title: Teenage and Young Adult Cancer-Related Fatigue Is Prevalent, Distressing, and Neglected: It Is Time to Intervene. A Systematic Literature Review and Narrative Synthesis.
abstract: OBJECTIVE
  Cancer-related fatigue in adults has been the subject of considerable recent research, confirming its importance as a common and debilitating symptom, and establishing a number of evidence-based interventions. There has, however, been limited focus on the fatigue suffered by teenagers and young adults with cancer, a group recognized as having unique experiences and developmental needs. We have undertaken a systematic review of the literature to provide a comprehensive overview of studies evaluating fatigue in this younger patient group in order to guide clinical practice and future research.
  
  
  METHODS
  We searched MEDLINE, EMBASE, PsycINFO, and CINAHL databases for literature containing data relating to any aspect of fatigue in patients aged 13-24 at cancer diagnosis or treatment.
  
  
  RESULTS
  Sixty articles were identified, of which five described interventional clinical trials. Cancer-related fatigue was consistently one of the most prevalent, severe, and distressing symptoms, and it persisted long-term in survivors. It was associated with a number of factors, including poor sleep, depression, and chemotherapy. There was little evidence for the effectiveness of any intervention, although exercise appears to be the most promising. Importantly, fatigue was itself a significant barrier to physical and social activities.
  
  
  CONCLUSIONS
  Cancer-related fatigue is a major and disabling problem in young cancer patients. Effective management strategies are needed to avoid compounding the dependence and social isolation of this vulnerable patient group. Future research should focus on providing evidence for the effectiveness of interventions, of which activity promotion and management of concurrent symptoms are the most promising.
authors: Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom . ; Department of Public Health and Primary Care, University of Cambridge , Cambridge, United Kingdom .
authors: Anna
authors: A
authors: Spathis
authors: Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom . ; University of Cambridge , Cambridge, United Kingdom .
authors: Sara
authors: S
authors: Booth
authors: Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom .
authors: Sarah
authors: S
authors: Grove
authors: TYA Cancer Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom .
authors: Helen
authors: H
authors: Hatcher
authors: University of Cambridge Medical Library , Cambridge, United Kingdom .
authors: Isla
authors: I
authors: Kuhn
authors: Department of Public Health and Primary Care, University of Cambridge , Cambridge, United Kingdom .
authors: Stephen
authors: S
authors: Barclay
mesh_terms: D000293:Adolescent; D000328:Adult; D005221:Fatigue / Q000209:etiology*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D015995:Prevalence; D011788:Quality of Life; D017741:Survivors; D055815:Young Adult
keywords: fatigue; impact; intervention; prevalence