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Original Abstract of the Article

Major Research Findings

Chronic fatigue syndrome (CFS) is characterized by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches, and impaired concentration and short-term memory. 16 , 20 , 22 , 18 , 23 CFS is a common, debilitating, and serious health problem.

Fatigue is a common and distressing symptom that can last for months or years in up to one-third of cancer survivors. 21 Despite its prevalence, the nature and mechanisms of cancer-related fatigue are poorly understood, and the available treatments may not provide sufficient relief. Fatigue has been identified as a significant contributor to decreased quality of life, making it an important target for intervention.

In healthy individuals, fatigue is a protective response to physical or mental stress, often relieved by rest. By contrast, in palliative care patients, fatigue can be severely debilitating, thereby impacting daily activity and quality of life, often with rest not counteracting fatigue. 9 Fatigue frequently occurs in patients with advanced disease, and modalities treating cancer often contribute or cause fatigue. Further complicating issues are its multidimensionality, subjective nature, and lack of a consensus definition of fatigue. Pathophysiology is not fully understood, and evidence-based treatment approaches are needed.

Exercise therapy has been shown to reduce fatigue and improve physical functioning in CFS. 4

Bright light therapy has been shown to improve cancer-related fatigue in cancer survivors. 24

Cognitive behavioral therapy (CBT) has been shown to be effective in reducing severe fatigue during cancer treatment. 28

Melatonin has been shown to reduce fatigue associated with breast cancer and its adjuvant treatments. 30

Treatment Summary

Exercise therapy for CFS has been investigated in 4 , 20 , 22 , 18 , 23 and has been shown to be beneficial in reducing fatigue and improving physical functioning.

Bright light therapy for cancer-related fatigue has been investigated in 21 , 24 and has been shown to have a positive impact on fatigue, mood, and quality of life in cancer survivors.

Pharmacological treatments for fatigue in palliative care patients have been investigated in 9 , 17 . However, the pathophysiology of fatigue is not fully understood, and evidence-based treatment approaches are needed.

CBT for severe fatigue during cancer treatment has been investigated in 28 and has been shown to be effective in reducing fatigue.

Melatonin for fatigue associated with breast cancer and its adjuvant treatments has been investigated in 30 and has been shown to reduce fatigue.

Benefits and Risks

Benefits Summary

Exercise therapy may improve fatigue and physical functioning in CFS. 4

Bright light therapy may improve cancer-related fatigue, mood, and quality of life. 24

CBT may reduce severe fatigue during cancer treatment. 28

Melatonin may reduce fatigue associated with breast cancer and its adjuvant treatments. 30

Risks Summary

Exercise therapy may be less acceptable to patients than other management approaches, such as rest or pacing. 4

Comparison of Studies

Commonalities of Studies

Many studies suggest that exercise therapy, light therapy, CBT, and pharmacological treatments have the potential to reduce fatigue symptoms.

Differences in Studies

Studies vary in various aspects, including the type of fatigue, target population, interventions used, and methods of measuring outcomes.

Consistency and Contradictions of Results

While there is consistency among study results, some contradictions also exist. For instance, the effectiveness of exercise therapy varies across studies, with 4 showing benefits while 28 demonstrates no effect.

Practical Applications and Considerations

When choosing a treatment for fatigue, it is essential to consider the patient's specific circumstances, the cause of fatigue, and the potential risks and benefits of treatment.

Limitations of Current Research

Many studies have small sample sizes and limited target populations, making it challenging to generalize findings.

Future Research Directions

Larger and longer-term studies are needed to investigate the long-term effects of various treatments for different types of fatigue. Research is also needed to explore the optimal combination of different treatments to reduce fatigue.

Conclusions

Exercise therapy, light therapy, CBT, and pharmacological treatments have the potential to reduce fatigue symptoms. However, study results show consistency while also revealing some contradictions. When choosing a treatment for fatigue, it is crucial to consider the patient's specific circumstances, the cause of fatigue, and the potential risks and benefits of treatment.

Individuals experiencing fatigue should consult with a healthcare professional to determine the most appropriate treatment approach for their individual needs.

Treatment List

Exercise therapy, Light therapy, Cognitive behavioral therapy (CBT), Pharmacological treatments


Literature analysis of 33 papers
Positive Content
27
Neutral Content
3
Negative Content
3
Article Type
16
12
15
14
33

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Author: VelthuisMiranda J, MayAnne M, Koppejan-RensenbrinkRia Ag, GijsenBrigitte C M, van BredaEric, de WitG Ardine, SchröderCarin D, MonninkhofEvelyn M, LindemanEline, van der WallElsken, PeetersPetra H M


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Author: CharlesCécile, Vaz LuisInes, ChiesaSéverine, BoironClaude, BourgierCéline, CavalcantiAndréa, DauchySarah, FavréEstelle, FerrandezJean-Claude, Gueroult-AccolasLaure, KarsentiLucille, MateusChristine, VansteeneDamien, AllaFrançois, MontagniIlaria, CambonLinda


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