Cancer fatigue: a review for psychiatrists.

OBJECTIVE: Cancer-related fatigue (CRF) is a ubiquitous and debilitating phenomenon for patients both during and after treatment for cancer of all types. This review will outline the complex neurobiological mechanisms underlying CRF and their relevance to various treatment routes. It will cover aspects of screening, diagnosis and treatment, including both pharmacological and behavioral interventions for CRF. The goal of the article was not to perform a comprehensive literature review or meta-analysis, but rather to integrate clinically relevant information from different areas of research related to cancer fatigue, including etiology, diagnosis and management for a nonspecialist audience.

METHOD: The methodology used involved broadly surveying the literature available on Medline using such search terms as "cancer," "fatigue," "cytokine" and "depression," exploring relevant articles over the past 15 years and relevant citations from these articles and focusing on recent advances in the study of CRF.

RESULTS: CRF occurs at high prevalence rates during and subsequent to cancer treatment. Multidisciplinary approaches are available for the assessment and management of fatigue including underlying contributory factors.

CONCLUSIONS: An increasing base for evidence is present to guide the management of CRF. Additional research is warranted to understand the neurobiological mechanisms, etiology and risk factors for fatigue.