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Fatigue

  • Michael J. FischEmail author
Chapter
Part of the Cancer Drug Discovery and Development book series (CDD&D)

Abstract

Fatigue is a highly prevalent, complex and poorly delineated symptom, which occurs before, during and after treatment for cancer. Difficulties in establishing a case definition of cancer-related fatigue have resulted in an absence of reliable and valid epidemiological data, and confound investigation into the etiology and pathogenesis of this problem. Among the possible predisposing and perpetuating factors underlying fatigue are female gender, personality factors such as neuroticism and/or a tendency toward catastrophizing, obesity, low level of activity, exposure to toxins, and prior infections. There is no evidence thus far to suggest that family history, genetic factors, or sociodemographic factors predominate. One of the most consistently evoked factors in describing the etiology of cancer fatigue is the role of cytokines. In cancer-related fatigue research, evidence and opinions support the role of cytokines, but there are also studies in which cytokine correlates were not found to be important. Anemia is a common underlying problem in cancer fatigue and can be due to cancer chemotherapy or the effects of the malignancy itself.

Various therapies may have efficacy for treating cancer-related fatigue. These include exercise, mind-body interventions such as Tai chi chuan and yoga, nutritional interventions, behavioral and psychoeducational interventions, the use of antidepressants, use of erythropoietic agents, and psychostimulants such as methylphenidate hydrochloride and modafinil. Most of the current understanding of fatigue in cancer has been influenced by and largely derived from the experience of patients with breast cancer. However, in the absence of an established evidence-based standard of care for the assessment and management of cancer-fatigue, further research is clearly needed, including more randomized, controlled clinical trials, research in different cancer diagnoses and treatment settings (aside from breast and prostate cancer outpatient settings); more rigorous outcomes assessment and study methodology; and discernment of dose effects and optimal frequency for dosing.

Keywords

Cancer fatigue Cytokines Fatigue assessment Fatigue etiology Metabolic fatigue Anemia 

