Cancer-related fatigue: mechanisms, assessment and treatment in older people

Cancer-related fatigue (CRF) is a debilitating symptom that affects the majority of cancer patients. It can occur at all stages of treatment, worsening in advanced disease. It can be especially troublesome in the older person. CRF is often under-recognized and insufficiently treated routinely. This review will discuss both the postulated mechanisms and clinical tools for identifying and monitoring CRF during cancer treatment. The role of drug treatment and exercise to manage CRF is also assessed. Further studies, particularly in older people, are required to improve the poor levels of evidence for current CRF management options.