Wu, Horng-Shiuann, Davis, Jean E, Natavio, Teofanes · Clinical journal of oncology nursing · 2012 · DOI
Cancer patients often experience severe tiredness and sleep problems at the same time, suggesting they may share a common cause. This paper proposes that stress hormones—particularly those controlled by a system called the HPA axis—may be disrupted in ways that trigger both fatigue and poor sleep. Because ME/CFS patients have similar symptoms and similar HPA axis problems, studying cancer-related fatigue might help us understand ME/CFS better.
This study is important because it identifies a potential shared biological mechanism (HPA axis and circadian dysfunction) that could explain overlapping symptoms in both cancer-related fatigue and ME/CFS. For ME/CFS patients and researchers, this suggests that cancer fatigue research may yield insights into the physiological drivers of chronic fatigue, potentially leading to new therapeutic approaches.
This is a mechanistic review, not an original research study, so it does not present new empirical evidence or prove causation. The paper does not demonstrate that HPA axis dysfunction definitively causes either CRF or ME/CFS symptoms—only that it is hypothesized to be involved. The proposed shared mechanism remains speculative without hypothesis-testing studies in ME/CFS populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Wu, Horng-Shiuann, Davis, Jean E, & Natavio, Teofanes (2012). Fatigue and disrupted sleep-wake patterns in patients with cancer: a shared mechanism.. Clinical journal of oncology nursing. https://doi.org/10.1188/12.CJON.E56-E68
BibTeX
@article{mecfsatlas-wu-2012-fatigue-disrupted,
author = {Wu, Horng-Shiuann and Davis, Jean E and Natavio, Teofanes},
title = {Fatigue and disrupted sleep-wake patterns in patients with cancer: a shared mechanism.},
journal = {Clinical journal of oncology nursing},
year = {2012},
doi = {10.1188/12.CJON.E56-E68},
note = {PubMed: 22459538},
url = {https://www.mecfsatlas.com/evidence/wu-2012-fatigue-disrupted},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/wu-2012-fatigue-disrupted
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