Abstract
Cancer-related fatigue (CRF) is the most common debilitating symptom in cancer, affecting almost 90% of cancer patients. CRF might persist for years after treatment. CRF is not relieved by rest or sleep, as opposed to a ‘burnout syndrome' in otherwise healthy persons. CRF is a disease entity by itself. Clinical studies have identified genetic, biological, psychosocial, and behavioral risk factors associated with CRF. Currently, there are limited intervention options to effectively treat CRF. Co-morbidities, as an attribute of increasing age and as contributors to CRF, should be diagnosed and treated either by pharmacological or by nonpharmacological interventions, similar to CRF. Chronic (neuro-)inflammation and chaotic (neuro-)immune signaling are up-coming biomarkers and targets for personalized treatment. Because of their proven anti-inflammatory properties, herbal remedies (Wisconsin ginseng, mistletoe extracts) have been used successfully in clinical trials to treat CRF. There are almost no adverse effects caused or amplified in combination with anti-cancer drugs and/or radiotherapy when the indispensable conventional first- or second-line therapies were supported (supportive care) by well-defined extracts from the plant kingdom. Patients currently suffering from CRF cannot wait for the ‘magic bullet', so for the time being, those observational results should be considered in clinical chemo- or chemo-radiotherapy protocols to fight against CRF and to increase quality of life.
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