Fibromyalgia in cancer patients: a systematic review and clinical implications for integrated care
Abstract
Introduction: In oncology, fibromyalgia (FM) is increasingly recognized as a clinically relevant comorbidity, as cancer patients frequently present overlapping symptoms such as pain, fatigue, and sleep disturbances, complicating clinical assessment and management. Moreover, anticancer treatments may trigger or exacerbate FM-like symptoms. This systematic review aimed to synthesize the available evidence on FM in oncological patients, focusing on prevalence, clinical characteristics, and its impact on pain perception, Health-Related Quality of Life (HRQoL), and treatment adherence.
Methods: A comprehensive literature search was conducted in PubMed, Embase, and Scopus, including studies published from 2014 to 2024. Eligible studies, in accordance with PRISMA guidelines, included observational, cross-sectional and interventional designs involving adult patients with FM in the context of cancer or cancer-related pain. Conversely, studies not assessing FM in relation to cancer or cancer-related pain were excluded. Risk of bias was evaluated using ROBINS-I tool and the RoB 2 tool.
Results: A total of 11 studies were included, encompassing heterogeneous populations and study designs, thereby precluding a quantitative synthesis of the literature. Overall, evidence suggests that FM did not increase cancer risk but significantly contributes to pain amplification, higher symptom burden, reduced HRQoL, and impaired treatment adherence. Pre-existing nociplastic pain features were…
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