ABSTRACT
Fatigue is a subjective sensation of weakness, lack of energy, or becoming easily tired. It is one of the most common and chronic symptoms experienced by advanced cancer patients. Fatigue is debilitating and profoundly impacts the quality of life of the patients and their families. Fatigue is reported as prevalent in most studied populations including patients with cancer and palliative care patients. The frequency of fatigue has been reported to be approximately 60–90% in patients with advanced cancer whereas prevalence of fatigue is around 20–30% in cancer survivors. Tumors can produce multiple by-products, including proteolytic and lipolytic factors and cytokines capable of interfering with close metabolism and inducing fatigue. The mechanisms by which fatigue is induced or perceived in the central nervous system are poorly understood. Anxiety, depression, and psychological distress may contribute to fatigue. Testosterone deficiency results in the loss of muscle mass, fatigue, reduced libido, and reduced hemoglobin.
