Skip to main content
SpringerLink
Log in

Cancer-related fatigue: scoping review to synthesize a definition for childhood cancer survivors

  • Review
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Context

There is no universal definition of cancer-related fatigue (CRF) specific to childhood cancer survivors, despite this population facing unique long-term side effects from their cancer. We aimed to synthesize and combine existing definitions of CRF specific to this context to inform on the necessity of a panel of experts to formulate a new definition of CRF for childhood cancer survivors.

Methods

The literature search was performed in various databases. Titles, abstracts, and keywords were screened by two researchers to confirm eligibility. The data extraction process was performed by two researchers. Our search was conducted in various databases.

Results

Thirty articles were included in the qualitative analysis. Two coders reached consensus on 14 codes. The thematization process produced 4 themes: frequency, context, attributes, and consequences of CRF. These themes were used to synthesize a definition of CRF, as follows: “In childhood cancer survivors, cancer-related fatigue is a common late effect of cancer and cancer treatments. It is characterized by a subjective, persistent, and multidimensional experience that differs from normal fatigue in the physical, emotional, and/or cognitive spheres. Cancer-related fatigue may have a variety of negative consequences including a reduced quality of life and level of functioning, a lack of vigor, work difficulties, relationship issues, and emotional distress.”

Conclusion

A definition of CRF applicable to childhood cancer survivors is timely to organize research efforts and design appropriate interventions. The proposed definition is a first step towards the formulation of a new definition of CRF specific to childhood cancer survivors by experts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

CRF:

Cancer-related fatigue

NCCN:

National Comprehensive Cancer Network

PRISMA-ScR:

Preferred Reporting Items for Systematic Reviews and the Meta-Analyses extension for Scoping Reviews

References

  1. World Health Organization. Childhood cancer 2021 [cited 2021 November 20]. Available from: https://www.who.int/fr/news-room/fact-sheets/detail/cancer-in-children.

  2. Ellison LF, Xie L, Sung L. Trends in paediatric cancer survival in Canada, 1992, to 2017 2021 [cited 2021 November 20]. Available from: https://www150.statcan.gc.ca/n1/pub/82-003-x/2021002/article/00001-eng.htm.

  3. Lam CG, Howard SC, Bouffet E, Pritchard-Jones K (2019) Science and health for all children with cancer. Science 363(6432):1182–1186

    Article  CAS  PubMed  Google Scholar 

  4. Ward ZJ, Yeh JM, Bhakta N, Frazier AL, Girardi F, Atun R (2019) Global childhood cancer survival estimates and priority-setting: a simulation-based analysis. Lancet Oncol 20(7):972–983

    Article  PubMed  Google Scholar 

  5. American Cancer Society. Late effects of childhood cancer treatment 2021 [Available from: https://www.cancer.org/treatment/children-and-cancer/when-your-child-has-cancer/late-effects-of-cancer-treatment.html.

  6. Sarfati D, Koczwara B, Jackson C (2016) The impact of comorbidity on cancer and its treatment CA: a cancer. J Clin 66(4):337–350

    Google Scholar 

  7. Siegel DA, Richardson LC, Henley SJ, Wilson RJ, Dowling NF, Weir HK et al (2020) Pediatric cancer mortality and survival in the United States, 2001–2016. Cancer 126(19):4379–4389

    Article  PubMed  Google Scholar 

  8. van Deuren S, Boonstra A, van Dulmen‐den Broeder E, Blijlevens N, Knoop H, Loonen J. 2020 Severe fatigue after treatment for childhood cancer. J Cochrane Database of Systematic Reviews. (3)

  9. Du S, Hu L, Dong J, Xu G, Jin S, Zhang H et al (2015) Patient education programs for cancer-related fatigue: a systematic review. Patient Educ Couns 98(11):1308–1319

    Article  PubMed  Google Scholar 

  10. Kangas M, Bovbjerg DH, Montgomery GH (2008) Cancer-related fatigue: a systematic and meta-analytic review of non-pharmacological therapies for cancer patients. Psychol Bull 134(5):700–741

