Management of Olaparib-Induced Fatigue

Patient Education and Counseling

The National Comprehensive Cancer Network recommends reassuring patients that treatment-related fatigue does not indicate disease progression or treatment failure, as this fear is a primary reason for underreporting symptoms 1
Patients should be educated before starting olaparib that fatigue may occur as a consequence of therapy and typically peaks early in treatment, according to the National Comprehensive Cancer Network 1
The National Comprehensive Cancer Network instructs patients to maintain a daily fatigue diary using a 0-10 numeric rating scale to track fatigue levels 2

The National Comprehensive Cancer Network teaches patients to schedule activities during peak energy periods by maintaining a daily and weekly diary to identify when energy levels are highest 1, 3
Patients should prioritize essential activities and delegate or postpone nonessential tasks when experiencing moderate to severe fatigue, as recommended by the National Comprehensive Cancer Network 1, 3
The National Comprehensive Cancer Network suggests implementing labor-saving techniques such as using reachers for grasping items, rolling carts for transporting objects, and wearing a bathrobe instead of toweling off after bathing 1, 3
Limiting daytime naps to less than 1 hour is recommended by the National Comprehensive Cancer Network to avoid disrupting nighttime sleep quality 3, 4

The National Comprehensive Cancer Network recommends exercise as the most strongly evidence-based intervention for cancer-related fatigue and should be initiated as tolerated 1, 5, 6
A combination of moderate-intensity endurance exercises and resistance training with light weights is suggested by the National Comprehensive Cancer Network 3, 4
Exercise should be prescribed cautiously in patients with bone metastases, thrombocytopenia, anemia, fever, or active infection, according to the National Comprehensive Cancer Network 3, 4

The National Comprehensive Cancer Network recommends cognitive behavioral therapy (CBT) as a strong evidence-based option for reducing fatigue and should be offered to patients with persistent moderate-to-severe symptoms 5, 6
Mindfulness-based stress reduction, psychoeducational therapies, and supportive-expressive therapies are all evidence-based options for managing fatigue, according to the National Comprehensive Cancer Network 6
CBT for sleep disturbances is recommended by the National Comprehensive Cancer Network as a Category 1 recommendation to improve fatigue levels 6

The National Comprehensive Cancer Network recommends referring patients to nutritional consultation to address any dietary deficiencies or alterations that may contribute to fatigue 1
Establishing consistent sleep and wake times, eliminating electronic devices before bedtime, and avoiding caffeine and alcohol in the evening is suggested by the National Comprehensive Cancer Network to optimize sleep quality 1
Screening for and aggressively treating sleep disorders is recommended by the National Comprehensive Cancer Network as these are common contributors to fatigue 1

The National Comprehensive Cancer Network recommends assessing and treating pain, emotional distress, and other concurrent symptoms that frequently cluster with fatigue 5, 4
Thyroid dysfunction, nutritional deficiencies, and other metabolic causes should be evaluated and treated according to the National Comprehensive Cancer Network 1

The National Comprehensive Cancer Network recommends considering methylphenidate after ruling out other treatable causes of fatigue, but should be used cautiously and only after treatment- and disease-specific morbidities have been characterized 3, 4
Optimal dosing and schedule for psychostimulants in cancer patients have not been established, according to the National Comprehensive Cancer Network 3
Treating underlying conditions such as hypothyroidism with levothyroxine is recommended by the National Comprehensive Cancer Network if identified 5

The National Comprehensive Cancer Network recommends screening for fatigue at every clinical visit using standardized assessment tools 2, 4
Reassessing fatigue levels regularly after implementing interventions is suggested by the National Comprehensive Cancer Network to document improvement and adjust management strategies 2
If fatigue remains unresolved despite treating contributing factors and implementing nonpharmacologic interventions, considering referral to supportive care specialists is recommended by the National Comprehensive Cancer Network 5, 4