Cancer-related Fatigue In Adults Research Articles

Cancer-Related Fatigue (2018-2022).

Systematic review briefs provide a summary of the findings from systematic reviews evaluated in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings related to interventions addressing cancer-related fatigue in adults living with and beyond cancer.

Corticosteroids for the management of cancer-related fatigue in adults with advanced cancer.

Corticosteroids for the management of cancer-related fatigue in adults with advanced cancer.

The Role of Complementary and Alternative Medicine on Cancer-Related Fatigue in Adults: An Overview of Systematic Reviews.

Cancer-related fatigue (CRF) has an enormous adverse impact on quality of life and subsequent therapy of cancer patients. Complementary and alternative medicine (CAM) is reported to improve CRF in many systematic reviews (SRs), but the effects are controversial because of variations in the quality and outcomes. Thirteen databases were searched from inception to September 2022. Only SRs of randomized controlled trials (RCTs) were included. We assessed the quality of included SRs with the AMSTAR-2 tool, the strength of evidence with the GRADE system, the risk of bias with the ROBIS tool, and the integrity of SRs with the PRISMA checklist. We included 30 eligible SRs (27 meta-analyses). Based on the AMSTAR-2 tool, 29 SRs were rated as "critically low" quality, and only one was rated as "low" quality. With the ROBIS tool, 19 SRs demonstrated a low risk of bias. According to the PRISMA checklist, no SRs reported all the items, and 10 SRs sufficiently reported over 70%. Based on the GRADE system, 7 outcomes were assessed as high-quality evidence. This overview demonstrates promising evidence for the effectiveness of CAM interventions in the treatment of CRF in adults. The roles of qigong, music, auricular point therapy, and dietary supplements in CRF need further evaluation. Although findings are mixed, it is recommend to select appropriate CAM to manage cancer-related fatigue under the guidance of physicians. More studies with rigorous methodological designs and sufficient sample sizes are needed.

Physical activity for the management of cancer-related fatigue in adults

Physical activity for the management of cancer-related fatigue in adults

0500 Increased adherence to light therapy and psychosocial outcomes in adolescents and young adults with cancer

Abstract Introduction Adolescent/young adult (AYA) oncology patients consistently report fatigue as one of the most distressing symptoms during treatment. Bright white light (BWL) has been demonstrated to improve the symptoms of cancer-related fatigue in adults, and our prior research demonstrated feasibility, acceptability, and preliminary efficacy of BWL in AYA with cancer. As part of the trial examining the feasibility and acceptability of BWL in AYA, we explored whether adherence affected patient outcomes in the BWL group. Methods Twenty-seven participants were randomized to receive BWL using LiteBook® (retrofitted with adherence monitors) for 30 minutes upon waking daily for eight weeks. Study team members met with patients weekly for the duration of the intervention to download adherence data from the monitors, administer questionnaires, and discuss barriers to adherence if necessary. Participants completed mood, quality of life, and fatigue measures at every other research visit (5 times over the duration of the study). Results Adherence was characterized by total number of days that participants used the light device while on study. Multivariate regression was used to examine the predictive relationship between adherence and patient outcomes. Adherence significantly predicted parent-reported physical functioning [β=1.45, p= 0.0079], emotional functioning [β=0.87, p=0.0137], and total health-related quality of life [β= 0.76, p= 0.0218]. Adherence did not predict any of the self-reported patient outcomes. Conclusion BWL is a promising treatment to improve cancer-related fatigue in AYA, and adherence is essential to treatment success. Although adherence did not predict any participant self-reported outcomes, participants with better adherence had improved parent-reported emotional and physical functioning and overall quality of life. Individually tailored interventions, including sleep hygiene psychoeducation and motivational interviewing, may be used to increase adherence to light therapy to improve patient outcomes. Measures to monitor and foster adherence should be included in future light therapy trials. Support (If Any) This research was funded and supported by ALSAC.

Can improving quality of sleep reduce the symptoms of cancer-related fatigue in adults?: A systematic review.