    Article  PubMed  Google Scholar 

  11. Scott JA, Lasch KE, Barsevick AM, Piault-Louis E (2011) Patients’ experiences with cancer-related fatigue: a review and synthesis of qualitative research. Oncol Nurs Forum 38(3):E191-203

    Article  PubMed  Google Scholar 

  12. Minton O, Richardson A, Sharpe M, Hotopf M, Stone P. Drug therapy for the management of cancer-related fatigue. Cochrane Database of Systematic Reviews. 2010:N.PAG-N.PAG.

  13. Ling W-m, Lui LYY, So WKW, Chan K (2014) Effects of acupuncture and acupressure on cancer-related fatigue: a systematic review. Oncol Nurs Forum 41(6):581–592

    Article  PubMed  Google Scholar 

  14. Penson A, van Deuren S, Bronkhorst E, Keizer E, Heskes T, Coenen MJH et al (2021) Methodology of the DCCSS later fatigue study: a model to investigate chronic fatigue in long-term survivors of childhood cancer. BMC Med Res Methodol 21(1):1–12

    Article  Google Scholar 

  15. Hamre H, Zeller B, Kanellopoulos A, Ruud E, Fosså SD, Loge JH et al (2013) Serum cytokines and chronic fatigue in adults surviving after childhood leukemia and lymphoma. Brain Behav Immun 30:80–87

    Article  CAS  PubMed  Google Scholar 

  16. Cheung YT, Brinkman TM, Mulrooney DA, Mzayek Y, Liu W, Banerjee P et al (2017) Impact of sleep, fatigue, and systemic inflammation on neurocognitive and behavioral outcomes in long-term survivors of childhood acute lymphoblastic leukemia. Cancer 123(17):3410–3419

    Article  CAS  PubMed  Google Scholar 

  17. Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D et al (2015) Cancer-related fatigue, version 2.2015. J Natl Compr Canc Netw 13(8):1012–1039

    Article  PubMed  PubMed Central  Google Scholar 

  18. American Cancer Society. What are the differences between cancer in adults and children? 2019 [cited 2022 May 6, 2022]. Available from: https://www.cancer.org/cancer/cancer-in-children/differences-adults-children.html.

  19. van Deuren S, van Dulmen-den Broeder E, Boonstra A, Gielissen M, Blijlevens N, Loonen J, et al. Fatigue-related cognitive-behavioral factors in survivors of childhood cancer: comparison with chronic fatigue syndrome and survivors of adult-onset cancer. Journal of Adolescent Young Adult Oncology. 2020.

  20. Yi J, Kim MA, Tian T (2014) Perceived long-term and physical health problems after cancer: adolescent and young adult survivors of childhood cancer in Korea. Eur J Oncol Nurs Official J Eur Oncol Nurs Soc 18(2):145–150

    Article  Google Scholar 

  21. Graef DM, Phipps S, Parris KR, Martin-Elbahesh K, Huang L, Zhang H et al (2016) Sleepiness, fatigue, behavioral functioning, and quality of life in survivors of childhood hematopoietic stem cell transplant. J Pediatr Psychol 41(6):600–609

    Article  PubMed  Google Scholar 

  22. Meeske KA, Patel SK, Palmer SN, Nelson MB, Parow AM (2007) Factors associated with health-related quality of life in pediatric cancer survivors. Pediatr Blood Cancer 49(3):298–305

    Article  PubMed  Google Scholar 

  23. Evans S, Seidman L, Sternlieb B, Casillas J, Zeltzer L, Tsao J (2017) Clinical case report: yoga for fatigue in five young adult survivors of childhood cancer. J Adolesc Young Adult Oncol 6(1):96–101

    Article  PubMed  PubMed Central  Google Scholar 

  24. Levesque A, Caru M, Duval M, Laverdière C, Sultan S. Exploring contributors to cancer-related fatigue in childhood cancer survivors and the use of non-pharmacological interventions: a scoping review protocol. JBI Evidence Synthesis. 2021.

