
Healthcare Providers
Cancer-Related Fatigue: Prevalent, Burdensome, and Unaddressed…Until Now!
Cancer-related fatigue is the most common and burdensome side effect experienced by people living with and after cancer and is an often overlooked condition in the medical field. Upwards of 95% of individuals experience cancer-related fatigue at some point following a cancer diagnosis, with approximately 30% experiencing significant and unresolved fatigue up to and beyond five years post-treatment. The causes of cancer-related fatigue are multifactorial and unique to each individual, requiring a personalized combination of medical, behavioural, psychosocial, and supportive therapies to address effectively. Due to the prevalence and relative lack of familiarity with cancer-related fatigue within the medical community, it is entirely likely that you have treated, or are currently treating, individuals with unrecognized and unresolved cancer fatigue who need and deserve personalized fatigue care.

Cancer-Related Fatigue Prevalence and Impact
Approximately 1,700,000 people are living with and after cancer in Canada (Canadian Cancer Statistics, 2021 & 2022). Epidemiological studies have reported that ≥29% of survivors living ≤5 years post-diagnosis and ≥10% of survivors living >5 to 25 years post-diagnosis experience clinically significant levels of cancer-related fatigue. These prevalence rates translate to >114,000 Ontarians and >460,000 Canadians living with this debilitating yet treatable condition. Despite this obvious need, there are currently limited resources available for individuals living with or attempting to minimize the effect of cancer-related fatigue.

The impact of cancer-related fatigue can be profound and is associated with higher rates of disability and lower quality of life. A 2010 paper by Larkin et al., reported that cancer-related fatigue is the longest-lasting and most intrusive side effect of chemotherapy treatment, persisting longer than pain, nausea, and depression, with the greatest effect on daily life. This same study found that people experiencing cancer-related fatigue report small tasks, such as walking, house cleaning and eating to be more difficult, with significant emotional consequences, such as a feeling of loss of control of their life.
Cancer fatigue also imposes a significant financial burden on people living with and after cancer, as well as their caregivers. Many individuals who report particularly burdensome levels of cancer-related fatigue are still actively engaged in school, work, raising and supporting their immediate and extended families, volunteering, or social activities. For example, a study by Curt et al. (2000) assessed the occupational impact of fatigue in 177 cancer patients, and reported that more than 75% of individuals had to change their employment status as a result of fatigue, with the mean number of sick days typically used as a result of fatigue being 4.2 per month.. Related research identified that approximately 20% of caregivers also need to take days off to help support their loved one’s and miss, on average, 4.5 days of work per month (Curt et al., 2000).

What to Look for In Your Patients
Many healthcare practitioners are unfamiliar with the symptoms, risk factors, and clinical presentation of cancer-related fatigue and may be unsure of how to best support patients living with it.
Common symptoms of cancer-related fatigue include:
- Strong and constant feelings of tiredness NOT relieved by sleep
- Decreased concentration or memory
- Decreased ability to carry out normal daily activities
- Irritability and mood changes
- Decreased interest in activities that usually bring joy
- Decreased motivation
- Decreased energy levels
- Decreased mental alertness
- Changes in sleep patterns or appetite
Are you treating patients who report or who you suspect may be experiencing cancer-related fatigue? Our clinical care team of physicians and rehabilitation specialists are available to help answer your questions or get started working with them right away!
Cancer Fatigue Services: Who We Are
Cancer Fatigue Services is the first medical service specializing in assessing and treating cancer-related fatigue in Canada. We were established in 2023 by Dr. Scott Adams, a physiologist and scientist with >15 years of experience studying the adverse effects of anti-cancer therapies and caring for people living with cancer treatment-related sequelae, like fatigue. Our mission is to transform the lives of cancer patients and survivors by alleviating their fatigue, reigniting their vitality, and restoring their hope for a life well-lived. Our clinical care model is based on the national (e.g. Canadian Partnership Against Cancer) and international guidelines (e.g. American Society of Clinical Oncology; European Society of Medical Oncology) for cancer fatigue management, directly informed by the guidance of global experts and the clinical experience of the leading international fatigue care centre (e.g. MD Anderson Cancer Center), and innovative, evidence-based fatigue testing and therapeutic approaches.

Our Process
A physician referral to our clinic is required for patients to be eligible for OHIP coverage. Once referrals are received, our Customer Care Team contacts patients to book a brief 30-minute intake call. During the call, we review the high-level details of patients’ fatigue concerns and health history, answer their questions, and provide more information about the specific services and healthcare coverage options that are available to them. Patients then meet our clinic care team to complete a Comprehensive Fatigue Consultation (i.e., a ~90-minute assessment). During the comprehensive consultation we assess all the known causes and contributing factors to cancer-related fatigue, including medical, physical, emotional, cognitive, behavioural, and demographic outcomes. Patients are also strongly encouraged to complete an optional, but highly informative, cardiopulmonary exercise test (CPET) which provides greater insight into the underlying pathophysiology of each individual’s fatigue.
Following the assessment, our team uses all available information to develop a personalized Fatigue Care Plan and delivers it back to patients in approximately 1-2 weeks, wherein treatment recommendations and next steps are discussed. With the Fatigue Care Plan in place, our patients then complete a free personalized Fatigue Counselling Session to address the greatest obstacles they face with respect to effectively managing and treating their fatigue, provide targeted educational resources, and teach self-monitoring / management strategies.
How to Refer
If you suspect your patient is experiencing cancer-related fatigue and are a physician, please use this referral form to refer your patient. We will provide you with regular updates on your patient’s progress within our care.
If you are not a physician, please inform your patient about our services and send them back to their family physician or oncologist seeking a referral to our clinic.