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Cancer-related fatigue (CRF) is one of the most common and severe challenges faced by cancer patients, affecting their quality of life, treatment adherence, and prognosis. As medical research advances, CRF has not only been included in the ICD-10 diagnosis classification of diseases but has also been addressed by prescription botanical drugs approved by health authorities. By treating fatigue, these drugs can improve patients' quality of life and facilitate the successful completion of the overall cancer treatment regimen.
Highlights
92% of cancer patients experience fatigue during their illness
1/4 of cancer-related fatigue patients require pharmacological assistance for moderate to severe fatigue
1/3 of cancer patients have had their treatment course affected by fatigue
Cancer-related fatigue is classified under the ICD-10 diagnosis code
In 2010, Taiwan's TFDA issued the first marketing approval for a prescription botanical drug to treat and improve cancer-related fatigue
In 2017, the Taiwan Society of Cancer Palliative Medicine and the Taiwan Oncology Nursing Society jointly developed and published the "Clinical Treatment Guidelines for Cancer-Related Fatigue"
In 2021, prescription botanical drugs for treating cancer-related fatigue were included in Taiwan's National Health Insurance reimbursement list
Cancer-related fatigue
92% of cancer patients suffer from fatigue, 1/4 of which are moderately to severely fatigued
Fatigue is not necessarily an indication of disease progression or ineffective treatment, nor is it an inevitable phenomenon during cancer treatment. Cancer-related fatigue is quite common, with statistics from a large-scale epidemiological survey by the Taiwan Society of Cancer Palliative Medicine showing that 92% of cancer patients in Taiwan experience fatigue. Among them, 1/4 of patients have moderate to severe fatigue (fatigue score of 4-10 points), which, if left untreated, can often lead to delays or interruptions in treatment, affecting its efficacy.
The World Health Organization (WHO) has included cancer-related fatigue in its disease diagnosis, with the ICD-10 diagnosis code R53.0.
The definition of cancerrelated fatigue (CRF) in the guidelines of the National Comprehensive Cancer Network (NCCN) is: a subjective, long-lasting and overwhelming sense of exhaustion caused by cancer or its treatment. This fatigue creates a continuous lack of energy in the body, mind, and spirit, causing emotional, cognitive, and physical burdens and affecting daily life. Fatigue in cancer patients is not directly related to activity levels and cannot be relieved by rest. Common symptoms include: fatigue, lack of energy, difficulty concentrating, insomnia or excessive sleepiness, loss of appetite, feeling of heaviness, depression, and loss of interest in life and social interactions.
Cancer-related fatigue has been recognized as a clinical disease by the World Health Organization (WHO) and is officially listed in the ICD-10 disease diagnosis, with a clear diagnostic criterion and a diagnosis code of R53.0. This indicates that cancer-related fatigue is a condition that requires attention and active treatment.
The number of cancer patients continues to rise, and cancer fatigue treatment drugs are included in the National Health Insurance coverage.
According to the latest cancer registry report published by the National Health Administration, in 2019, on average, one person was diagnosed with cancer every 4 minutes and 20 seconds, which is 11 seconds faster than in 2018. The number of new cancer cases was 121,254, an increase of 5,123 compared to 2018. Due to rapid population aging and unhealthy lifestyles, the number of cancer cases will continue to rise.
In response to the need for improved medical quality, the Central Health Insurance Administration of the Ministry of Health and Welfare included the first prescription botanical new drug with an indication for treating cancer-related fatigue in National Health Insurance coverage in March 2021. This initiative aims to help cancer patients effectively treat fatigue, complete their treatment course smoothly, and achieve successful cancer treatment outcomes.
Related information
Taiwan's TFDA issued a new prescription plant drug for the treatment of cancerrelated fatigue
Medical Information
Taiwan medical association jointly publishes "Clinical Treatment Guidelines for Cancer-Related Fatigue"
Cancer-related fatigue (CRF) is one of the most common symptoms and challenges faced by cancer patients, often having a significant impact on their quality of life. However, in clinical practice, cancer patients rarely mention fatigue symptoms, leading to the issue of cancer-related fatigue being easily overlooked and not receiving appropriate treatment.
