Cancer-related fatigue in older adults

This thesis evaluates several aspects of cancer-related fatigue (CRF). The introduction in chapter 1 summarizes background knowledge about CRF. It describes its multidimensional character and introduces different processes that may be causally related to the development and/or chronicity of CRF. Chapter 2 presents an overview of self-report questionnaires for assessing CRF, and evaluates the quality of these questionnaires based on scoring criteria for clinimetric quality and user-friendliness. Chapter 3 reports the results of a review and meta-analysis of randomized clinical trials studying the effect of exercise on CRF during medical treatment. Chapter 4 describes a study of symptom clusters in survivors of colorectal cancer, and whether these clusters differ across age groups. A study that investigates the possible association of pre-surgical levels of CRF with postoperative complications and length of hospital stay can be found in chapter 5. In chapter 6 we report on a qualitative study that explored which factors limit or stimulate preoperative physical activity of older adults scheduled for colorectal cancer surgery. This thesis ends with a general discussion of the research of this thesis and an overall summary.