ESMO guidelines on diagnosing and treating cancer-related fatigue

  • Ann Oncol

  • Oncology guidelines update
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The European Society for Medical Oncology (ESMO) has published clinical practice guidelines on the diagnosis and management of cancer-related fatigue (CRF).

ESMO says healthcare professionals should acknowledge the reality and impact of CRF. Among the recommendations are the following:

  • Information and counselling are recommended for patients and caregivers.
  • Routine screening for CRF during therapy and aftercare.
  • Comprehensive, focused diagnostic assessment of patients who screen positive.
  • Physical exercise of moderate intensity.
  • The use of modafinil and armodafinil is not recommended.
  • No consensus on the use of methylphenidate, dexmethylphenidate, long-acting methylphenidate, and dexamphetamine.
  • Antidepressants, in particular paroxetine, are not recommended.
  • Donepezil is not recommended.
  • The use of eszopiclone, megestrol acetate, and melatonin is not recommended.
  • The use of L-carnitine, coenzyme Q10, astragalus, guarana is currently not recommended.
  • Short-term dexamethasone or methylprednisolone is recommended for the control of CRF in patients with metastatic cancer.
  • Psychoeducation and cognitive behavioural therapy (CBT) are recommended.
  • MBSR and yoga could be an option to improve CRF.
  • No consensus on the use of acupuncture.
  • Pharmacological interventions are not recommended for the control of CRF in patients aged ≥65 years.

The full guidelines are published in the Annal of Oncology.