Cancerrelated fatigue

Fatigue is a subjective sensation of weakness, lack of energy, and tiredness (Stone et al. 1998). Fatigue and the term asthenia are related terms; however, asthenia evokes even more clearly both the physical and mental components of fatigue sensation. The three components of fatigue perception (Barnes and Bruera 2002) are illustrated in Fig. 4.1. CRF has been reported in 70-100% of patients undergoing treatment (Morrow et al. 2002; Mock 2001) and it can persist for years after its completion (Morrow et al. 2002; Barnes and Bruera 2002). Up to 80% of all cancer patients experience fatigue (Smith and de Boer 2002). It is present in almost the same proportion of patients with cancer cachexia. Fatigue can precede weight loss, and this is probably, in a number of cancer patients, a direct consequence of treatment with chemotherapy (Servaes et al. 2002; Morrow et al. 2002; Richardson 1995; Ancoli-Israel et al. 2001), radiotherapy (Morrow et al. 2002; Richardson 1995; Visser and Smets 1998; Greenberg et al. 1993), and bio-therapy (Richardson 1995; Quesada et al. 1986; Kurzok 2001; Malik et al. 2001).

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