References

  1. 1.
    Fernandes R, Stone P, Andrews P, Morgan R, Sharma S. 2006; Comparison between fatigue, sleep disturbance, and circadian rhythm in cancer inpatients and healthy volunteers: evaluation of diagnostic criteria for cancer-related fatigue. J Pain Symptom Manage 32:(3)245–54.PubMedCrossRefGoogle Scholar
  2. 2.
    Morrow GR, Shelke AR, Roscoe JA, Hickok JT, Mustian K. 2005; Management of cancer-related fatigue. Cancer Invest 23:(3)229–39.PubMedCrossRefGoogle Scholar
  3. 3.
    Prue G, Rankin J, Allen J, Gracey J, Cramp F. 2006; Cancer-related fatigue: a critical appraisal. Eur J Cancer 42:(7)846–63.PubMedCrossRefGoogle Scholar
  4. 4.
    Stone P, Hardy J, Broadley K, Tookman AJ, Kurowska A, A’Hern R. 1999; Fatigue in advanced cancer: a prospective controlled cross-sectional study. Br J Cancer 79:(9–10)1479–86.PubMedCrossRefGoogle Scholar
  5. 5.
    Wagner LI, Cella D. 2004; Fatigue and cancer: causes, prevalence and treatment approaches. Br J Cancer 91:(5)822–8.PubMedGoogle Scholar
  6. 6.
    Bower JE, Ganz PA, Desmond KA,. et al. 2006; Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer 106:(4)751–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Curt GA, Breitbart W, Cella D,. et al. 2000; Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 5:(5)353–60.PubMedCrossRefGoogle Scholar
  8. 8.
    Fossa SD, Dahl AA, Loge JH. 2003; Fatigue, anxiety, and depression in long-term survivors of testicular cancer. J Clin Oncol 21:(7)1249–54.PubMedCrossRefGoogle Scholar
  9. 9.
    Hjermstad MJ, Fossa SD, Oldervoll L, Holte H, Jacobsen AB, Loge JH. 2005; Fatigue in long-term Hodgkin’s Disease survivors: a follow-up study. J Clin Oncol 23:(27)6587–95.PubMedCrossRefGoogle Scholar
  10. 10.
    Nieboer P, Buijs C, Rodenhuis S,. et al. 2005; Fatigue and relating factors in high-risk breast cancer patients treated with adjuvant standard or high-dose chemotherapy: a longitudinal study. J Clin Oncol 23:(33)8296–304.PubMedCrossRefGoogle Scholar
  11. 11.
    Reyes-Gibby CC, Aday LA, Anderson KO, Mendoza TR, Cleeland CS. 2006; Pain, depression, and fatigue in community-dwelling adults with and without a history of cancer. J Pain Symptom Manage 32:(2)118–28.PubMedCrossRefGoogle Scholar
  12. 12.
    Prins JB, van der Meer JW, Bleijenberg G. 2006; Chronic fatigue syndrome. Lancet 367:(9507)346–55.PubMedCrossRefGoogle Scholar
  13. 13.
    Bowen JL. 2006; Educational strategies to promote clinical diagnostic reasoning. N Engl J Med 355:(21)2217–25.PubMedCrossRefGoogle Scholar
  14. 14.
    . Cancer-Related Fatigue. National Comprehensive Cancer Network (NCCN), 2006. (Accessed November 27, 2006.Google Scholar
  15. 15.
    Andrykowski MA, Schmidt JE, Salsman JM, Beacham AO, Jacobsen PB. 2005; Use of a case definition approach to identify cancer-related fatigue in women undergoing adjuvant therapy for breast cancer. J Clin Oncol 23:(27)6613–22.PubMedCrossRefGoogle Scholar
  16. 16.
    . Fleishman SB. Treatment of symptom clusters: pain, depression, and fatigue. J Natl Cancer Inst Monogr 2004(32):119–23.Google Scholar
  17. 17.
    Hwang SS, Chang VT, Kasimis BS. 2003; A comparison of three fatigue measures in veterans with cancer. Cancer Invest 21:(3)363–73.PubMedCrossRefGoogle Scholar
  18. 18.
    Van Belle S, Paridaens R, Evers G,. et al. 2005; Comparison of proposed diagnostic criteria with FACT-F and VAS for cancer-related fatigue: proposal for use as a screening tool. Support Care Cancer 13:(4)246–54.PubMedCrossRefGoogle Scholar
  19. 19.
    Hwang SS, Chang VT, Cogswell J, Kasimis BS. 2002; Clinical relevance of fatigue levels in cancer patients at a Veterans Administration Medical Center. Cancer 94:(9)2481–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Schwartz AL, Meek, PMNail, LM et al. 2002; Measurement of fatigue. Determining minimally important clinical differences J Clin Epidemiol 55:(3)239–44.PubMedCrossRefGoogle Scholar
  21. 21.
