Getting Support From Other People
Just about everyone needs support from someone else when they have cancer. You can get support from family, friends, doctors or nurses.
You can also get support from other people who’ve been through a similar thing. Sharing your feelings with someone in a similar situation can make you feel less anxious. You can often get tips on how to cope better from talking about your situation. Talk to your specialist nurse about support groups available to you in your area. Or you can look at cancer charity websites.
Talking to other people in a support group can also show you that you are not alone. It can confirm that fatigue is something many people with cancer have.
You could also try having some counselling. It can help to open up to someone who can listen without judgement. There are specialist therapists and counsellors to help people with cancer.
Fatigue Before Cancer Treatment
Almost a quarter of cancer patients may already be experiencing severe fatigue before their treatment starts, researchers in the Netherlands have found. They assessed 179 patients with various malignancies before treatment initiation and found that 23.5 per cent were severely fatigued. Prevalence of fatigue varied between diagnoses with prostate cancer at 14.3 per cent, breast cancer at 20.3 per cent and gastrointestinal cancer at 28.1 per cent. Factors that appeared to contribute to severe fatigue were lower physical activity, depressive mood, impaired sleep and rest during the day and night, and fatigue one year before diagnosis.
Goedendorp MM, Gielissen MFM, Verhagen CAH et al. Br J Cancer 2008 99:1408-14
Originally published in the November 2008 edition of MIMS Oncology & Palliative Care.
Nutrition Needs Change And Cause Or Increase Fatigue
For many patients, the effects of cancer and cancer treatments make it hard to eat well. The body’s energy comes from food. Fatigue may occur if the body does not take in enough food to give the body the energy it needs. In people with cancer, three major factors may affect nutrition:
- A change in the way the body uses food. A patient may eat the same amount as before having cancer, but the body may not be able to absorb and use all the nutrients from the food. This is caused by the cancer or its treatment.
- An increase in the amount of energy needed by the body because of a growing tumor, infection, fever, or shortness of breath.
- A decrease in the amount of food eaten because of low appetite, nausea, vomiting, diarrhea, or a blocked bowel.
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Manage Other Side Effects
Other side effects of breast cancer treatment can also contribute to your fatigue. Nausea and vomiting, for example, usually means that you arent able to eat enough food to keep your energy up.
Anemia, or a low red blood cell count, can be caused by chemotherapy and lead to fatigue. Ask your doctor about which treatments are available to manage the side effects of breast cancer therapy.
Ethics Approval And Consent To Participate
This study was conducted based on approval from the Danish Data Protection Agency journal number #2013-41-2616 and #2012-58-0023 and under their rules of data protection. According to Danish law, approval by the Ethics Committee and written informed consent is not required in questionnaire-based and register-based projects. Additional information is available at The National Committee on Health Research Ethics webpage in the Act on Research Ethics Review of Health Research Projects§ 14,2. available from
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Cancer Fatigue Is Different From Fatigue That Healthy People Feel
When a healthy person is tired from day-to-day activities, their fatigue can be relieved with sleep and rest. Cancer fatigue is different. People with cancer get tired after less activity than people who do not have cancer. Also, cancer fatigue is not completely relieved by sleep and rest, interferes with daily activities, and may last for a long time. Fatigue usually decreases after cancer treatment ends, but some people may still feel fatigue for months or years.
Take Care Of Your Mental Health
Fatigue can be a side effect of depression a common symptom of breast cancer that can also result from treatments. If you feel depressed, anxious, or generally down after your diagnosis, talk to your cancer care provider. They can refer you to a specialist, such as a therapist or a psychiatrist, who specializes in working with people living with breast cancer. These specialists might suggest treatments that include:
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Clinical Trials And Specialists
Cancer-related fatigue can be the most distressing symptom for many patients, but it is not always on the top of the healthcare provider’s list of problems. Nevertheless, you should not hesitate to tell your healthcare team if you are experiencing fatigue and how it is affecting your quality of life. Patients should talk with their healthcare team about treatments and interventions to help with fatigue. Inquire about clinical trials investigating fatigue. Some centers have fatigue clinics that deal with this symptom specifically. Find available trials using the OncoLink Clinical Trials Matching System.
How Can We Help Relieve Or Prevent Fatigue
Only two interventions have been proven truly effective in large clinical trials to relieve or prevent fatigue: correction of anemia and exercise. One reason it has been difficult to evaluate new therapies is due to a lack of understanding of the exact cause of CRF, as well as the lack of an animal model in which to do preliminary studies. You can’t exactly ask a mouse to rate his fatigue! In addition to anemia and exercise, we will discuss some other ways to manage fatigue that have been shown to be helpful.
