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Fatigue (PDQ®): Supportive care - Health Professional Information [NCI] - Posttreatment Considerations


Although many studies document the incidence of fatigue in those who are no longer receiving cancer treatment, the specific mechanism of fatigue remains unknown. Because fatigue is a multifaceted problem, determining its etiology is difficult.

The information available regarding fatigue in survivors of childhood cancer is from the literature describing the physiologic and cognitive effects following treatment. In one study, cognitive outcomes were evaluated in children 3 to 4 years after diagnosis of brain tumors. Fatigue was a factor in poor school performance.[12]

In another study, survivors of acute lymphoblastic leukemia who were evaluated for cognitive deficits after treatment were noted to have a typical fatigue effect. This was thought to be a factor in the variability of their test scores.[13] Anecdotally, individuals who have received chest and total-body irradiation complain of fatigue, with an increased sleep requirement.

People who are successfully treated for cancer are at risk for a variety of organ-specific complications that are secondary to their treatment.[14] Fatigue in the posttreatment population underscores the importance of follow-up care. The persistence of fatigue following cancer treatment requires a thorough evaluation to rule out contributing physiologic conditions.


  1. Servaes P, van der Werf S, Prins J, et al.: Fatigue in disease-free cancer patients compared with fatigue in patients with chronic fatigue syndrome. Support Care Cancer 9 (1): 11-7, 2001.
  2. Whedon M, Stearns D, Mills LE: Quality of life of long-term adult survivors of autologous bone marrow transplantation. Oncol Nurs Forum 22 (10): 1527-35; discussion 1535-7, 1995 Nov-Dec.
  3. Bush NE, Haberman M, Donaldson G, et al.: Quality of life of 125 adults surviving 6-18 years after bone marrow transplantation. Soc Sci Med 40 (4): 479-90, 1995.
  4. Ferrell BR, Grant M, Dean GE, et al.: Bone tired: the experience of fatigue and its impact on quality of life. Oncol Nurs Forum 23 (10): 1539-47, 1996.
  5. Devlen J, Maguire P, Phillips P, et al.: Psychological problems associated with diagnosis and treatment of lymphomas. II: Prospective study. Br Med J (Clin Res Ed) 295 (6604): 955-7, 1987.
  6. Fobair P, Hoppe RT, Bloom J, et al.: Psychosocial problems among survivors of Hodgkin's disease. J Clin Oncol 4 (5): 805-14, 1986.
  7. Loge JH, Abrahamsen AF, Ekeberg, et al.: Fatigue and psychiatric morbidity among Hodgkin's disease survivors. J Pain Symptom Manage 19 (2): 91-9, 2000.
  8. Berglund G, Bolund C, Fornander T, et al.: Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. Eur J Cancer 27 (9): 1075-81, 1991.
  9. Servaes P, Verhagen S, Bleijenberg G: Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study. Ann Oncol 13 (4): 589-98, 2002.
  10. Knobel H, Loge JH, Nordøy T, et al.: High level of fatigue in lymphoma patients treated with high dose therapy. J Pain Symptom Manage 19 (6): 446-56, 2000.
  11. Bower JE, Ganz PA, Desmond KA, et al.: Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer 106 (4): 751-8, 2006.
  12. Radcliffe J, Packer RJ, Atkins TE, et al.: Three- and four-year cognitive outcome in children with noncortical brain tumors treated with whole-brain radiotherapy. Ann Neurol 32 (4): 551-4, 1992.
  13. Brouwers P: Neuropsychological abilities of long-term survivors of childhood leukemia. In: Aaronsen NK, Beckmann J, eds.: The Quality of Life of Cancer Patients. New York: Raven Press, 1987, pp 153-65.
  14. Baker F, Denniston M, Smith T, et al.: Adult cancer survivors: how are they faring? Cancer 104 (11 Suppl): 2565-76, 2005.

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
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