    Lai JS, Cella D, Chang CH, Bode RK, Heinemann AW. 2003; Item banking to improve, shorten and computerize self-reported fatigue: an illustration of steps to create a core item bank from the FACIT-Fatigue Scale. Qual Life Res 12:(5)485–501.PubMedCrossRefGoogle Scholar
  22. 22.
    Given CW, Given B, Azzouz F, Kozachik S, Stommel M. 2001; Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. J Pain Symptom Manage 21:(6)456–66.PubMedCrossRefGoogle Scholar
  23. 23.
    . Lawrence DP, Kupelnick B, Miller K, Devine D, Lau J. Evidence report on the occurrence, assessment, and treatment of fatigue in cancer patients. J Natl Cancer Inst Monogr 2004(32):40–50.Google Scholar
  24. 24.
    Bower JE. 2005; Prevalence and causes of fatigue after cancer treatment: the next generation of research. J Clin Oncol 23:(33)8280–2.PubMedCrossRefGoogle Scholar
  25. 25.
    Hickok JT, Roscoe JA, Morrow GR, Mustian K, Okunieff P, Bole CW. 2005; Frequency, severity, clinical course, and correlates of fatigue in 372 patients during 5 weeks of radiotherapy for cancer. Cancer 104:(8)1772–8.PubMedCrossRefGoogle Scholar
  26. 26.
    . Jacobsen PB. Assessment of fatigue in cancer patients. J Natl Cancer Inst Monogr 2004(32):93–7.Google Scholar
  27. 27.
    Jacobsen PB, Garland LL, Booth-Jones M,. et al. 2004; Relationship of hemoglobin levels to fatigue and cognitive functioning among cancer patients receiving chemotherapy. J Pain Symptom Manage 28:(1)7–18.PubMedCrossRefGoogle Scholar
  28. 28.
    Rodgers GM, 3rd, Cella D, Chanan-Khan A,. et al. 2005; Cancer- and treatment-related anemia. J Natl Compr Canc Netw 3:(6)772–89.PubMedGoogle Scholar
  29. 29.
    Morrow GR, Hickok JT, Roscoe JA,. et al. 2003; Differential effects of paroxetine on fatigue and depression: a randomized, double-blind trial from the University of Rochester Cancer Center Community Clinical Oncology Program. J Clin Oncol 21:(24)4635–41.PubMedCrossRefGoogle Scholar
  30. 30.
    Stone P, Richards M, Hardy J. 1998; Fatigue in patients with cancer. Eur J Cancer 34:(11)1670–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Cleeland CS, Bennett GJ, Dantzer R,. et al. 2003; Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? A cytokine-immunologic model of cancer symptoms. Cancer 97:(11)2919–25.PubMedCrossRefGoogle Scholar
  32. 32.
    Raison CL, Miller AH. 2003; Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry 54:(3)283–94.PubMedCrossRefGoogle Scholar
  33. 33.
    Musselman DL, Lawson DH, Gumnick JF,. et al. 2001; Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med 344:(13)961–6.PubMedCrossRefGoogle Scholar
  34. 34.
    Capuron L, Gumnick JF, Musselman DL,. et al. 2002; Neurobehavioral effects of interferon-alpha in cancer patients: phenomenology and paroxetine responsiveness of symptom dimensions. Neuropsychopharmacology 26:(5)643–52.PubMedCrossRefGoogle Scholar
  35. 35.
    Bower JE, Ganz PA, Aziz N, Fahey JL. 2002; Fatigue and proinflammatory cytokine activity in breast cancer survivors. Psychosom Med 64:(4)604–11.PubMedGoogle Scholar
  36. 36.
    Brown DJ, McMillan DC, Milroy R. 2005; The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer. Cancer 103:(2)377–82.PubMedCrossRefGoogle Scholar
  37. 37.
    Collado-Hidalgo A, Bower JE, Ganz PA, Cole SW, Irwin MR. 2006; Inflammatory biomarkers for persistent fatigue in breast cancer survivors. Clin Cancer Res 12:(9)2759–66.PubMedCrossRefGoogle Scholar
  38. 38.
    Kurzrock R. 2001; The role of cytokines in cancer-related fatigue. Cancer 92:(6 Suppl)1684–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Meyers CA, Albitar M, Estey E. 2005; Cognitive impairment, fatigue, and cytokine levels in patients with acute myelogenous leukemia or myelodysplastic syndrome. Cancer 104:(4)788–93.PubMedCrossRefGoogle Scholar
  40. 40.
    Dimeo F, Schmittel A, Fietz T,. et al. 2004; Physical performance, depression, immune status and fatigue in patients with hematological malignancies after treatment. Ann Oncol 15:(8)1237–42.PubMedCrossRefGoogle Scholar