PurposeCancer‐related fatigue (CRF) results in reduced quality of life for cancer patients. The relationship between tiredness and fatigue has been established in cancer patients and has been shown to be reciprocal, meaning the relationship is somewhat ‘chicken or the egg’ with tiredness influencing fatigue and vice versa. The aim of this study is to determine whether an improvement in sleep quality can ease the symptoms of CRF and whether this can support the theory that CRF symptoms stem from the effect of tiredness.MethodThree databases were searched producing 259 papers. The papers were filtered using several inclusion criteria, resulting in a final list of 20 papers for analysis. The remaining papers (20) were critically appraised using the Critical Appraisals Skills Programme (CASP) randomised control trial checklist and assessed for bias using the Cochrane Collaboration's tool for assessing risk of bias in randomised trials.ResultsFourteen papers showed an increase in sleep quality that also resulted in an improvement in fatigue symptoms. Cognitive behavioural therapy was shown to be the most effective intervention with a statistically significant decrease in fatigue alongside significant improvement in sleep quality shown in six of the papers (p < 0.05). Sleep education also had a positive impact on both sleep and fatigue scores with three papers showing significant improvements. Three papers focusing on exercise interventions produced a significant improvement in fatigue symptoms and quality of sleep.ConclusionImproving quality of sleep does ease the symptoms of CRF; however, the ‘chicken or the egg’ question regarding CRF and tiredness cannot be answered at this stage.

Corticosteroids for the management of cancer-related fatigue in adults with advanced cancer

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of corticosteroids compared with placebo, no intervention, or any active comparator (including supportive care or alternate non‐pharmacological treatment) in adults with cancer‐related fatigue.

Iranian Version of Cancer-Related Fatigue Questionnaire: Construction and Validation

Background: Patients with cancer experience various physical and psychological complications during treatment. Fatigue is a common and often disabling medical symptom in patients with cancer. Objectives: It is necessary to have a reliable and valid tool to examine cancer-related fatigue in adults with cancer. Methods: This descriptive study was conducted on 150 patients with cancer that had referred to Shahid Sadoughi Hospital (Yazd/Iran). Data were collected by a researcher-made questionnaire that was designed for fatigue assessment. The reliability was determined using the Cronbach’s alpha and test-retest method. Factor analysis was used in SPSS/21 software to verify construct validity. Results: Face validity and content validity was confirmed through an expert panel. According to experts’ suggestions, unnecessary items were removed and required changes were made in the questionnaire. According to the results of factor analysis, this questionnaire has three categories including: Daily activities and general problems (ten questions), sleep problems (nine questions), and mental states and emotions (five questions). Cronbach’s alpha was more than 0.8 for all dimensions and was 0.93 for the entire scale. Intra-class correlation coefficient (ICC) was in the range of 0.84 to 0.92; also, ICC was 0.92 for the total questionnaire and was close to one for all dimensions of the questionnaire. In addition, the total mean fatigue was 53.44 ± 16.61, considering the total score of 100. There was a significant difference between total mean fatigue and gender, job, economic status, and type of cancer. Conclusions: This study shows that cancer-related fatigue questionnaire can be used as a tool with validity and reliability at all research levels.

Effects of exercise on cancer related fatigue in adults: A literature review and meta-analysis of randomized controlled trials

Cancer related fatigue (CRF) is one among the common distressing symptoms experienced by cancer patients. Evidence showed that exercise interventions are effective in decreasing CRF. This review is to evaluate the evidence of the effectiveness of exercise interventions on CRF among adults with varied types of cancer in all phases of the cancer trajectory. A literature review with meta-analysis of randomized controlled trials (RCTs) was conducted. The results of RCTs (n = 20) that examined the effects of exercise on CRF were combined using two approaches: meta-analysis (n = 18) and summative analysis (n = 2). A summary effects size of the standardized mean difference (SMD) with 95% confidence intervals was calculated using random effects model and heterogeneity was assessed with the I2 statistic. The results showed overall, a small but significant decrease in the level of CRF (SMD, -0.32; 95% CI, -0.51 to -0.12; p = .002) was observed following exercise intervention. Subgroup analyses showed that both mixed modes (combination of resistance and aerobic exercises) and aerobic exercises were effective in significantly reducing CRF (p = .033; p = .046 respectively). The results indicated substantial heterogeneity between studies (I2 = 79%; p ≤ .0001). Summative analysis also suggested that exercise may be effective in reducing CRF. In conclusion, both resistance and aerobic exercises may be effective in decreasing CRF in adult patients. The result needs to be interpreted with caution due to considerable between-study heterogeneity.

