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The information contained in this article, including but not limited to clinical practice guidelines and other guidance, is based on the best available evidence at the time of creation and is provided by ASCO to assist providers in clinical decision making. Additional details on the methods used for the development of this guideline are reported in a Data Supplement. The content review is completed by an ad hoc panel (Appendix Table A1, online only), with guidance from an advisory group (Appendix Table A2, online only), convened by ASCO that includes multidisciplinary representation. The methodologic review is completed by a member of the CPGC Methodology Subcommittee and/or by ASCO senior guideline staff.

The review includes two parts: methodologic review and content review. Adapted guideline manuscripts are reviewed and approved by the ASCO Clinical Practice Guidelines Committee (CPGC). The ASCO adaptation process begins with a literature search to identify candidate guidelines for adaptation. The objective of the ADAPTE process ( ) is to take advantage of existing guidelines to enhance efficient production, reduce duplication, and promote the local uptake of quality guideline recommendations. Adaptation of guidelines is considered by ASCO in selected circumstances, when one or more quality guidelines from other organizations already exist on the same topic. This guideline adaptation was informed by the ADAPTE methodology, 8 which was used as an alternative to de novo guideline development for this guideline.

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This guidance is intended to inform professional health care providers (eg, medical, surgical, and radiation oncologists, psychosocial and rehabilitation professionals, primary care providers, nurses, and others involved in the delivery of care for survivors) as well as patients, family members, and caregivers of patients who have survived cancer.

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The clinical question of focus is: What are the optimal screening, assessment, and treatment approaches in the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment? This practice guideline pertains to cancer survivors diagnosed at age ≥ 18 years who have completed primary cancer treatment with curative intent and are in clinical remission off therapy as well as patients who are disease free and have transitioned to maintenance or prophylactic therapy (eg, patients with breast cancer receiving hormonal therapy, patients with chronic myelogenous leukemia receiving tyrosine kinase inhibitors). This article summarizes the results of that process and presents the adapted practice recommendations.

However, there is no consistent evidence of their effectiveness.ĪSCO has established a process for adapting other organizations' clinical practice guidelines. Small pilot studies have evaluated the impact of supplements, such as ginseng, vitamin D, and others, on cancer-related fatigue. 6 The objective of this guideline is to identify evidence-based clinical practice guidelines, assessment tools, and screening instruments to help health care professionals care for survivors of adult-onset cancers who are experiencing symptoms of fatigue after completion of primary treatment. 6, 7 Fatigue is one the most prevalent and distressing long-term effects of cancer treatment, significantly affecting patients' quality of life.

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Existing guidelines should be refined and new evidence-based guidelines should be developed through public-and private-sector efforts.” 2(p155) This guideline addresses one of a series of topics that have been identified and prioritized for development in cancer survivorship.Ī majority of patients will experience some level of fatigue during their course of treatment however, approximately 30% of patients will endure persistent fatigue for a number of years after treatment.

3– 5 More specifically, the ASCO Cancer Survivorship Committee has mobilized to address recommendation three of the IOM, which calls for the “use of systematically developed evidence-based clinical practice guidelines, assessment tools, and screening instruments to help identify and manage late effects of cancer and its treatment. 1 The American Society of Clinical Oncology (ASCO) has taken steps to address the recommendations made by the Institute of Medicine (IOM) 2 to promote evidence-based, comprehensive, compassionate, and coordinated survivorship care. The American Cancer Society estimates that as of January 2012, there were 13.7 million cancer survivors in the United States, and this number is estimated to rise to nearly 18 million by 2022. Recent advances in cancer screening and treatment have resulted in an expanding number of cancer survivors.