Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation
Identifieur interne : 002547 ( Main/Exploration ); précédent : 002546; suivant : 002548Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation
Auteurs : Julienne E. Bower ; Kate Bak ; Ann Berger ; William Breitbart ; Carmelita P. Escalante ; Patricia A. Ganz ; Hester Hill Schnipper ; Christina Lacchetti ; Jennifer A. Ligibel ; Gary H. Lyman ; Mohammed S. Ogaily ; William F. Pirl ; Paul B. JacobsenSource :
- Journal of Clinical Oncology [ 0732-183X ] ; 2014.
Abstract
This guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment.
A systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation.
It is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment.
Fatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors.
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DOI: 10.1200/JCO.2013.53.4495
PubMed: 24733803
PubMed Central: 4039870
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Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Bak, Kate" sort="Bak, Kate" uniqKey="Bak K" first="Kate" last="Bak">Kate Bak</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Berger, Ann" sort="Berger, Ann" uniqKey="Berger A" first="Ann" last="Berger">Ann Berger</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. 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Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Escalante, Carmelita P" sort="Escalante, Carmelita P" uniqKey="Escalante C" first="Carmelita P." last="Escalante">Carmelita P. Escalante</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Ganz, Patricia A" sort="Ganz, Patricia A" uniqKey="Ganz P" first="Patricia A." last="Ganz">Patricia A. Ganz</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. 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Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Lacchetti, Christina" sort="Lacchetti, Christina" uniqKey="Lacchetti C" first="Christina" last="Lacchetti">Christina Lacchetti</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Ligibel, Jennifer A" sort="Ligibel, Jennifer A" uniqKey="Ligibel J" first="Jennifer A." last="Ligibel">Jennifer A. Ligibel</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Lyman, Gary H" sort="Lyman, Gary H" uniqKey="Lyman G" first="Gary H." last="Lyman">Gary H. Lyman</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Ogaily, Mohammed S" sort="Ogaily, Mohammed S" uniqKey="Ogaily M" first="Mohammed S." last="Ogaily">Mohammed S. Ogaily</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Pirl, William F" sort="Pirl, William F" uniqKey="Pirl W" first="William F." last="Pirl">William F. Pirl</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. 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Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. 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Bower</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Bak, Kate" sort="Bak, Kate" uniqKey="Bak K" first="Kate" last="Bak">Kate Bak</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Berger, Ann" sort="Berger, Ann" uniqKey="Berger A" first="Ann" last="Berger">Ann Berger</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Breitbart, William" sort="Breitbart, William" uniqKey="Breitbart W" first="William" last="Breitbart">William Breitbart</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Escalante, Carmelita P" sort="Escalante, Carmelita P" uniqKey="Escalante C" first="Carmelita P." last="Escalante">Carmelita P. Escalante</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Ganz, Patricia A" sort="Ganz, Patricia A" uniqKey="Ganz P" first="Patricia A." last="Ganz">Patricia A. Ganz</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Schnipper, Hester Hill" sort="Schnipper, Hester Hill" uniqKey="Schnipper H" first="Hester Hill" last="Schnipper">Hester Hill Schnipper</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Lacchetti, Christina" sort="Lacchetti, Christina" uniqKey="Lacchetti C" first="Christina" last="Lacchetti">Christina Lacchetti</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Ligibel, Jennifer A" sort="Ligibel, Jennifer A" uniqKey="Ligibel J" first="Jennifer A." last="Ligibel">Jennifer A. Ligibel</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Lyman, Gary H" sort="Lyman, Gary H" uniqKey="Lyman G" first="Gary H." last="Lyman">Gary H. Lyman</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Ogaily, Mohammed S" sort="Ogaily, Mohammed S" uniqKey="Ogaily M" first="Mohammed S." last="Ogaily">Mohammed S. Ogaily</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Pirl, William F" sort="Pirl, William F" uniqKey="Pirl W" first="William F." last="Pirl">William F. Pirl</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author><author><name sortKey="Jacobsen, Paul B" sort="Jacobsen, Paul B" uniqKey="Jacobsen P" first="Paul B." last="Jacobsen">Paul B. Jacobsen</name><affiliation><nlm:aff id="aff1">Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology–Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.</nlm:aff><wicri:noCountry code="subfield">FL.</wicri:noCountry></affiliation></author></analytic><series><title level="j">Journal of Clinical Oncology</title><idno type="ISSN">0732-183X</idno><idno type="eISSN">1527-7755</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>This guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment.</p></sec><sec><title>Methods</title><p>A systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation.</p></sec><sec><title>Results</title><p>It is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment.</p></sec><sec><title>Conclusion</title><p>Fatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Bak, Kate" sort="Bak, Kate" uniqKey="Bak K" first="Kate" last="Bak">Kate Bak</name><name sortKey="Berger, Ann" sort="Berger, Ann" uniqKey="Berger A" first="Ann" last="Berger">Ann Berger</name><name sortKey="Bower, Julienne E" sort="Bower, Julienne E" uniqKey="Bower J" first="Julienne E." last="Bower">Julienne E. Bower</name><name sortKey="Breitbart, William" sort="Breitbart, William" uniqKey="Breitbart W" first="William" last="Breitbart">William Breitbart</name><name sortKey="Escalante, Carmelita P" sort="Escalante, Carmelita P" uniqKey="Escalante C" first="Carmelita P." last="Escalante">Carmelita P. Escalante</name><name sortKey="Ganz, Patricia A" sort="Ganz, Patricia A" uniqKey="Ganz P" first="Patricia A." last="Ganz">Patricia A. Ganz</name><name sortKey="Jacobsen, Paul B" sort="Jacobsen, Paul B" uniqKey="Jacobsen P" first="Paul B." last="Jacobsen">Paul B. Jacobsen</name><name sortKey="Lacchetti, Christina" sort="Lacchetti, Christina" uniqKey="Lacchetti C" first="Christina" last="Lacchetti">Christina Lacchetti</name><name sortKey="Ligibel, Jennifer A" sort="Ligibel, Jennifer A" uniqKey="Ligibel J" first="Jennifer A." last="Ligibel">Jennifer A. Ligibel</name><name sortKey="Lyman, Gary H" sort="Lyman, Gary H" uniqKey="Lyman G" first="Gary H." last="Lyman">Gary H. Lyman</name><name sortKey="Ogaily, Mohammed S" sort="Ogaily, Mohammed S" uniqKey="Ogaily M" first="Mohammed S." last="Ogaily">Mohammed S. Ogaily</name><name sortKey="Pirl, William F" sort="Pirl, William F" uniqKey="Pirl W" first="William F." last="Pirl">William F. Pirl</name><name sortKey="Schnipper, Hester Hill" sort="Schnipper, Hester Hill" uniqKey="Schnipper H" first="Hester Hill" last="Schnipper">Hester Hill Schnipper</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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