  25. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169(7):467–473

    Article  PubMed  Google Scholar 

  26. Levesque A, Caru M, Duval M, Laverdière C, Marjerrison S, Sultan S. Cancer-related fatigue in childhood cancer survivors: a systematic scoping review on contributors of fatigue and how they are targeted by non-pharmacological interventions. Critical Reviews in Oncology/Hematology. 2022:103804.

  27. Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK et al (2008) Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS). Sleep 31(2):271–281

    Article  PubMed  PubMed Central  Google Scholar 

  28. Henderson TO, Oeffinger KC, Whitton J, Leisenring W, Neglia J, Meadows A et al (2012) Secondary gastrointestinal cancer in childhood cancer survivors: a cohort study. Ann Intern Med 156(11):757–766

    Article  PubMed  PubMed Central  Google Scholar 

  29. Feuerstein M (2007) Defining cancer survivorship. J Cancer Surviv Res Practice 1(1):5–7

    Article  Google Scholar 

  30. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101

    Article  Google Scholar 

  31. Prepostseo. Compare two documents for duplicate content 2022 [Available from: https://www.prepostseo.com/plagiarism-comparison-search.

  32. Berg C, Hayashi RJ. Participation and self-management strategies of young adult childhood cancer survivors. OTJR: Occupation, Participation and Health. 2013;33(1):21–30.

  33. Blaauwbroek R, Bouma MJ, Tuinier W, Groenier KH, de Greef MHG, Meyboom-de Jong B et al (2009) The effect of exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer: a pilot study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 17(8):1041–1048

    Article  PubMed  Google Scholar 

  34. Boonstra A, Gielissen M, van Dulmen-den BE, Blijlevens N, Knoop H, Loonen J (2019) Cognitive behavior therapy for persistent severe fatigue in childhood cancer survivors: a pilot study. J Pediatr Hematol Oncol 41(4):313–318

    Article  PubMed  Google Scholar 

  35. Hamre H, Zeller B, Kanellopoulos A, Kiserud CE, Aakhus S, Lund MB et al (2013) High prevalence of chronic fatigue in adult long-term survivors of acute lymphoblastic leukemia and lymphoma during childhood and adolescence 2:2–9

    Google Scholar 

  36. Johannsdottir IMR, Hamre H, Fosså SD, Loge JH, Drolsum L, Lund MB et al (2017) Adverse health outcomes and associations with self-reported general health in childhood lymphoma survivors. J Adolesc Young Adult Oncol 6(3):470–476

    Article  PubMed  Google Scholar 

  37. Karimi M, Cox AD, White SV, Karlson CW (2020) Fatigue, physical and functional mobility, and obesity in pediatric cancer survivors. Cancer Nurs 43(4):E239–E245

    Article  PubMed  Google Scholar 

  38. Kelada L, Wakefield C, Heathcote L, Jaaniste T, Signorelli C, Fardell J et al (2019) Perceived cancer-related pain and fatigue, information needs, and fear of cancer recurrence among adult survivors of childhood cancer. Patient Educ Couns 102(12):2270–2278

    Article  CAS  PubMed  Google Scholar 

  39. Langeveld N, Ubbink M, Smets E (2000) “I don’t have any energy”: the experience of fatigue in young adult survivors of childhood cancer. Eur J Oncol Nurs 4(1):20–28

    Article  CAS  PubMed  Google Scholar 

  40. Langeveld NE, Grootenhuis MA, Voûte PA, de Haan RJ, van den Bos C. 2003 No excess fatigue in young adult survivors of childhood cancer. European journal of cancer (Oxford, England 1990) 39(2):204–14.