Following the completion of the epidemiological survey on cancer-related fatigue in Taiwan, clinical experts from the Taiwan Society of Cancer Palliative Medicine collaborated with the Taiwan Oncology Nursing Society to develop and publish the "Clinical Treatment Guidelines for Cancer-Related Fatigue." The aim is to raise awareness among patients, their families, and healthcare professionals about the importance of treating cancer fatigue and to ensure that cancer patients receive the best possible medical care.
Related Medical Association Links
Taiwan Society of Cancer Palliative Medicine
- Introduction to Cancer-Related Fatigue | Taiwan Society of Cancer Palliative Medicine
Additional Information
Fighting cancer is a long-lasting battle, and more than 90% of cancer patients in Taiwan are affected by cancer-related fatigue. Cancer-related fatigue encompasses both physiological and psychological aspects, and discussing "how to treat and manage cancer-related fatigue" with a clinical team is essential. If you are experiencing cancer-related fatigue or related challenges, please consult your primary physician and do not let fatigue affect your cancer treatment and life.
Health Education Resources
Cancer-related fatigue (CRF) is one of the most common challenges faced by cancer patients, often affecting the smooth progress of cancer treatment and significantly impacting their quality of life. Through the creation of diverse health education tools by the medical community and patient groups, accurate information on cancer fatigue is provided, encouraging cancer patients to be more proactive in discussing fatigue symptoms with healthcare professionals and discussing treatments for cancer fatigue so that patients' fatigue can be effectively improved, and the overall cancer treatment process can be successfully completed.
Never tired of you！ Beat Cancer-Related Fatigue！
Taiwan Society of Cancer Palliative Medicine has produced an animated health education video titled "Never tired of you! Beat Cancer-Related Fatigue!" in Mandarin, English, and Taiwanese. The animation introduces cancer-related fatigue and its treatment in an easy-to-understand manner, helping people effectively combat cancer fatigue.
What is Cancer-Related Fatigue? The New Trend in Treatment You Must Know!
The HOPE Cancer Foundation's "Anti-Cancer Strategies" series features a video titled "What is Cancer-Related Fatigue? The New Trend in Treatment You Must Know!" inviting clinical physicians to provide an in-depth yet accessible introduction to cancer fatigue, its impact on patient's lives and treatment, as well as methods for treatment and improvement. It also addresses whether it can be prevented in advance.
Are You Tired? It Could Be "Cancer-Related Fatigue"!
The HOPE Cancer Foundation's “fatigue care kit” includes a video titled "Are You Tired? It Could Be 'Cancer-Related Fatigue'!"which provides information for patients and the public to understand the difference between cancer fatigue and regular tiredness. It covers everything from the assessment and diagnosis of cancer-related fatigue to drug treatments, providing a comprehensive overview of the condition.
How to Describe and Assess "Cancer-Related Fatigue"?
According to the epidemiological survey of cancer patients' "cancer-related fatigue" conducted by the Taiwan Society of Cancer Palliative Medicine, 92% of cancer patients experience fatigue during their illness, but only about half of them actively mention fatigue to healthcare professionals. Among them, 1/4 of cancer patients have moderate to severe fatigue requiring drug treatment, and the first step in treatment is the description and assessment of fatigue.
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Please consider the following three questions:
- Do you currently feel any tiredness or fatigue?
- If so, on a scale between 0 and 10 (0 being not tired at all and 10 being the most fatigued state you can imagine), describe your daily level of fatigue.
- Does this fatigue affect your daily functioning (e.g., work, housework, etc.)?
Cancer-related fatigue can occur at any time, among any type of cancer, or in any population. In addition to using fatigue scales to assess fatigue levels, patients can also regularly assess and record fatigue scores using the "Fatigue Diary" prepared by the Taiwan Society of Cancer Palliative Medicine. By actively reporting to healthcare professionals in a timely manner, fatigue can be improved and treated, avoiding delays or interruptions in cancer treatment due to fatigue.
Related Medical Association Links:
Taiwan Society for Cancer Palliative Medicine
Cancer Hope Foundation HOPE