Exercise and cancer-related fatigue in adults: a systematic review of previous systematic reviews with meta-analyses

BackgroundConduct a systematic review of previous systematic reviews with meta-analysis to determine the effects of exercise (aerobic, strength or both) on cancer-related-fatigue (CRF) in adults with any type of cancer.MethodsSystematic reviews with meta-analyses of previous randomized controlled trials published through July of 2016 were included by searching six electronic databases and cross-referencing. Dual-selection and data abstraction were conducted. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Standardized mean differences (SMD) that were pooled using random-effects models were included as the effect size. In addition, 95% prediction intervals (PI), number needed-to-treat (NNT) and percentile improvements were calculated.ResultsSixteen studies representing 2 to 48 SMD effect sizes per analysis (mean ± SD, 7 ± 8, median = 5) and 37 to 3254 participants (mean ± SD, 633 ± 690, median = 400) were included. Length of training lasted from 3 to 52 weeks (mean ± SD, 14.6 ± 3.1, median = 14), frequency from 1 to 10 times per week (mean ± SD, 3.4 ± 0.8, median = 3), and duration from 10 to 120 min per session (mean ± SD, 44.3 ± 5.5, median = 45). Adjusted AMSTAR scores ranged from 44.4% to 80.0% (mean ± SD, 68.8% ± 12.0%, median = 72.5%). Overall, mean SMD improvements in CRF ranged from −1.05 to −0.01, with 22 of 55 meta-analytic results (52.7%) statistically significant (non-overlapping 95% CI). When PI were calculated for results with non-overlapping 95% CI, only 3 of 25 (12%) yielded non-overlapping 95% PI favoring reductions in CRF. Number needed-to-treat and percentile improvements ranged from 3 to 16 and 4.4 to 26.4, respectively.ConclusionsA lack of certainty exists regarding the benefits of exercise on CRF in adults. However, exercise does not appear to increase CRF in adults.Trial registrationPROSPERO Registration # CRD42016045405.

Cancer related fatigue in adults, adolescents and children. Literature review

Cancer related fatigue in adults, adolescents and children. Literature review

Aerobic Exercise And Cancer-Related Fatigue In Adults

BACKGROUND: Using the traditional random-effects model, a recent meta-analysis of randomized controlled trials reported a statistically significant standardized mean difference (SMD) reduction in cancer-related fatigue (CRF) as a result of aerobic exercise (SMD, -0.22, 95% CI, -0.39 to -0.04, p = 0.01). However, a recently developed inverse heterogeneity (IVhet) model has been shown to be more valid than the traditional random-effects model. PURPOSE: The purpose of this study was to compare these previous meta-analytic results with those using the IVhet model. METHODS: Using data from a previous meta-analysis that included 36 SMD effect sizes (ES’s) representing 2,830 adults (1,426 exercise, 1,404 control), results were pooled using the IVhet model. In addition, absolute and relative differences between the IVhet and random-effects results for CRF were calculated as well as influence analysis with each SMD ES deleted from the IVhet model once. Non-overlapping 95% confidence intervals were considered statistically significant. RESULTS: A statistically non-significant reduction in CRF fatigue was found as a result of aerobic exercise using the IVhet model (SMD, -0.08, 95% CI, -0.31 to 0.14, p = 0.46). The IVhet model yielded a SMD ES that was 0.14 (63.6%) smaller than the random-effects model. With each study deleted from the IVhet model once, results remained statistically non-significant with SMD ES’s ranging from -0.11 (95% CI, -0.33 to 0.11) to -0.06 (95% CI, -0.28 to 0.16). CONCLUSIONS: The results of the current study suggest that there is currently insufficient evidence to support the use of aerobic exercise for reducing CRF in adults. Future studies should consider use of the IVhet versus traditional random-effects model when conducting aggregate data meta-analyses. Supported by NIH Grant U54GM104942

Aerobic Exercise and Cancer-Related Fatigue in Adults: A Reexamination Using the IVhet Model for Meta-analysis.

