Cancer Related Fatigue (CRF)

Cancer-related fatigue (CRF) is the all-encompassing, bone-weary exhaustion that many people with cancer experience.

The National Comprehensive Cancer Network (NCCN) defined CRF as:

“Distressing, persistent or cognitive tiredness or exhaustion related to cancer or cancer treatment, that is not proportional to activity, interferes with usual functioning, and is not relieved by rest”.

This CRF can occur anywhere in the cancer journey. At diagnosis, 40% of cancer patients will report CRF, during chemotherapy 90% and radiation 80%. Usually, CRF reduces during the first year following treatment. However, it can persist for 5-10 years affecting the Quality of Life of the cancer survivor and their family or carers.

Acupuncture has been shown to improve the Quality of Life of those suffering with CRF, it is not intended to cure but to improve symptoms associated with cancer and cancer treatment.

My most frequently used and favourite acupuncture point for CRF is ZuSanLi “three leg li”(ST36).

Grant SJ, Smith CA, de Silva N, Su C. Defining the Quality of Acupuncture: The Case of Acupuncture for Cancer-Related Fatigue. Integrative Cancer Therapies. 2015;14(3):258-270. doi:10.1177/1534735415572879

Liu, Y., Xu, P., Song, C., Jiang, T., Liu, J.-E., & Shi, T. (2022). The effectiveness of non-pharmacological interventions on cancer related fatigue in breast cancer patients: A protocol for systematic review and network meta-analysis. Nursing Open, 9, 851– 855.

Choi TY, Ang L, Jun JH, Alraek T, Birch S, Lu W, Lee MS. Acupuncture for Managing Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel). 2022 Sep 11;14(18):4419. doi: 10.3390/cancers14184419. PMID: 36139579; PMCID: PMC9496910.

Wu, C., Zheng, Y., Duan, Y., Lai, X., Cui, S., Xu, N., Tang, C. and Lu, L. (2019), Nonpharmacological Interventions for Cancer-Related Fatigue: A Systematic Review and Bayesian Network Meta-Analysis. Worldviews on Evidence-Based Nursing, 16: 102-110.

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Jang A, Brown C, Lamoury G, et al. The Effects of Acupuncture on Cancer-Related Fatigue: Updated Systematic Review and Meta-Analysis. Integrative Cancer Therapies. 2020;19. doi:10.1177/1534735420949679

Hunter J, Smith C, Delaney GP, Templeman K, Grant S, Ussher JM. Coverage of cancer services in Australia and providers’ views on service gaps: findings from a national cross-sectional survey. BMC Cancer. 2019 Jun 11;19(1):570. doi: 10.1186/s12885-019-5649-6. PMID: 31185937; PMCID: PMC6560726.