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| Cancer related fatigue diagnosis and treatment |
| Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China |
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Abstract Fatigue is a common problem in cancer patients. Main factors contributing to CRF are progressive tumor, cytotoxic chemotherapy, biologic response modifiers, molecularly targeted therapy (particularly the small molecular tyrosine kinase inhibitors and monoclonal antibodies targeting the VEGF/EGFR), radiotherapy, anemia, pain, emotional distress, sleep disturbance, and malnutrition. Therefore, CRF screening and treatment has become the focus of supportive care in contemporary cancer treatment. Here, we systematically reviewed definitions, epidemiology, pathogenesis, screening, clinical assessment and treatment of CRF in cancer survivors. Moreover, management of CRF includes specific treatment for potentially reversible causes (treating anemia, metabolic or endocrine abnormalities, as well as managing pain, insomnia, depression or anxiety) and symptomatic treatment. Nonspecific symptomatic treatment includes education, counseling, pharmacologic (eg. psychostimulants and other wakefulness agents) and nonpharmacologic (eg. exercise, yoga, acupuncture) approaches. To be more important, we focus on exercise therapy, treatment of anemia, improvement of sleep disorders, psychological cognitive interventions, physical and psychological interventions, medical therapy and Chinese traditional medical treatment. Up to now, exercise therapy is the most effective therapy. Furthermore,
the individualized moderate aerobic exercise can improve CRF in most patients with CRF, if exercise is not contraindicated.
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2018, Vol. 5 