  41. 41.
    Geinitz H, Zimmermann FB, Stoll P,. et al. 2001; Fatigue, serum cytokine levels, and blood cell counts during radiotherapy of patients with breast cancer. Int J Radiat Oncol Biol Phys 51:(3)691–8.PubMedCrossRefGoogle Scholar
  42. 42.
    Berger AM, Higginbotham P. 2000; Correlates of fatigue during and following adjuvant breast cancer chemotherapy: a pilot study. Oncol Nurs Forum 27:(9)1443–8.PubMedGoogle Scholar
  43. 43.
    Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR. 2000; Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 18:(4)743–53.PubMedGoogle Scholar
  44. 44.
    Stone P, Richards M, A’Hern R, Hardy J. 2000; A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Ann Oncol 11:(5)561–7.PubMedCrossRefGoogle Scholar
  45. 45.
    . Miaskowski C. Gender differences in pain, fatigue, and depression in patients with cancer. J Natl Cancer Inst Monogr 2004(32):139–43.Google Scholar
  46. 46.
    Jacobsen PB, Andrykowski MA, Thors CL. 2004; Relationship of catastrophizing to fatigue among women receiving treatment for breast cancer. J Consult Clin Psychol 72:(2)355–61.PubMedCrossRefGoogle Scholar
  47. 47.
    Sugawara Y, Akechi T, Okuyama T,. et al. 2005; Occurrence of fatigue and associated factors in disease-free breast cancer patients without depression. Support Care Cancer 13:(8)628–36.PubMedCrossRefGoogle Scholar
  48. 48.
    Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L. 2005; Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:(24)5501–10.PubMedCrossRefGoogle Scholar
  49. 49.
    Demetri GD, Kris M, Wade J, Degos L, Cella D. 1998; Quality-of-life benefit in chemotherapy patients treated with epoetin-alpha is independent of disease response or tumor type: results from a prospective community oncology study. J Clin Oncol 16:3412–25.PubMedGoogle Scholar
  50. 50.
    Glaspy J, Bukowski, RSteinberg, DTaylor, CTchekmedyian, SVadhan-Raj. S1997; Impact of therapy with epoetin alfa on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. Procrit Study Group J Clin Oncol 15:(3)1218–34.PubMedGoogle Scholar
  51. 51.
    Brower V. 2003;Epoetin for cancer patients: a boon or a danger? J Natl Cancer Inst 95:(24)1820–1.Google Scholar
  52. 52.
    Leyland-Jones B. 2003; Breast cancer trial with erythropoietin terminated unexpectedly. Lancet Oncol 4:(8)459–60.PubMedCrossRefGoogle Scholar
  53. 53.
    Henke M, Laszig R, Rube C,. et al. 2003; Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial. Lancet 362:(9392)1255–60.PubMedCrossRefGoogle Scholar
  54. 54.
    Henke MMattern DPepeMattern M et al. 2006; Do erythropoietin receptors on cancer cells explain unexpected clinical findings? J Clin Oncol 24:(29)4708–13.PubMedCrossRefGoogle Scholar
  55. 55.
    Bohlius J, Weingart O, Trelle S, Engert A. 2006; Cancer-related anemia and recombinant human erythropoietin – an updated overview. Nat Clin Pract Oncol 3:(3)152–64.PubMedCrossRefGoogle Scholar
  56. 56.
    Oyer DS, Shah A, Bettenhausen S. 2006; How to manage steroid diabetes in the patient with cancer. J Support Oncol 4:(9)479–83.PubMedGoogle Scholar
  57. 57.
    Desai J, Yassa L, Marqusee E,. et al. 2006; Hypothyroidism after sunitinib treatment for patients with gastrointestinal stromal tumors. Ann Intern Med 145:(9)660–4.PubMedGoogle Scholar
  58. 58.
    Garcia JM, Li H, Mann D,. et al. 2006; Hypogonadism in male patients with cancer. Cancer 106:(12)2583–91.PubMedCrossRefGoogle Scholar
  59. 59.
    Strasser F, Palmer JL, Schover LR,. et al. 2006; The impact of hypogonadism and autonomic dysfunction on fatigue, emotional function, and sexual desire in male patients with advanced cancer: a pilot study. Cancer 107:(12)2949–57.PubMedCrossRefGoogle Scholar
  60. 60.
