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Fatigue is today the most common and incapacitating side effect in patients with cancer. Fatigue affects both physical and psychosocial function and reduces the patients’ quality of life. It is aggravated with co-morbidities and the presence and severity of other symptoms like pain, insomnia, depression, anxiety, diarrhoea. Risk factors also include female gender and young age. The mechanisms explaining fatigue is still mostly unknown and there is no general treatment to alleviate the symptoms, although effective treatment of co-existing symptoms and easy exercise will make some benefit. The multidimensional syndrome fatigue has a profound effect on the patients’ quality of life, including the physical, psychological, and economic/occupational aspects. The objectives of the article are further to describe the causes and contributing factors for fatigue, tentative mechanisms of action and treatment.1

Patients with severe diseases such as cancer commonly report tiredness or a lack of energy during the course of their disease and treatment,2 which is not equivalent to anything they have experienced before the advent of their illness. This syndrome, called fatigue, is long lasting and interferes with every aspect of life.3 The National Comprehensive Cancer Network (NCCN) defines cancer-related fatigue (CRF) as ‘a persistent, subjective sense of tiredness related to cancer or cancer treatments that interferes with usual functioning’.4 ,5 It differs from the fatigue of everyday life, which usually is temporary and is relived by rest. CRF is more severe, more distressing and usually not relieved by rest.5

CRF is a multidimensional syndrome. There are …

Correspondence to Per Hartvig Honoré, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark; peh{at}

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