  41. Rach AM, Crabtree VM, Brinkman TM, Zeltzer L, Marchak JG, Srivastava D et al (2017) Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin’s lymphoma: a report from the childhood cancer survivor study. J Cancer Surviv Res Pract 11(2):256–263

    Article  Google Scholar 

  42. Rogers VE, Mowbray C, Zhu S, Liu L, Ancoli-Israel S, Barr EA, et al. Circadian activity rhythms and fatigue of adolescent cancer survivors and healthy controls: a pilot study. journal of clinical sleep medicine: JCSM: Official Publication of the American Academy of Sleep Medicine. 2020.

  43. Zeller B, Loge JH, Kanellopoulos A, Hamre H, Wyller VB, Ruud E (2014) Chronic fatigue in long-term survivors of childhood lymphomas and leukemia: persistence and associated clinical factors. J Pediatr Hematol Oncol 36(6):438–444

    Article  PubMed  Google Scholar 

  44. Zeller B, Ruud E, Havard Loge J, Kanellopoulos A, Hamre H, Godang K et al (2014) Chronic fatigue in adult survivors of childhood cancer: associated symptoms, neuroendocrine markers, and autonomic cardiovascular responses. Psychosomatics 55(6):621–629

    Article  PubMed  Google Scholar 

  45. National Cancer Institute. Adolescents and young adults with cancer 2021 [Available from: https://www.cancer.gov/types/aya.

  46. Berg C, Neufeld P, Harvey J, Downes A, Hayashi RJ. Late effects of childhood cancer, participation, and quality of life of adolescents. OTJR: Occupation, Participation & Health. 2009;29(3):116–24.

  47. Hooke MC, Gilchrist L, Foster L, Langevin M, Lee J (2016) Yoga for children and adolescents after completing cancer treatment journal of pediatric oncology nursing : official. J Association Pediat Oncol Nurses 33(1):64–73

    Article  Google Scholar 

  48. Irestorm E, Olsson IT, Johansson B, Øra I (2020) Cognitive fatigue in relation to depressive symptoms after treatment for childhood cancer. BMC Psychology 8(1):1–9

    Article  Google Scholar 

  49. Karst JS, Hoag JA, Anderson LJ, Schmidt DJ, Schroedl RL, Bingen KM. Evaluation of fatigue and related factors in survivors of pediatric cancer and hematopoietic stem cell transplant. Journal of Child Health Care. 2021:13674935211014748.

  50. Li WH, Ho K, Lam K, Lam H, Chui S, Chan GC et al (2018) Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors: a randomized controlled trial. Int J Nurs Stud 83:65–74

    Article  PubMed  Google Scholar 

  51. Mört S, Lähteenmäki PM, Matomäki J, Salmi TT, Salanterä S (2011) Fatigue in young survivors of extracranial childhood cancer: a Finnish nationwide survey. Oncol Nurs Forum 38(6):E445–E454

    Article  PubMed  Google Scholar 

  52. Nagai A, Zou N, Kubota M, Kojima C, Adachi S, Usami I et al (2012) Fatigue in survivors of childhood acute lymphoblastic and myeloid leukemia in Japan. Pediat Int official J Japan Pediat Soc 54(2):272–276

    Article  Google Scholar 

  53. 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 official J Am Soc Clin Oncol 23(24):5501–5510

    Article  Google Scholar 

  54. Ho KY, Li WHC, Lam KWK, Wei X, Chiu SY, Chan C-FG, et al. Relationships among fatigue, physical activity, depressive symptoms, and quality of life in Chinese children and adolescents surviving cancer. European journal of oncology nursing : the official journal of European Oncology Nursing Society. 2019;38:21–7.

