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.
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. 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. 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.
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