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PROFILE: Fatigue Study Group

January 2017
The Fatigue Study Group (FSG) was established with the primary purpose of conducting research, especially multidisciplinary pilot studies. The group’s multiple areas of focus include basic science on fatigue mechanisms, translational studies (of both basic science and practice guidelines), and various aspects of fatigue in relation to the healthcare spectrum, including prevention, screening, detection, treatment, rehabilitation, survivorship, late effects, and palliative or end-of-life care.

A secondary purpose of the FSG is education. Many patients with cancer are not prepared for the degree of fatigue they might experience as a result of their disease or its treatment. Many are not educated in management strategies to cope with fatigue, even though a number of interventions have been found helpful. The group serves as a resource for MASCC and its members on all aspects of cancer-related fatigue. This includes identifying speakers and topics for scientific and plenary sessions at MASCC meetings, submitting publications to Supportive Care in Cancer, and providing information for the MASCC website on fatigue presentations, posters, resources, and FSG activities.


The FSG promotes collaboration among researchers and clinicians to counter the lack of understanding regarding the causes, definition, and measurement of cancer-related fatigue. The group recognizes the need for consensus on the defining features of fatigue in cancer survivors and standardized interventions and measurement outcomes. Recent research by FSG members has addressed diverse aspects of fatigue and energy levels in cancer survivors and chemotherapy patients. A few examples are age differences in fatigue and energy levels of cancer chemotherapy patients, the relationship between fatigue and depression in these patients, the role of neurotransmitters in the development and maintenance of fatigue and energy levels in breast cancer patients, effects of yoga and other exercise on cancer-related fatigue, fatigue in older cancer survivors, and phenotypic characteristics and genetic polymorphisms associated with high fatigue and low energy after breast cancer surgery.

Clinical Practice Guideline Development

The FSG has formed a working group to develop treatment guidelines for cancer-related fatigue. The working group comprises exercise, integrative therapies, pharmaceutical/nutraceutical, and psychosocial components.


The FSG has also been very active in presenting workshops at the MASCC/ISOO Annual Meeting. Past workshops include “Cancer Cachexia and Fatigue in Advanced Cancer Patients” (2013), “Geriatric Oncology and Cancer-Related Fatigue: Advancing Supportive Care for Older Adults with Cancer” (2014), “Advances in Cancer-Related Fatigue: A Focus on Patients with Advanced Cancer” (2015), and “Sleep, Drowsiness, and Fatigue in Cancer Patients” (2015).

At the 2017 MASCC/ISOO Meeting in Washington, DC, the FSG will collaborate with the Palliative Care Study Group and the Rehabilitation, Survivorship, and Quality of Life Study Group in the presentation of a workshop titled “Circadian Rhythms and Chronobiology in Cancer: Relationship to Cancer-Related Fatigue and Other Toxicities.” This workshop will educate clinicians and researchers about potential mechanisms of toxicity, especially those that can give rise to multiple adverse events. Circadian phenomena have strong and direct implications for fatigue, sleep problems, delirium, pain, and other toxicities. A better understanding of the relationships involved will help clinicians choose treatments and will help researchers develop new and more effective therapies.

Junior Investigator Awards

The FSG is unique among MASCC Study Groups in having instituted awards to honor outstanding research in cancer-related fatigue by trainees and young investigators. In 2016, for instance, the Study Group presented a Junior Investigator Award to Kord Kober, PhD, for his work on “Gene Expression Profiling of Inflammation and Immune Response Pathways in Oncology Patients Undergoing Chemotherapy with Distinct Evening Fatigue Trajectories” (see Research Highlight below). Kord is an Assistant Professor in the School of Nursing at the University of California, San Francisco. The FSG also honored Yun-Jen Chou, RN, MSN, with a New Investigator Award for her research on “Fatigue Management and Its Effectiveness Reported by Cancer Patients: A National Survey.” Yun-Jen is at the School of Nursing, National Taiwan University, Taipei City, Taiwan. Recipients of previous Junior Investigator Awards can be found at the MASCC website. See the Annual Meeting Highlights for each year.


karen_mustianThe Chair of the FSG is Karen Mustian, PhD, MPH. Vice-Chairs are Debra Barton, RN, PhD, AOCN, FANN and Stephen R. Samuel, MPT. Karen Mustian is Associate Professor in the Departments of Surgery, Public Health Sciences, and Radiation Oncology, and at the James P. Wilmot Cancer Center at the University of Rochester School of Medicine in Rochester, New York, USA. With a PhD in exercise science, Karen has long been interested in fatigue among cancer patients and in the benefits of exercise for combating fatigue and other adverse effects of cancer and its treatment. She has pointed out that, since cancer and its treatments can affect many organs (heart, lungs, muscles, bones) as well as the immune system, it’s important to develop safe and effective exercise programs with realistic goals. Her recent research includes investigations of gentle yoga, walking, and strength training among cancer patients. Karen is a member of MASCC Study Groups on Fatigue, Nutrition & Cachexia, and Rehabilitation, Survivorship, and Quality of Life.

Debra_BartonDebra Barton is the Mary Lou Willard French Professor of Nursing in the Department of Systems, Populations and Leadership at the University of Michigan School of Nursing in Ann Arbor, Michigan, USA. She has been involved in numerous areas of research and teaching and currently teaches intervention research in the PhD program. She has led many large clinical trials in oncology symptom management and has led studies of translational strategies aimed at understanding mechanisms of action and symptom physiology. Her research interests include fatigue, cognitive dysfunction, sleep, nausea and vomiting, and other effects of cancer and its treatment. She is also studying ways to improve self-image and sexual health among women with a history of breast and gynecologic cancer. Deb is a member of MASCC Study Groups on Fatigue, Psychosocial Issues, and Rehabilitation, Survivorship, and Quality of Life.

Stephen_SamuelStephen R. Samuel, MPT, is a Research Fellow at Manipal University in Udupi, Karnataka, India. Stephen is a physiologist dedicated to improving the lives of patients with cancer. His PhD research explores the effects of exercise training on functional capacity and quality of life among head and neck cancer patients receiving chemotherapy. His research interests also include the use of low-level laser therapy in treating oral mucositis. Stephen is a member of MASCC Study Groups on Fatigue, Mucositis, and Rehabilitation, Survivorship, and Quality of Life. Currently, the FSG has over 150 members. The leaders invite all MASCC members to become involved in its activities, including research, abstract reviewing, and planning future activities. The FSG is also interested in collaborative work, focusing on fatigue, with other MASCC Study Groups.