clinical Decision-Making, Cancer Survivors, Survivorship, Age Factors, Antineoplastic Combined Chemotherapy Protocols, Combined Modality Therapy, Disease Susceptibility, Fatigue, Humans, Neoplasms, Radiotherapy, Risk Factors, Comorbidity, Prevalence, Treatment Outcome, Disease Management

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