To examine the impact of optimizing treatment of accompanying symptoms on cancer-related fatigue, Pleun J. de Raaf, M.D., of the Erasmus MC Daniel den Hoed Cancer Center in Rotterdam, Netherlands, and colleagues conducted a trial involving 152 fatigued patients with advanced cancer. Patients were randomized in a 1:1 ratio to receive nurse-led monitoring and protocolized patient-tailored treatment of symptoms or usual care.

The researchers found that, over time, there was a significant improvement in general fatigue in favor of protocolized patient-tailored treatment, with significant differences compared with controls at months one and two. Specific secondary outcomes, including reduced activity and reduced motivation fatigue dimensions, fatigue numerical rating scale score, symptom burden, interference of fatigue with daily life, and anxiety, were also significantly better with patient-tailored treatment.

"It is advisable to refer fatigued patients with advanced cancer to a nurse trained in palliative care for monitoring symptom intensity, educating the patient, and referring to other health care providers, if necessary," the authors write. "Further research should focus on elucidating which components are responsible for the effect of improving symptom burden on fatigue and on establishing the cost-effectiveness of this intervention."

Abstract
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