Managing Cancer-related Fatigue: Evidence-based Interventions in Oncology Nursing Practice

Vanesa John^*
*Correspondence: Vanesa John, Department of Oncology Nursing, National University Cancer Institute Singapore, Singapore, Email:

Introduction

Cancer-Related Fatigue (CRF) is one of the most distressing and prevalent symptoms experienced by oncology patients, affecting up to 80% during or after treatment. Unlike typical tiredness, CRF is persistent, not relieved by rest and significantly impairs physical, emotional and cognitive functioning. Oncology nurses play a pivotal role in identifying, assessing and managing this complex symptom through evidence-based interventions. A multidimensional and patient-centered approach that integrates physical, psychosocial and behavioral strategies is essential for improving quality of life and treatment adherence in cancer patients [1].

Description

CRF arises from the disease itself, the effects of treatments such as chemotherapy, radiation and immunotherapy, as well as psychological stressors and comorbid conditions. Due to its subjective and multifactorial nature, comprehensive assessment and tailored interventions are essential. Accurate assessment of CRF is critical and begins with thorough history taking, which includes fatigue onset, duration, pattern, impact on daily life and associated symptoms such as insomnia, depression, or pain. Standardized tools like the Brief Fatigue Inventory (BFI) or the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale are commonly used in clinical practice. Physical assessments focus on vital signs, performance status and evaluation of nutritional and hydration status, which can influence fatigue severity. Oncology nurses also consider psychosocial factors including mood, anxiety, coping mechanisms and support systems, which often exacerbate fatigue [2].

Nursing interventions for CRF are grounded in evidence-based guidelines, emphasizing both pharmacologic and non-pharmacologic strategies tailored to individual needs and preferences. Moderate-intensity aerobic exercise, such as walking or cycling, has consistently shown benefits in reducing CRF and enhancing functional capacity. Oncology nurses collaborate with physiotherapists to develop personalized exercise plans, taking into account the patientâ??s cancer type, stage, treatment status and overall condition. Resistance training may also be incorporated to combat muscle wasting and improve strength. Nurses educate patients on pacing activities, prioritizing tasks and scheduling rest periods to prevent energy depletion. Use of fatigue diaries can help patients and caregivers identify energy patterns and adapt routines accordingly. Psychological factors significantly influence fatigue perception. Cognitive-Behavioral Therapy (CBT), Mindfulness-Based Stress Reduction (MBSR) and support groups are effective in alleviating emotional burden and fatigue. Oncology nurses play a vital role in facilitating referrals to mental health professionals and leading patient support initiatives [3].

Malnutrition and cachexia contribute to fatigue. Nurses assess dietary intake, screen for weight changes and coordinate care with dietitians. Nutritional interventions include meal planning, supplementation and hydration strategies to optimize energy levels. While pharmacologic treatment is not the first-line approach, medications like psychostimulants (e.g., methylphenidate) or corticosteroids may be considered for select patients under medical supervision. Nurses monitor for efficacy and adverse effects, ensuring safe administration. Sleep disturbances worsen fatigue. Nurses counsel patients on establishing regular sleep routines, minimizing daytime naps and creating conducive sleep environments. Relaxation techniques such as guided imagery and progressive muscle relaxation are also recommended. Digital health tools are emerging in CRF management. Mobile apps help track fatigue levels, monitor activity and deliver educational content. Nurses guide patients in utilizing these tools effectively, promoting active self-management and engagement in care [4].

Effective education empowers patients to understand and cope with CRF. Nurses tailor education to individual literacy levels and cultural contexts, using simple language, visual aids and the teach-back method to ensure comprehension. Key education topics include recognizing triggers, implementing lifestyle changes and when to seek help. Encouraging family involvement enhances support and adherence. Oncology nurses also address common misconceptions, such as the belief that rest alone will alleviate fatigue and provide evidence-based information to dispel myths. CRF has physical, emotional and spiritual dimensions. Nurses address these comprehensively, considering cultural values and beliefs in planning care. Cultural competence fosters trust, adherence and patient satisfaction, especially in diverse oncology populations. Management of CRF requires a team-based approach involving oncologists, physical therapists, psychologists, dietitians and social workers. Nurses serve as care coordinators and advocates, ensuring timely referrals and holistic support throughout the cancer care continuum [5].

Conclusion

Cancer-related fatigue is a multifaceted symptom that significantly impacts the well-being of cancer patients. Oncology nurses are at the forefront of managing CRF through evidence-based, individualized and holistic interventions. By combining physical activity, psychosocial support, energy conservation and patient education, nurses can alleviate fatigue and improve quality of life. Continued research, professional development and interdisciplinary collaboration are essential to refine strategies and deliver optimal care in oncology settings.

Acknowledgement

None.

Conflict of Interest

None.

References

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