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  • Review Article
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Cancer-related fatigue—mechanisms, risk factors, and treatments

Nature Reviews Clinical Oncology volume 11, pages 597–609 (2014)Cite this article

Subjects

Key Points

  • Fatigue is the most common adverse effect of cancer

  • Inflammation is a key mechanism of cancer-related fatigue

  • Host factors increase risk for fatigue in patients with cancer

  • Effective interventions include exercise and targeted psychological and mind–body treatments

Abstract

Fatigue is one of the most common adverse effects of cancer that might persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and might be a risk factor of reduced survival. The prevalence and course of fatigue in patients with cancer have been well characterized and there is growing understanding of the underlying biological mechanisms. Inflammation seems to have a key role in fatigue before, during, and after cancer-treatment. However, there is a considerable variability in the presentation of cancer-related fatigue, much of which is not explained by disease-related or treatment-related characteristics, suggesting that host factors might be important in the development and persistence of this symptom. Indeed, longitudinal studies have identified genetic, biological, psychosocial, and behavioural risk factors associated with cancer-related fatigue. Although no current gold-standard treatment for fatigue is available, a variety of intervention approaches have shown beneficial effects in randomized controlled trials, including physical activity, psychosocial, mind–body, and pharmacological treatments. This Review describes the mechanisms, risk factors, and possible interventions for cancer-related fatigue, focusing on recent longitudinal studies and randomized trials that have targeted fatigued patients.

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Figure 1: Mechanisms of cancer-related fatigue.

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Acknowledgements

The author acknowledges research support from the NIH/National Cancer Institute (grant 5R01CA160427).

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  1. Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, 90095-1563, CA, USA

    Julienne E. Bower

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Bower, J. Cancer-related fatigue—mechanisms, risk factors, and treatments. Nat Rev Clin Oncol 11, 597–609 (2014). https://doi.org/10.1038/nrclinonc.2014.127

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