Guidelines for screening and managing cancer-related fatigue

Review these 2011 practice guidelines to learn about the best ways to manage fatigue in adult patients with cancer

This report shares screening, assessment and care practices for managing fatigue in adult patients with cancer who have been identified using the Edmonton Symptom Assessment System (ESAS).

These guidelines apply to adults with cancer at any phase of their cancer care – no matter the type of cancer, disease stage or type of treatment. Also, these guidelines don’t focus on managing fatigue before a cancer diagnosis, but they recognize that risk factor during assessment. If differences apply because of something like clinical status, then those differences are noted.

Cancer-related fatigue is different from the fatigue that the general adult population may feel in everyday life. Definitions of cancer-related fatigue are different. However, all definitions include a subjective feeling of tiredness or exhaustion due to cancer or cancer treatment that is inappropriate to the level of activity, is not relieved by rest and hampers everyday activities. Because cancer patients and survivors report high rates of fatigue, frequent screening and assessment are needed to make sure fatigue doesn’t disrupt a patient’s quality of life.

The report’s results suggest that screening for fatigue should include a patient’s detailed history. A patient’s fatigue pattern and its effects, especially on risk factors which can be turned around, should also be noted through screening. As well, patients should be taught about fatigue, symptom management and available treatment.


After the reversible causes of fatigue, like depression, anemia and pain are treated, the following approaches can be used to manage fatigue:

  • Enhancing activities and exercise
  • Conserving energy
  • Managing stress and psychosocial interventions
  • Reducing sleep disturbance

The Partnership’s Person-Centred Perspective initiative is committed to improving the patient experience. We are working with partners across Canada to find the best ways to offer a person-centred perspective throughout a person’s cancer journey and to help information flow throughout. The impact of a cancer diagnosis goes far beyond the physical disease. It affects every aspect of a person’s life. The initiative has focused on reporting about the patient experience, and giving health-care providers patient-centred tools and resources, which have been validated and standardized.

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