Cancer-related fatigue is the most distressing symptom of oncological patients with cancer-therapy, also in and after rehabilitation. The aim of our study was to adapt oncological rehabilitation to this symptom, so we developed and evaluated a fatigue-related management module called FaM-Modul for rehabilitation.

The rehabilitation team developed and discussed the FaM-Modul. For study we used a sequential control group design with a control group (CG: n=189) and an intervention group (IG: n=194). Only participants with substantial fatigue-related problems in oncological rehabilitation were recruited. The effects of the FaM-Modul in the intervention group were evaluated by questionnaires asking for the fatigue-related therapies and fatigue-related outcomes (MFI: general- (GF), physical- (PF), mental fatigue (MF); health-related quality of life (QoL-EORTC)) at the beginning (t1), the end (t2) and 3 months after oncological rehabilitation (t3). Non-parametric-tests and analysis of covariance with repeated measures were applied to investigate differences between CG and IG.

The FaM-Modul consists additional to standard oncological rehabilitation of psychosocial, nutritional and exercise therapies. The IG evaluated both contents (P<0.001) and organization (P<0.001) better than the CG with standard oncological rehabilitation and they were more pleased with the fatigue-therapies (P<0.001). There were improvements of the outcomes from t1 to t2 in both groups. However, from t1 to t3 the IG showed reductions in GF (P<0.05), PF (P<0.01) and MF (P<0.01) and an increase in QoL (P<0.01) compare to the CG.

Also standard oncological rehabilitation is successful to reduce fatigue-related symptoms of oncological patients in rehabilitation, but not after discharge. With a symptom-oriented module, developed by the rehabilitation team we can reduce fatigue-related symptoms until 3 months after discharge. The FaM-Modul completes standard rehabilitation therapies and supports rehabilitation. A controlled and multi-center study should be carried out to verify these results.