For Adult Cancer Survivors

The American Society of Clinical Oncology has released three 
guidelines on treating problems commonly encountered by adult cancer 
survivors: chemotherapy-induced peripheral neuropathy, anxiety and 
depression, and fatigue. The guidelines are published in the Journal 
of Clinical Oncology.

To treat chemotherapy-induced peripheral neuropathy, clinicians may 
offer patients duloxetine. The group declined to make official 
recommendations on tricyclic antidepressants, gabapentin, and a 
topical gel (comprising baclofen, amitriptyline, and ketamine), but 
said they may be reasonable options in certain patients.

Patients should be periodically evaluated for depression and anxiety, 
and compliance with treatments should be assessed regularly. After 8 
weeks, if symptoms have not improved, clinicians should try a new 
approach.

Patients should be screened for fatigue at the time of cancer 
diagnosis and routinely thereafter, at least annually. They should be 
educated about ways to manage fatigue, such as through physical 
activity (150 minutes of moderate aerobic weekly plus two to three 
strength training sessions), cognitive behavioral therapy, and 
mindfulness-based approaches like yoga and acupuncture.

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