Anemia is defined as a hemoglobin level below 12 g/dl, and symptoms include shortness of breath or difficulty breathing with exertion and fatigue. Anemia in a cancer patient can have many causes including bleeding, bone marrow involvement of disease, chemotherapy, radiation therapy, organ dysfunction , or nutritional deficiencies. Anemia is believed to be one factor contributing to fatigue, and its correction has alleviated fatigue in clinical trials. One way to correct anemia is through the use of blood transfusions in some cases, this may be the best method, particularly if the patient is bleeding or having symptoms. Despite many safeguards, blood transfusions are not without risk and can lead to the transmission of viruses, allergic reactions, and lung injury.
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Is Your Fatigue A Symptom Of Cancer
Could your fatigue be the first symptom of cancer? At one point or another, we have all experienced fatigue. For most of us, it is temporary, usually caused by stress or being overworked.
For some people, however, fatigue can become persistent, occurring daily. When fatigue becomes frequent, it is natural to be concerned about what may be causing it.
One of the first things many people think maybe the culprit for their fatigue is cancer. When might feeling tired be a sign of cancer and how often is it?
We often hear about cancer patients who are extremely fatigued, but a lot of cancer-related fatigue is caused by the side effects of cancer treatment, not always cancer itself. In other words, for people with many cancers, the fatigue begins after diagnosis.
While fatigue alone without other symptoms is uncommon in many cancers, for people with leukemias and lymphomas fatigue may well be the first symptom.
Different Activities And Therapies
Exercise, yoga, massage therapy, counseling, and dietary or nutritional counseling are all used to help treat fatigue and weakness.
If youre having problems sleeping or sleeping too much, your doctor or nurse may suggest sleep therapy. This therapy can help you minimize sleep disturbances and learn improved sleep hygiene.
More research is needed and is being done in this area, but there are stimulant drugs your health care team may prescribe you if your fatigue doesn’t improve. These stimulants are only prescribed for a short period. It’s important you talk to your doctor about the benefits of taking these drugs, as well as the different side effects that may occur such as daytime sleepiness, withdrawal symptoms, insomnia, memory problems, or allergic reactions.
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Managing And Treating Cancer Fatigue
There are ways to manage fatigue and the symptoms you might have. It’s important to tell your doctor or nurse if you think you might have it.
Treating the causes of cancer related fatigue can sometimes help to reduce tiredness. Help is also available for the symptoms of fatigue. There are some suggestions below.
It might take some trial and error to learn how to manage fatigue and to know what works for you.
The NHS website mention’s an app called Untire: Beating cancer fatigue. It has handy tips and advice, online support, it records your energy levels and you can see your progress.
Permission To Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as NCIs PDQ cancer information summary about breast cancer prevention states the risks in the following way: .
The best way to cite this PDQ summary is:
PDQ® Supportive and Palliative Care Editorial Board. PDQ Fatigue. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .
Images in this summary are used with permission of the author, artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.
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How To Recognize Fatigue
You may think you’re simply tired, but if your feelings of listlessness and disinterest go on for weeks, you probably have fatigue. Symptoms of fatigue include:
Several breast cancer treatments can cause fatigue.
Surgery can disrupt your bodys normal rhythm and can often cause fatigue that lasts longer than you may expect. General anesthesia and after-surgery discomfort, pain medication, and restricted activity can also cause fatigue.
Chemotherapy medicines often reduce the number of red blood cells, immune cells, and platelets your bone marrow produces. Chemotherapy medicines also can damage some cells or limit their ability to function. Low blood cell counts can contribute to fatigue. For example, if you have a low red blood cell a condition known as anemia you’ll probably have less energy. If your immune cell count is low, you’re less able to fight off infections. Infections and fever can lead to fatigue. Chemotherapy also may cause early menopause, which changes the balance of hormone in your body and can lead to fatigue.
Hormonal therapy reduces the effect of estrogen in your body, just like going through menopause, which can make you feel tired and weak. Many pre-menopausal women have menopausal side effects while taking hormonal therapy, such as hot flashes, which can disrupt your sleep and lead to fatigue. Hormonal therapies include:
What To Look For
- You feel tired and it doesnt get better with rest or sleep, it keeps coming back, or it becomes severe.
- Youre more tired than usual during or after an activity.
- Youre feeling tired and its not related to an activity.
- Youre too tired to do the things you normally do.
- Your arms and legs feel heavy and hard to move.
- You have no energy.
- You spend more time in bed and/or sleep more. Or, you may have trouble sleeping.
- You stay in bed for more than 24 hours.
- You become confused or cant concentrate or focus your thoughts.
- Your tiredness disrupts your work, social life, or daily routine.
It may be hard for you to talk about it, but tell your cancer care team about your fatigue. Tell them how its affecting your life. Someone on your team should be able to help you if they know youre having this problem. Managing fatigue is part of good cancer care. Work with your cancer care team to find and treat the causes of your fatigue.
