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3. Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation.

Author

Bower, Julienne, Bak, Kate, Berger, Ann, Breitbart, William, Escalante, Carmelita, Ganz, Patricia, Schnipper, Hester, Lacchetti, Christina, Ligibel, Jennifer, Lyman, Gary, Ogaily, Mohammed, Pirl, William, and Jacobsen, Paul

Subjects
Adult, Fatigue, Female, Humans, Male, Neoplasms, Quality of Life, Survivors, Treatment Outcome
Abstract

PURPOSE: This guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment. METHODS: A systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation. RESULTS: It is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment. CONCLUSION: Fatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patients specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors.

Published
2014

5. Electronic health records analytics to identify cancer patients with metabolic syndrome.

Author

Hwang, Jessica Park, primary, Siu, Kimberly W., additional, Foreman, Jessica T., additional, Razouki, Zayd, additional, Bassaragh, Angella, additional, Boone, Tonya, additional, Davis, Teresa A., additional, Manzullo, Ellen F., additional, Oh, Jeong Hoon, additional, Tanha, Jila, additional, Basen-Engquist, Karen, additional, Ali, Sara, additional, Boving, Valentine G., additional, Park, Anne K., additional, Pathak, Kavita, additional, and Escalante, Carmelita P., additional

Published
2022
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10. Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation

Author

Bower, Julienne E, Bak, Kate, Berger, Ann, Breitbart, William, Escalante, Carmelita P, Ganz, Patricia A, Schnipper, Hester Hill, Lacchetti, Christina, Ligibel, Jennifer A, Lyman, Gary H, Ogaily, Mohammed S, Pirl, William F, Jacobsen, Paul B, and American Society of Clinical Oncology

Subjects
Adult, Male, Pediatric Research Initiative, Prevention, Rehabilitation, Clinical Sciences, Oncology and Carcinogenesis, Health Services, 7.3 Management and decision making, American Society of Clinical Oncology, Treatment Outcome, 7.1 Individual care needs, Clinical Research, Neoplasms, Behavioral and Social Science, Quality of Life, Humans, Female, Survivors, Management of diseases and conditions, Oncology & Carcinogenesis, Fatigue, Cancer
Abstract

PurposeThis guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment.MethodsA systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation.ResultsIt is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment.ConclusionFatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors.

Published
2014

15. Improving transitions of care through implementation of a standardized handoff at a comprehensive cancer center.

Author

Bodurka, Diane C., primary, Ait Aiss, Mohamed, additional, Phu, Helene P, additional, Day, Lakeisha R, additional, Abraham, Varkey, additional, Chen, Karen, additional, Rodrigo, Mejia, additional, Razvi, Shehla, additional, Gonzalez, Carmen E., additional, Brito-Dellan, Norman, additional, Banala, Srinivas, additional, Rubio, David, additional, Vaughan-Adams, Nicole, additional, Ruiz, Debra S, additional, Jens, Tan, additional, Levenback, Charles F., additional, Frumovitz, Michael M., additional, Zand, Behrouz, additional, and Escalante, Carmelita P., additional

Published
2016
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21. A randomized, double blind, placebo-controlled crossover trial of a sustained release methylphenidate in cancer-related fatigue.

Author

Escalante, Carmelita P., primary, Meyers, Christina A., additional, Reuben, James M., additional, Wang, Xuemei, additional, Qiao, Wei, additional, Manzullo, Ellen F., additional, Alvarez, Ricardo H., additional, Morrow, Phuong Khanh H., additional, Gonzalez-Angulo, Ana M., additional, Mendoza, Tito R., additional, Wang, Xin Shelley, additional, Liu, Wenli, additional, Holmes, Holly Michelle, additional, Hwang, Jessica, additional, Pisters, Katherine, additional, Overman, Michael J., additional, and Cleeland, Charles S., additional

Published
2012
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23. Outcomes and Cost of Outpatient or Inpatient Management of 712 Patients With Febrile Neutropenia

Author

Elting, Linda S., primary, Lu, Charles, additional, Escalante, Carmelita P., additional, Giordano, Sharon H., additional, Trent, Jonathan C., additional, Cooksley, Catherine, additional, Avritscher, Elenir B.C., additional, Shih, Ya-Chen Tina, additional, Ensor, Joe, additional, Bekele, B. Nebiyou, additional, Gralla, Richard J., additional, Talcott, James A., additional, and Rolston, Kenneth, additional

Published
2008
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25. Bacterial infections in low‐risk, febrile neutropenic patientsPresented in part as abstract 376 at the 41st Annual Meeting of the Infectious Diseases Society of America, San Diego, California, October 9–12, 2003.: Over a decade of experience at a comprehensive cancer center

Author

Kamana, Mallika, Escalante, Carmelita, Mullen, Craig A., Frisbee‐Hume, Susan, and Rolston, Kenneth V. I.

Abstract

Accurate identification of low‐risk, febrile neutropenic patients has become possible only recently. Many such patients are treated with oral antibiotics without hospitalization. To the authors' knowledge, data concerning the spectrum of bacterial infections in these patients are scarce, and collecting such data may have an impact on the choice of empiric oral regimen(s).Using the same risk‐prediction and eligibility criteria, four studies of empiric therapy in low‐risk, febrile neutropenic patients were conducted at the authors' institution. Based on that experience, patients also were entered on clinical pathways for outpatient therapy. For the current study, microbiologic data were pooled from those trials and clinical pathways (757 episodes) to describe the nature and spectrum of infections seen in this setting.Unexplained fever occurred most often (58% of episodes), and both clinically documented and microbiologically documented infections were seen with equal frequency (21% of episodes, respectively). The most common clinical sites of infection were the upper respiratory tract, skin, and skin structure. Among microbiologically documented infections, monomicrobial, gram‐positive infections accounted for 49% (with coagulase‐negative staphylococci the most frequent); monomicrobial, gram‐negative infections accounted for 36% (with Escherichia coli the most frequent); and 15% of infections were polymicrobial.In this description of the spectrum of infections in the largest cohort of low‐risk febrile neutropenic patients to date, episodes of unexplained fever were predominant, but gram‐positive, gram‐negative, and polymicrobial infections also were documented. Although these patients were at low risk for complications, they required broad‐spectrum antibiotic therapy when they developed neutropenic fever. Cancer 2005. © 2005 American Cancer Society.

Published
2005
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