“Fatigue is the most commonly reported symptom in children and adolescents during and after treatment for cancer. Fatigue is associated with decreased quality of life and may contribute to decreased physical function and impede normal childhood development. Currently, the only validated way to measure fatigue is through collection of self-reported data which may not be feasible for all children, specifically younger or sicker children, or those with lower reading levels. Proxy (i.e., parent) reports are often used as substitute measures but may not replace a child’s own report. In the precision medicine era, identifying biomarkers for fatigue would be beneficial in screening for and applying interventions to address this common symptom. A metabolomic approach to unraveling symptom experiences is promising as it allows for investigation of multiple metabolites and pathways at once and can provide insight into the physiological status of an individual at any one point in time.”

Implications for Nursing

“Nurses are at the forefront of symptom science research and patient care and as such should advocate for assessment and management of symptoms during chronic illnesses such as cancer. As many symptoms are subjective in nature, having biomarkers validated as proxy measures for symptom presence and severity would be useful to guide interventions, and to access symptoms and treatment response. As physical activity and now physical function are both associated with decreased fatigue in children with cancer, nurses should assist with moving this evidence into practice through advocating for education related to mobility during cancer therapy including early referrals to physical therapy or other rehabilitation services.”

Withycombe, J. S., Bai, J., Xiao, C., & Eldridge, R. C. (2025). Metabolomic Associations With Fatigue and Physical Function in Children With Cancer: A Pilot Study. Biological research for nursing, 27(3), 453–463. Full Text for Emory Users