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The problem of cancer-related fatigue, which affects 70% to 100% of cancer patients, has been exacerbated by the increased use of fatigue-inducing multimodal treatments and dose-dense, dose-intense protocols. In patients with metastatic disease, the prevalence of cancer-related fatigue exceeds 75%, and cancer survivors report that fatigue is a disruptive symptom months or even years after treatment ends. To address the significant problem of cancer-related fatigue, the NCCN convened a panel of experts in the field of fatigue. The Cancer-Related Fatigue Clinical Practice Guidelines synthesize the available research and clinical experience in this field and provide recommendations for patient care.

For the most recent version of the guidelines, please visit NCCN.org

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Paul G. Richardson, Jacob P. Laubach, Robert L. Schlossman, Constantine Mitsiades, and Kenneth Anderson

Peripheral neuropathy (PN) and asthenia (fatigue) are among the most commonly seen complications in patients undergoing multiple myeloma (MM) therapy. These potentially debilitating adverse effects are frequently dose limiting, and they may

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Andrea Angelo Martoni, Luigi Cavanna, and Gianpiero Porzio

Re: Sriram Yennurajalingam, Nizar M. Tannir, Janet L. Williams, et al. A Double-Blind, Randomized, Placebo-Controlled Trial of Panax Ginseng for Cancer-Related Fatigue in Patients With Advanced Cancer. J Natl Compr Canc Netw 2017

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Ann M. Berger and Kathi Mooney

Evidence-based recommendations for cancer-related fatigue (CRF) have been disseminated recently by all major cancer organizations (NCCN, Oncology Nursing Society [ONS], Canadian Partnership Against Cancer/Canadian Association of Psychosocial

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John A. Glaspy

anemic cancer patients when referenced to the general population . J Clin Oncol 2003 ; 21 : 366 – 373 . 2 Cella D Kallich J McDermott A Xu X . The longitudinal relationship of hemoglobin, fatigue and quality of life in anemic cancer

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John A. Glaspy

X . The longitudinal relationship of hemoglobin, fatigue and quality of life in anemic cancer patients: results from five randomized clinical trials . Ann Oncol 2004 ; 15 : 979 – 986 . 6. Berndt E Kallich J McDermott A . Reductions in

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Romy M. van Amelsfoort, Iris Walraven, Jacobien Kieffer, Edwin P.M. Jansen, Annemieke Cats, Nicole C.T. van Grieken, Elma Meershoek-Klein Kranenbarg, Hein Putter, Johanna W. van Sandick, Karolina Sikorska, Cornelis J.H. van de Velde, Neil K. Aaronson, Marcel Verheij, and on behalf of the CRITICS Investigators

functioning, role functioning, cognitive functioning, emotional functioning, and social functioning), 3 multi-item symptom scales (fatigue, nausea and vomiting, and pain), 6 single-item symptom scales (dyspnea, insomnia, appetite loss, constipation, diarrhea

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Tara M. Mackay, Anouk E.J. Latenstein, Mirjam A.G. Sprangers, Lydia G. van der Geest, Geert-Jan Creemers, Susan van Dieren, Jan-Willem B. de Groot, Bas Groot Koerkamp, Ignace H. de Hingh, Marjolein Y.V. Homs, Evelien J.M. de Jong, I. Quintus Molenaar, Gijs A. Patijn, Lonneke V. van de Poll-Franse, Hjalmar C. van Santvoort, Judith de Vos-Geelen, Johanna W. Wilmink, Casper H. van Eijck, Marc G. Besselink, Hanneke W.M. van Laarhoven, and for the Dutch Pancreatic Cancer Group

cancer-specific EORTC QLQ-C30 questionnaire encompasses global health status, 5 functioning scales (ie, physical, role, emotional, cognitive, and social functioning) and 8 symptom scales/items (ie, fatigue, nausea and vomiting, pain, dyspnea, insomnia

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Crystal S. Denlinger, Jennifer A. Ligibel, Madhuri Are, K. Scott Baker, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Lee Jones, Allison King, Grace H. Ku, Elizabeth Kvale, Terry S. Langbaum, Kristin Leonardi-Warren, Mary S. McCabe, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Mary Ann Morgan, Javid J. Moslehi, Tracey O’Connor, Linda Overholser, Electra D. Paskett, Muhammad Raza, Karen L. Syrjala, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Nicole McMillian, and Deborah Freedman-Cass

parasomnias. 1 Sleep disorders affect 30% to 50% of patients with cancer and survivors, often in combination with fatigue, anxiety, or depression. 1 - 10 Improvements in sleep lead to improvements in fatigue, mood, and quality of life. 11 Most clinicians

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Sriman Swarup, Anita Sultan, Nusrat Jahan, Upama Sharma, Nimesh Adhikari, Yin M. Myat, Ye Aung, Myo H. Zaw, and Kyaw Z. Thein

treated with cabozantinib. Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases, and meeting abstracts through September 30, 2018. Phase 3 trials that mention HRQOL events like pain, arthralgia, fatigue