Cancer related fatigue: A focus on breast cancer and Hodgkin's disease survivors

Background and Purpose. Fatigue is one of the most common and troubling symptoms in cancer survivors. In this paper we review information about cancer related fatigue in survivors of breast cancer and Hodgkin's disease, discuss some of the potential biological mechanisms for this problem in cancer survivors, and briefly discuss potential interventions. Findings. Cancer-related fatigue persists long after cancer treatments end, and is associated with more intensive treatments (combined chemotherapy and radiation therapy) in these cancers. Fatigue prior to the onset of treatment is a strong predictor of persistent fatigue. Studies in breast cancer survivors suggest elevated levels of pro-inflammatory cytokines in association with persistent fatigue, as well as abnormalities in the hypothalamic- pituitary axis. Psychosocial and physical activity interventions have been shown in some studies to alleviate fatigue. Conclusions. Recognizing the syndrome of cancer- related fatigue is a high priority for the many cancer survivors who continue to experience this complaint as as chronic health problem.