  55. Li WHC, Ho KY, Lam KKW, Lam HS, Chui SY, Chan GCF et al (2018) Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors: a randomized controlled trial. Int J Nurs Stud 83:65–74

    Article  PubMed  Google Scholar 

  56. Henderson TO, Friedman DL, Meadows AT (2010) Childhood cancer survivors: transition to adult-focused risk-based care. Pediatrics 126(1):129–136

    Article  PubMed  Google Scholar 

  57. Klosky JL, Cash DK, Buscemi J, Lensing S, Garces-Webb DM, Zhao W et al (2008) Factors influencing long-term follow-up clinic attendance among survivors of childhood cancer. J Cancer Surviv 2(4):225–232

    Article  PubMed  PubMed Central  Google Scholar 

  58. Oeffinger KC, Wallace WHB (2006) Barriers to follow-up care of survivors in the United States and the United Kingdom. Pediatr Blood Cancer 46(2):135–142

    Article  PubMed  Google Scholar 

  59. Cherven B, Mertens A, Meacham LR, Williamson R, Boring C, Wasilewski-Masker K (2014) Knowledge and risk perception of late effects among childhood cancer survivors and parents before and after visiting a childhood cancer survivor clinic. J Pediatr Oncol Nurs 31(6):339–349

    Article  PubMed  Google Scholar 

  60. Oeffinger KC, Mertens AC, Hudson MM, Gurney JG, Casillas J, Chen H et al (2004) Health care of young adult survivors of childhood cancer: a report from the childhood cancer survivor study. The Annals of Family Med 2(1):61–70

    Article  Google Scholar 

  61. Bennett S, Pigott A, Beller EM, Haines T, Meredith P, Delaney C. Educational interventions for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2016 11 008144.

  62. Goedendorp MM, Gielissen MF, Verhagen CA, Bleijenberg G. Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database of Systematic Reviews. 2009:N.PAG-N.PAG.

  63. Jacobsen PB, Donovan KA, Vadaparampil ST, Small BJ (2007) Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue. Health Psychol 26(6):660–667

    Article  PubMed  PubMed Central  Google Scholar 

  64. Song S, Yu J, Ruan Y, Liu X, Xiu L, Yue X (2018) Ameliorative effects of Tai Chi on cancer-related fatigue: a meta-analysis of randomized controlled trials. Support Care Cancer 26(7):2091–2102

    Article  PubMed  Google Scholar 

  65. Munn Z, Peters MD, Stern C, Tufanaru C, McArthur A, Aromataris E (2018) Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 18(1):143

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Université de Montreal, Montreal, Canada

    Ariane Levesque & Serge Sultan

  2. Research Center, Sainte-Justine University Health Center, Montreal, Canada

    Ariane Levesque, Michel Duval, Caroline Laverdière & Serge Sultan

  3. Department of Pediatric Hematology and Oncology, and Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA

    Maxime Caru

  4. Charles-Bruneau Cancer Care Center, Sainte-Justine University Health Center, Montreal, Canada

    Michel Duval, Caroline Laverdière & Serge Sultan

  5. Department of Pediatrics, Université de Montreal, Montreal, Canada

    Michel Duval, Caroline Laverdière & Serge Sultan

  6. Department of Pediatrics, McMaster University Children’s Hospital, Hamilton, ON, Canada

    Stacey Marjerrison

Authors
  1. Ariane Levesque
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maxime Caru
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michel Duval
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Caroline Laverdière
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stacey Marjerrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Serge Sultan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Ariane Levesque substantially contributed to the conceptualization and design of the study, extracted data from included articles, performed the qualitative analysis, drafted the initial manuscript, and critically revised the manuscript for important intellectual content. Maxime Caru substantially contributed to the conceptualization and design of the study, extracted data from included articles, performed the qualitative analysis, and critically revised the manuscript for important intellectual content. Michel Duval, Caroline Laverdière, and Stacey Marjerrison substantially helped analyze and interpret the data and critically revised the manuscript for important intellectual content. Serge Sultan substantially contributed to the conceptualization and design of the study, substantially helped analyze and interpret the data, and critically revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted.

Corresponding author

Correspondence to Ariane Levesque.

Ethics declarations

Competing interests

The authors declare no competing interests.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Levesque, A., Caru, M., Duval, M. et al. Cancer-related fatigue: scoping review to synthesize a definition for childhood cancer survivors. Support Care Cancer 31, 231 (2023). https://doi.org/10.1007/s00520-023-07690-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00520-023-07690-x

Keywords

Search

Navigation