| Target population |
- This practice guideline pertains to cancer survivors diagnosed at age ≥18 years who have completed primary cancer treatment with curative intent and are in clinical remission off therapy as well as patients who are disease free and have transitioned to maintenance or adjuvant therapy (eg, patients with breast cancer receiving hormonal therapy, patients with chronic myelogenous leukemia receiving tyrosine kinase inhibitors)
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| Target audience |
- This guidance is intended to inform health care professionals (eg, medical, surgical, and radiation oncologists, psychosocial and rehabilitation professionals, primary care providers, nurses, and others involved in the delivery of care for survivors) as well as patients, family members, and caregivers of patients who have survived cancer
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| Recommendations |
| Screening |
- All health care providers should routinely screen for the presence of fatigue from the point of diagnosis onward, including after completion of primary treatment
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- All patients should be screened for fatigue as clinically indicated and at least annually
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- Screening should be performed and documented using a quantitative or semiquantitative assessment
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| Comprehensive and focused assessment |
| History and physical |
- Perform a focused fatigue history
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- Assess treatable contributing factors
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- As a shared responsibility, the clinical team must decide when referral to an appropriately trained professional (eg, cardiologist, endocrinologist, mental health professional, internist, and so on) is needed
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| Laboratory evaluation |
- Consider performing laboratory evaluation based on presence of other symptoms and onset and severity of fatigue
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