Background:
Cancer-related fatigue (CRF) is a common, debilitating consequence of cancer and its treatment, yet it remains frequently underrecognized and undertreated. As a result, many patients receive neither targeted assessment nor appropriate treatment recommendations. This study evaluates the utilization, intervention uptake, and patient satisfaction with a specialized CRF consultation service at 10 cancer counseling centers in Bavaria, Germany.

Method:
A prospective, observational, multicenter study was conducted between March 2022 and February 2024. Patients with a cancer diagnosis and clinically relevant fatigue were eligible for CRF consultation. Of the 557 patients who received a CRF consultation, 524 participated in the study, of whom 496 were clinically diagnosed with CRF; 447 completed the follow-up.

Results:
Among patients with confirmed CRF (n = 496), a shared decision-making process involving patient and clinician resulted in the selection of three evidence-based interventions in most cases (80%), most commonly physical activity (63%), energy conservation and activity management (45%), and mind–body approaches (39%). At follow-up (n = 447), 44% of the recommended interventions had been implemented either fully or to a large extent. Even for the most frequently selected interventions, implementation remained moderate (33% to 56%). Barriers to implementation—which were primarily related to health limitations, family and work commitments, and limited service availability—were reported by 87% of the patients. Despite these challenges, satisfaction with the consultation was high (mean value of 1.2 and 1.4, on a scale from 1 = very good to 6 = very poor), and patients expressed strong support for continuing the service. Suggestions for improvement included shorter waits, assistance in implementing interventions, and support with administrative procedures.

Conclusion:
The CRF consultation service of the Bavarian Cancer Society is a feasible, well-accepted, and patient-centered approach that addresses a major unmet need in cancer care. This model may serve as a best practice example for similar initiatives nationally and internationally. Long-term implementation in the healthcare system requires structural integration, sustainable funding, and policy recognition.