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Fatigue Affects Breast Cancer Patients Even Before First Chemotherapy Treatment According To Study
- University Of Nebraska
- A new study has found that even before women with breast cancer undergo chemotherapy, they experience fatigue and disruptions in sleep and activity levels.
A University of Nebraska Medical Center study has found that even before women with breast cancer undergo chemotherapy, they experience fatigue and disruptions in sleep and activity levels. Researchers say their findings suggest health professionals should address fatigue following breast cancer surgery.
Researchers say controlling fatigue after surgery — before starting chemotherapy — is important because fatigue typically increases during chemotherapy. Between 70 to 95 percent of breast cancer patients experience fatigue while undergoing chemotherapy.
The study was published in the current issue of the Journal of Pain and Symptom Management. Having studied 130 women with early stage breast cancer , it the largest study to document the prevalence of fatigue associated with altered sleep and activity patterns before chemotherapy treatment. The data confirms what was reported in a previous smaller study funded by the National Institutes of Health.
Researchers measured sleep and activity patterns during the 48 hours prior to the first chemotherapy treatment using wristwatch-sized activity monitors called actigraphs.
Dr. Berger said the findings provide an important benchmark to begin looking for interventions to reduce cancer-related fatigue.
Anxiety And Depression Are The Most Common Psychological Causes Of Fatigue In People With Cancer
The emotional stress of cancer can cause physical problems, including fatigue. It’s common for you to have changes in moods and attitudes. You may feel anxiety and fear before and after a cancer diagnosis. These feelings may cause fatigue. The effect of the disease on your physical, mental, social, and financial well-being can increase emotional distress.
About 15% to 25% ofpeople with cancer get depressed, which may increase fatigue caused by physical factors. Patients who have depression before starting treatment are more likely to have depression during and after treatment. The following are signs of depression:
- Lack of energy and mental alertness.
- Loss of interest in life.
- Problems thinking.
- Feeling a loss of hope.
Patients who have a history of stressful experiences in childhood, such as abuse and neglect, may have increased fatigue. See the PDQ summaries on Adjustment to Cancer: Anxiety and Distress and Depression for more information.
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When Are Hormone Therapy Given
Hormone therapy medications control hormones by blocking the bodys hormone production or altering the way hormones work in the body. Organs that secrete hormones may be removed by surgery, radiation, or the drug goserelin to fight cancer.
Before Surgery: This is called neoadjuvant treatment. The goal is to reduce the tumors size, so there is less to remove during surgery. Not everyone has treatments before surgery. Your oncologist will let you know if this is right for you.
Adjuvant therapy for early-stage breast cancer uses hormone therapy after surgery to stop cancer from coming back. It blocks the effects of estrogen or progesterone on cancer cells but does not stop the hormone from being produced.
After cancer has gone into remission, women with estrogen-positive breast cancer can use a hormone therapy regimen for about five years to help keep it from returning. Some women may benefit from treatment periods that last longer than five years.
The Presence Of Severe Fatigue In Cancer Patients Before Treatment
In the total sample 23.5% of the cancer patients were severely fatigued, but this percentage varied between diagnoses . The presence of severe fatigue was the lowest in patients with prostate cancer , but higher in breast cancer patients . In the group of patients with other tumours the presence of severe fatigue was the highest . When patients with gastrointestinal cancer were considered as a separate group, fatigue in this specific group was 28.1%. In patients with other tumours without gastrointestinal cancer severe fatigue even rose to 38.2%. A significant overall effect of diagnosis on severe fatigue was found using the Ï2 test . In addition, we tested if the means of the three diagnosis groups were different on the CIS using ANOVA, and also a significant overall effect was found . Using a post hoc test we tested which of the three groups , prostate cancer , or other tumours including gastrointestinal cancer ) differed from each other, and found one significant difference. Patients with prostate cancer were significantly less fatigued compared with the group of patients with other tumours .
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Swollen Heavy Arms Or Hands
If youâve had lymph nodes removed from your armpit or chest during breast cancer surgery or radiation, you’re more likely to get lymphedema, a buildup of fluid in the fatty tissues just under the skin in those areas.
To lower your odds of getting this condition, try to avoid cuts, burns, constriction, and muscle strain on your affected side.
- Have blood draws, shots, and blood pressure checks on the opposite side if possible.
- Wear protective gloves when doing housework and cooking.
- Use antibiotic cream on scratches.
- Wear compression sleeves on long plane flights.
- Avoid heavy lifting on your affected side.
If you already have lymphedema, ask your doctor to recommend a specially trained physical therapist. The therapist may give you compression garments, special bandages, and exercises to do to ease the swelling.