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A Pan Canadian Practice Guideline for Screening, Assessment, and Management of Cancer-Related Fatigue in Adults (Version 2) Open Access


Author or creator
Howell, Doris
Broadfield, Larry
Harth, Tamara
McLeod, Deborah
Phan, Stephanie
Swinton, Nelda
Ali, Muhammad U.
Keshavarz, Homa
Hamel, Marc
Jones, Jennifer
Olson, Karin
Sawka, Annie
Hack, Tom
Additional contributors
adapted guideline
supportive care
Type of item
Research Material
Background Cancer-related fatigue (CRF) is a prevalent problem in cancer and has a side effect of treatment that often worsens during cancer treatment and can persist as a long-term problem for many patients including those in palliative care and cancer survivor populations. Reported prevalence rates for fatigue range from 59% to 100%. CRF is reported as the most distressing side effect of cancer and treatment and causes greater interference with daily life than any other symptom. CRF also impacts on personal, social, work roles and it can have a profound negative impact on overall quality of life (QoL). Because its etiology is not well understood, it is frequently unrecognized and is difficult to manage in clinical practice. Scope and Purpose of this Review The scope of this 2015-Version 2 of CRF guideline is focused on the provision of clinical practice recommendations for members of oncology interdisciplinary team (e.g. primary care physicians, oncologists, nurses, physiotherapist, occupational therapists, rehabilitation specialists), who screen, assess, and manage CRF in their daily clinical practice. Additionally, the recommendations may also help patients and families learn about the most effective strategies for managing CRF. The recommendations apply to those with CRF across the cancer trajectory, from cancer treatment to post-treatment survivorship and palliative or end-of-life care. The guidelines focused on the adult cancer population with fatigue due to cancer and/or cancer treatment. Intended Users The intended users of this guideline are the primary oncology interdisciplinary team, and community practitioners such as family physicians and palliative care teams. The recommendations are intended to also be relevant to specialists in fatigue including psychology and psychiatry, and other members of the allied health care team (occupational therapists, rehabilitation specialists, physiotherapists) who provide counselling to patients in the management of cancer-related fatigue. Patients and their families may also find this guideline useful for understanding the current recommendations and evidence for management for cancer and/or treatment related fatigue. Questions 1. What are the current guideline recommendations for routine screening and assessment of CRF in adults? 2. What is the efficacy of interventions (pharmacological, non‐pharmacological, and/or combinations) for reducing CRF in adults?
Date created
License information
© 2015 Doris Howell et al. This version of this article is open access and can be downloaded and shared. The original authors and source must be cited.
Citation for previous publication
Howell, D., Keshavarz, H., Broadfield, L., Hack, T., Hamel, M., Harth, T., Jones, J., McLeod, D., Olson, K., Phan, S., Sawka, A., Swinton, N., & Ali, M. 2015. A pan Canadian practice guideline for screening, assessment, and management of cancer-related fatigue in adults (Version 2). Toronto: Canadian Partnership Against Cancer (Cancer Journey Advisory Group) and the Canadian Association of Psychosocial Oncology.

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