Although the results of a recent meta-analysis using the traditional random effects model yielded a statistically significant standardized mean difference (SMD) reduction in cancer-related fatigue (CRF) as a result of aerobic exercise, a recently developed inverse heterogeneity (IVhet) model has been shown to be more valid than the traditional random effects model. The purpose of this study was to compare these previous meta-analytic results using the IVhet model. Using data from a previous meta-analysis that included 36 SMD effect sizes (ES) representing 2,830 adults (1,426 exercise, 1,404 control), results were pooled using the IVhet model. Absolute and relative differences between the IVhet and random effects results for CRF were also calculated as well as influence analysis with each SMD ES deleted from the IVhet model. Nonoverlapping 95% confidence intervals (CI) were considered statistically significant. A statistically nonsignificant reduction in CRF fatigue was found as a result of aerobic exercise using the IVhet model (SMD, -0.08; 95% CI, -0.31-0.14; P = 0.46). The IVhet model yielded a SMD ES that was 0.14 (63.6%) smaller than the random effects model. With each study deleted from the IVhet model once, results remained statistically nonsignificant with SMD ESs ranging from -0.11 (95% CI, -0.33-0.11) to -0.06 (95% CI, -0.28-0.16). Insufficient evidence currently exists to support the use of aerobic exercise for reducing CRF in adults. Additional studies are needed to determine the certainty of aerobic exercise on CRF in adults. Cancer Epidemiol Biomarkers Prev; 26(2); 281-3. ©2016 AACR.

Educational interventions for the management of cancer-related fatigue in adults.

Educational interventions for the management of cancer-related fatigue in adults.

Teenage and Young Adult Cancer-Related Fatigue Is Prevalent, Distressing, and Neglected: It Is Time to Intervene. A Systematic Literature Review and Narrative Synthesis.

Cancer-related fatigue in adults has been the subject of considerable recent research, confirming its importance as a common and debilitating symptom, and establishing a number of evidence-based interventions. There has, however, been limited focus on the fatigue suffered by teenagers and young adults with cancer, a group recognized as having unique experiences and developmental needs. We have undertaken a systematic review of the literature to provide a comprehensive overview of studies evaluating fatigue in this younger patient group in order to guide clinical practice and future research. We searched MEDLINE, EMBASE, PsycINFO, and CINAHL databases for literature containing data relating to any aspect of fatigue in patients aged 13-24 at cancer diagnosis or treatment. Sixty articles were identified, of which five described interventional clinical trials. Cancer-related fatigue was consistently one of the most prevalent, severe, and distressing symptoms, and it persisted long-term in survivors. It was associated with a number of factors, including poor sleep, depression, and chemotherapy. There was little evidence for the effectiveness of any intervention, although exercise appears to be the most promising. Importantly, fatigue was itself a significant barrier to physical and social activities. Cancer-related fatigue is a major and disabling problem in young cancer patients. Effective management strategies are needed to avoid compounding the dependence and social isolation of this vulnerable patient group. Future research should focus on providing evidence for the effectiveness of interventions, of which activity promotion and management of concurrent symptoms are the most promising.

Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation.

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.

What are the effects of exercise for managing cancer-related fatigue in adults?

What are the effects of exercise for managing cancer-related fatigue in adults?

Exercise improves fatigue during and after breast and prostate cancer treatment, with benefits seen for aerobic exercise

Commentary on: Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012;11:CD006145[OpenUrl][1][PubMed][2] Cramp and Byron-Daniel conducted a systematic review of studies addressing...

Exercise for the management of cancer-related fatigue in adults.