    Rajagopal A, Vassilopoulou-Sellin R, Palmer JL, Kaur G, Bruera E. 2003; Hypogonadism and sexual dysfunction in male cancer survivors receiving chronic opioid therapy. J Pain Symptom Manage 26:(5)1055–61.PubMedCrossRefGoogle Scholar
  61. 61.
    Rajagopal A, Vassilopoulou-Sellin R, Palmer JL, Kaur G, Bruera E. 2004; Symptomatic hypogonadism in male survivors of cancer with chronic exposure to opioids. Cancer 100:(4)851–8.PubMedCrossRefGoogle Scholar
  62. 62.
    FischLadha MJ2006; Fatigue trials in ambulatory cancer patients: where do we begin and where could it possibly end? J Support Oncol 4:(10)519–20.Google Scholar
  63. 63.
    . Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2006(4):CD005001.Google Scholar
  64. 64.
    Ladha AB, Courneya KS, Bell GJ, Field CJ, Grundy P. 2006; Effects of acute exercise on neutrophils in pediatric acute lymphoblastic leukemia survivors: a pilot study. J Pediatr Hematol Oncol 28:(10)671–7.PubMedCrossRefGoogle Scholar
  65. 65.
    Karvinen KH, Courneya KS, Campbell KL,. et al. 2006; Exercise preferences of endometrial cancer survivors: a population-based study. Cancer Nurs 29:(4)259–65.PubMedCrossRefGoogle Scholar
  66. 66.
    Courneya KS, Friedenreich CM, Quinney HA,. et al. 2005; A longitudinal study of exercise barriers in colorectal cancer survivors participating in a randomized controlled trial. Ann Behav Med 29:(2)147–53.PubMedCrossRefGoogle Scholar
  67. 67.
    Jones LW, Courneya KS, Vallance JK,. et al. 2004; Association between exercise and quality of life in multiple myeloma cancer survivors. Support Care Cancer 12:(11)780–8.PubMedCrossRefGoogle Scholar
  68. 68.
    Segal RJ, Reid RD, Courneya KS,. et al. 2003; Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 21:(9)1653–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS. 2003; A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care (Engl) 12:(4)347–57.CrossRefGoogle Scholar
  70. 70.
    Mansky P, Sannes T, Wallerstedt D,. et al. 2006; Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors. Integr Cancer Ther 5:(3)192–201.PubMedCrossRefGoogle Scholar
  71. 71.
    Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. 2006; A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psychooncology 15:(10)891–7.PubMedCrossRefGoogle Scholar
  72. 72.
    Carlson LE, Speca M, Patel KD, Goodey E. 2004; Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology 29:(4)448–74.PubMedCrossRefGoogle Scholar
  73. 73.
    Cohen L, Warneke C, Fouladi RT, Rodriguez MA, Chaoul-Reich A. 2004; Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer 100:(10)2253–60.PubMedCrossRefGoogle Scholar
  74. 74.
    Mustian KM, Katula JA, Zhao H. 2006; A pilot study to assess the influence of Tai Chi Chuan on functional capacity among breast cancer survivors. J Support Oncol 4:(3)139–45.PubMedGoogle Scholar
  75. 75.
    Ott MJ, Norris RL, Bauer-Wu SM. 2006; Mindfulness meditation for oncology patients: a discussion and critical review. Integr Cancer Ther 5:(2)98–108.PubMedCrossRefGoogle Scholar
  76. 76.
    Inui A. 2002; Cancer anorexia-cachexia syndrome: current issues in research and management. CA Cancer J Clin 52:(2)72–91.PubMedCrossRefGoogle Scholar
  77. 77.
    Strang P. 1997; The effect of megestrol acetate on anorexia, weight loss and cachexia in cancer and AIDS patients (review). Anticancer Res 17:(1B)657–62.PubMedGoogle Scholar
  78. 78.
    Cruciani RA, Dvorkin E, Homel P,. et al. 2004; L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency: a preliminary analysis. Ann N Y Acad Sci 1033:168–76.PubMedCrossRefGoogle Scholar
  79. 79.
    Barsevick AM, Dudley W, Beck S, Sweeney C, Whitmer K, Nail L. 2004; A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer 100:(6)1302–10.PubMedCrossRefGoogle Scholar
  80. 80.
    Yates P, Aranda S, Hargraves M,. et al. 2005; Randomized controlled trial of an educational intervention for managing fatigue in women receiving adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol 23:(25)6027–36.PubMedCrossRefGoogle Scholar
