Traditional Chinese herbal medicine and compounds on cancer-related fatigue: The current understandings of the mechanisms

Abstract

Cancer-related fatigue (CRF) is one of the most prevalent and debilitating symptoms experienced by cancer patients, significantly affecting treatment adherence and quality of life. Its pathogenesis is multifaceted, involving inflammatory responses, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, and mitochondrial energy metabolism disorders. To date, the therapeutic outcomes of CRF have not met clinical needs, and no pharmacological or non-pharmacological approach has been specifically approved for CRF. This review examines the current understanding of CRF mechanisms, discusses the limitations of current therapeutic modalities, and highlights the unique potential advantages of traditional Chinese medicine (TCM) interventions for CRF. Existing evidence indicates that TCM, with its advantages of holistic regulation and multi-targeted intervention, may have clinical value in alleviating symptoms, improving quality of life, and mitigating adverse reactions associated with Western medical treatments in patients with CRF. These beneficial effects may be closely associated with anti-inflammatory activity, restoration of HPA axis homeostasis, and improvement of mitochondrial energy metabolism. In this review, classic Chinese herbal formulas used for CRF management are briefly summarized. As increasing studies have investigated active components from individual herbs, particularly those with both medicinal and food properties, recent progress regarding these active components, including oil compounds, flavonoids, polysaccharides, and saponins, is reviewed in greater detail. Future studies focusing on therapeutic efficacy, novel and specific mechanisms, and interactions among active compounds in TCM treatment of CRF may help establish more effective and safer therapeutic strategies.