Cancer-related fatigue is recognised as an important symptom associated with cancer and its treatment. A number of studies have investigated the effects of physical activity in reducing cancer-related fatigue. This is an updated version of the original Cochrane review published in The Cochrane Library (2008, Issue 1). The original review identified some benefits of physical activity on fatigue in cancer both during and after adjuvant treatment. We identified a number of limitations in the evidence, providing clear justification for an updated review. To evaluate the effect of exercise on cancer-related fatigue both during and after cancer treatment. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 1, 2011), MEDLINE (1966 to March 2011), EMBASE (1980 to March 2011), CINAHL (1982 to March 2011), British Nursing Index (January 1984 to March 2011), AMED (1985 to March 2011), SIGLE (1980 to March 2011) and Dissertation Abstracts International (1861 to March 2011) using key words. We also searched reference lists off all studies identified for inclusion and relevant reviews. In addition, we handsearched relevant journals and contacted experts in the field of cancer-related fatigue. We sought and included randomised controlled trials (RCTs) that investigated the effect of exercise on cancer-related fatigue in adults. Two review authors independently assessed the risk of bias of studies and extracted data based upon predefined criteria. Where data were available we performed meta-analyses for fatigue using a random-effects model. For this update we identified a total of 56 studies (4068 participants) for inclusion (28 from the original search and 28 from the updated search), with the majority carried out in participants with breast cancer (28 studies). A meta-analysis of all fatigue data, incorporating 38 comparisons, provided data for 1461 participants who received an exercise intervention and 1187 control participants. At the end of the intervention period exercise was seen to be statistically more effective than the control intervention (standardised mean difference (SMD) -0.27, 95% confidence interval (CI) -0.37 to -0.17). Benefits of exercise on fatigue were observed for interventions delivered during or post-adjuvant cancer therapy. In relation to diagnosis, we identified benefits of exercise on fatigue for breast and prostate cancer but not for those with haematological malignancies. Finally, aerobic exercise significantly reduced fatigue but resistance training and alternative forms of exercise failed to reach significance. The findings of the updated review have enabled a more precise conclusion to be made in that aerobic exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post-cancer therapy, specifically those with solid tumours. Further research is required to determine the optimal type, intensity and timing of an exercise intervention.

Exercise to reduce cancer fatigue in adults

“We did this review to look at the effects of exercise on fatigue levels in people with cancer. Fatigue is the most common side effect of cancer treatment, affecting a very high percentage of patients. The fatigue experienced by people with cancer can be very different to what the general population are used to after, for example, a disturbed night’s sleep or a hard day’s work. Cancer-related fatigue might not be relieved by rest and may continue for a long time even after the cancer treatment has finished. It may affect the person mentally, physically, emotionally, and spiritually and these effects are not always appreciated by friends and family or even by the healthcare professionals caring for the patient. Finding interventions that can help people to manage their fatigue is therefore an important goal. We identified exercise as one such intervention that was worthy of review, as it would be easy to implement and may increase the sense of control that a person with cancer has over their fatigue experience. We included 28 studies investigating the effect of exercise on cancer-related fatigue in adults. There were nearly 3000 participants who were receiving or had previously received treatment for cancer. We found that the people in these trials who received an exercise intervention reported less fatigue than those who did not receive it. Exercise reduced fatigue when carried out during the cancer treatment as well as after the treatment. The types of exercise varied between the included studies but the majority included walking or cycling. Most of the studies in this review were fairly small. This is not surprising as fatigue has only recently been recognized by healthcare professionals as an important consequence of cancer and most of studies done so far have taken place in single cancer centres with little funding. Despite this, when looked at together, this body of research provides convincing support for the benefits of exercise in reducing cancer-related fatigue. Adding exercise to a person’s cancer management could make a difference to their ability to function on a daily basis. It could mean the difference between lying in bed most of the day and being able to get up and make a cup of tea or, even cook dinner. These differences may sound small but could be very important to someone receiving treatment for cancer. Exercise is a cheap and simple option that could be implemented into all cancer services to help patients cope with fatigue. It is a flexible intervention that can be tailored to suit the individual. Our review also showed it often has other benefits such as improving quality of life, and reducing levels of depression and anxiety. In conclusion, we might not yet know how much exercise is best for each person but our review does suggest that physical exercise can help to reduce fatigue both during and after treatment for cancer. It highlights the need for all patients with cancer to have access to professional support and advice regarding exercise.”