  81. 81.
    Given B, Given CW, McCorkle R,. et al. 2002; Pain and fatigue management: results of a nursing randomized clinical trial. Oncol Nurs Forum 29:(6)949–56.PubMedCrossRefGoogle Scholar
  82. 82.
    Godino C, Jodar L, Duran A, Martinez I, Schiaffino A. 2006; Nursing education as an intervention to decrease fatigue perception in oncology patients. Eur J Oncol Nurs 10:(2)150–5.PubMedCrossRefGoogle Scholar
  83. 83.
    Sood A, Barton DL, Loprinzi CL. 2006; Use of methylphenidate in patients with cancer. Am J Hosp Palliat Care 23:(1)35–40.PubMedCrossRefGoogle Scholar
  84. 84.
    Sarhill N, Walsh D, Nelson KA, Homsi J, LeGrand S, Davis MP. 2001; Methylphenidate for fatigue in advanced cancer: a prospective open-label pilot study. Am J Hosp Palliat Care 18:(3)187–92.PubMedCrossRefGoogle Scholar
  85. 85.
    Bruera E, Miller MJ, Macmillan K, Kuehn N. 1992; Neuropsychological effects of methylphenidate in patients receiving a continuous infusion of narcotics for cancer pain. Pain 48:(2)163–6.PubMedCrossRefGoogle Scholar
  86. 86.
    Wilwerding MB, Loprinzi CL, Mailliard JA,. et al. 1995; A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics. Support Care Cancer 3:(2)135–8.PubMedCrossRefGoogle Scholar
  87. 87.
    Fillion L, Gelinas C, Simard S, Savard J, Gagnon P. 2003; Validation evidence for the French Canadian adaptation of the Multidimensional Fatigue Inventory as a measure of cancer-related fatigue. Cancer Nurs 26:(2)143–54.PubMedCrossRefGoogle Scholar
  88. 88.
    Meyers CA, Weitzner MA, Valentine AD, Levin VA. 1998; Methylphenidate therapy improves cognition, mood, and function of brain tumor patients. J Clin Oncol 16:(7)2522–7.PubMedGoogle Scholar
  89. 89.
    Mulhern RK, Khan RB, Kaplan S,. et al. 2004; Short-term efficacy of methylphenidate: a randomized, double-blind, placebo-controlled trial among survivors of childhood cancer. J Clin Oncol 22:(23)4795–803.PubMedCrossRefGoogle Scholar
  90. 90.
    Thompson SJ, Leigh L, Christensen R,. et al. 2001; Immediate neurocognitive effects of methylphenidate on learning-impaired survivors of childhood cancer. J Clin Oncol 19:(6)1802–8.PubMedGoogle Scholar
  91. 91.
    Bruera E, Driver L, Barnes EA,. et al. 2003; Patient-controlled methylphenidate for the management of fatigue in patients with advanced cancer: a preliminary report. J Clin Oncol 21:(23)4439–43.PubMedCrossRefGoogle Scholar
  92. 92.
    Hanna A, Sledge G, Mayer ML,. et al. 2006; A phase II study of methylphenidate for the treatment of fatigue. Support Care Cancer 14:(3)210–5.PubMedCrossRefGoogle Scholar
  93. 93.
    Bruera E, Valero V, Driver L,. et al. 2006; Patient-controlled methylphenidate for cancer fatigue: a double-blind, randomized, placebo-controlled trial. J Clin Oncol 24:(13)2073–8.PubMedCrossRefGoogle Scholar
  94. 94.
    Madras BK, Xie Z, Lin Z,. et al. 2006; Modafinil occupies dopamine and norepinephrine transporters in vivo and modulates the transporters and trace amine activity in vitro. J Pharmacol Exp Ther 319:(2)561–9.PubMedCrossRefGoogle Scholar
  95. 95.
    Morrow GR, Andrews PL, Hickok JT, Roscoe JA, Matteson S. 2002; Fatigue associated with cancer and its treatment. Support Care Cancer 10:(5)389–98.PubMedCrossRefGoogle Scholar
  96. 96.
    Raison CL, Demetrashvili M, Capuron L, Miller AH. 2005; Neuropsychiatric adverse effects of interferon-alpha: recognition and management. CNS Drugs 19:(2)105–23.PubMedCrossRefGoogle Scholar
  97. 97.
    Jean-Pierre P, Mustian K, Kohli S, Roscoe JA, Hickok JT, Morrow GR. 2006; Community-based clinical oncology research trials for cancer-related fatigue. J Support Oncol 4:(10)511–6.PubMedGoogle Scholar

Copyright information

© Humana Press, a part of Springer Science + Business Media, LLC 2009

Authors and Affiliations

  1. 1.M.D. Anderson Cancer Center Unit 241 HMB8.063The University of TexasHoustonUSA

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