Management of fatigue in older adults with cancer

Introduction The global and U.S. population is aging at an unprecedented rate. Cancer is a disease affecting predominantly older persons with incidence and prevalence increasing with age. Fifty-seven percent of newly diagnosed cancers and 71 percent of cancer deaths occur in those aged 65 years or older. In addition to cancer, many older persons have comorbid medical conditions (e.g., cardiomyopathies, diabetes, depression), rendering them more susceptible to illness and treatment as well as limiting their functional capacities. Fatigue from cancer and/or its treatment is the most commonly reported symptom by older cancer patients and affects 70–100 percent of those receiving treatment for cancer. This chapter discusses the current evidence regarding cancer-related fatigue in the elderly and provides recommendations for the assessment and management of this distressing symptom in the elderly cancer population as well as future areas of research that are needed to further the science. Review of the current evidence As society ages, the number of older adults with cancer will continue to increase, and 70–100 percent of those receiving treatment for cancer will experience fatigue. Cancer-related fatigue (CRF) is defined by the National Comprehensive Cancer Network (NCCN) as “a distressing persistent, subjective sense of physical, emotional and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.