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
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.