What Causes Fatigue With Colorectal Cancer
The exact reason for colorectal cancer-related fatigue is unknown. It may be related to the disease itself or its treatments.
The following colorectal cancer treatments are commonly associated with fatigue:
- Chemotherapy. Any chemotherapy drug or regimen may cause fatigue. Fatigue usually develops after several weeks of chemotherapy. In some, fatigue lasts a few days, while others say the problem persists throughout the course of treatment and even after the treatment is complete.
- Radiation therapy.Radiation, commonly used in the treatment of rectal cancer, can cause fatigue that increases over time. This can occur regardless of the treatment site. Fatigue usually lasts from 3 to 4 weeks after treatment stops, but can continue for up to 2 to 3 months.
- Combination therapy. More than one cancer treatment at the same time or one after the other increases the chances of developing fatigue.
Is It Possible That I Have Pots And Was Incorrectly Diagnosed
This is entirely possible. Given how common POTS symptoms are and how unfamiliar many doctors are with this condition, diagnostic mishaps happen. POTS is frequently misidentified as chronic fatigue syndrome, fibromyalgia, myofascial pain syndrome, anxiety disorder, ADHD, irritable bowel syndrome, myositis, etc. It is also possible that you have both POTS and one of these conditions, which may complicate the diagnosis. Sometimes people with POTS are told that its all in your head, implying that the cause of their symptoms is psychological. If you feel like something is physically wrong, dont hesitate to seek a second, and even a third or fourth opinion.
COVID-19 and POTS: Is There a Link?
Although many people recover quickly from COVID-19, the disease caused by the coronavirus, others who recover may continue to experience symptoms for months. Researchers are still determining the cause of these extended symptoms, but some COVID-19 “long-haulers” may actually be dealing with POTS.
When Should I Call My Doctor About Cancer
Although cancer-related fatigue is a common, and often expected, side effect of cancer and its treatments, you should feel free to mention your concerns to your doctors. There are times when fatigue may be a clue to an underlying medical problem. Other times, there may be treatments to help control some of the causes of fatigue.
Finally, there may be suggestions that are more specific to your situation that would help in combating your fatigue. Be sure to let your doctor or nurse know if you have:
- Increased shortness of breath with minimal exertion
- Uncontrolled pain
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How To Find Help For Cancer Fatigue
It can be hard to pinpoint the cause of cancer-related fatigue, especially if a combination of factors is working together to cause it. There may not be one simple answer. Keep looking for help, even if initial tests for obvious sources of fatigue are negative.
Keep in mind that conventional oncologists arent usually trained on all the research thats been done on how to manage side effects and help improve quality of life. Their focus is on drugs used to treat cancer. But don’t assume your oncologist is the only one capable of managing your side effects, nor the only one who should be following your progress.
Physicians who work in integrative medicine, functional medicine and naturopathy may be more experienced with how to manage those symptoms using relatively non-toxic approaches. These providers may be more likely to know about and use strategies that show the potential to improve patients quality of life without causing harmful side effects. However, be cautious with any provider who claims their treatments will cure cancer in lieu of conventional therapy.
If youre not getting the help youre looking for, consider seeking a second opinion at an oncology center like CTCA. Cancer centers are more likely to offer resources to explore the multifactorial processes that could be affecting fatigue.
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
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.
Exercise
Energy Conservation
Integrative Therapies
Medications
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Fatigue Prior To Treatment
Several studies have now shown that women with breast cancer complain of fatigue even before the start of treatment., Ancoli-Israel et al. found that women diagnosed with breast cancer had increased fatigue, disturbed sleep, and increased daily dysfunction before the start of chemotherapy, and that those patients with fatigue, poor sleep, and depression pre-chemotherapy experienced more fatigue and poor quality of life during chemotherapy than women with fewer pre-treatment symptoms. These data suggest that fatigue is not just a result of radiation or chemotherapy, but rather is multifactorial.
Is Fatigue A Sign Of Cancer
Fatigue may develop as a symptom of blood cancers, such as leukemia, lymphoma and multiple myeloma, because these cancers start in the bone marrow, which produces red blood cells that carry oxygen throughout the body.
Fatigue may also be a symptom of undiagnosed metastatic cancer . This is more common in cancers that arent typically caught early, such as lung cancer or ovarian cancer.
Its uncommon for fatigue to be the only symptom of undiagnosed cancer. A more concerning scenario develops when patients experience both fatigue and pain in one area thats getting progressively worse, along with unexplained weight loss and loss of appetite.
However, these symptoms may also be caused by an infection or another medical condition, such as anemia, depression, thyroid dysfunction, vitamin deficiency or sleep apnea, to name a few possibilities.
If a patient came to me complaining primarily of fatigue, my first thoughteven as an oncologistprobably wouldnt be cancer.
There may not be a simple answer behind whats causing your fatigue, and discovering the root cause often takes some digging, along with some trial and error with various therapeutic approaches.
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Fatigue Is The Most Common Side Effect Of Cancer Treatment
Cancer treatments such as chemotherapy, radiation therapy, hormone therapy, bone marrow transplantation, and immunotherapy can cause fatigue. Fatigue is also a common symptom of some types of cancer. People with cancer describe fatigue as feeling tired, weak,worn-out, heavy, slow, or that they have no energy or get-up-and-go. Fatigue in people with cancer may be called cancer fatigue, cancer-related fatigue, and cancer treatment-related fatigue.
How Long Does Cancer Fatigue Last
Everyones experience with cancer fatigue is unique. For some people, fatigue lasts a few weeks. Others may feel exhausted for years. You may feel better when your cancer treatments stop, but often fatigue lingers.
- Bone marrow transplants can cause prolonged fatigue that lasts up to a year.
- Radiation therapy fatigue often gets worse as treatments progress. Fatigue should lessen a few months after you stop treatment.
- Surgery tends to cause temporary fatigue that goes away after you recover.
- Systemic treatments can cause fatigue that comes and goes. These treatments include chemotherapy, immunotherapy and targeted therapy. You may be exhausted while taking the medications and feel better during the recovery phase . When treatment resumes, you feel exhausted again. You should have more energy when you finish the treatment.
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Finding The Cause Of Your Fatigue
If youre experiencing unexplained fatigue thats concerning you and interfering with your daily activities, start with a visit to your primary care physician to investigate more common reasons for fatigue.
Your physician will probably ask about the level of fatigue youre experiencing and when it began. He or she should evaluate medications you may be taking for other health conditions because fatigue is a side effect of some medications.
Some common blood tests your doctor may order include:
- A blood chemistry panel to check for kidney disease, liver disease, electrolyte imbalance and signs of cardiovascular disease
- A complete blood count to screen for conditions such as anemia, immune deficiency or infection
- Thyroid function tests to evaluate thyroid gland function
- A vitamin D test to determine whether you have vitamin D deficiency
Other screenings may include a psychological analysis to determine whether youre depressed or a sleep study to see whether youre at risk for obstructive sleep apnea.
If those tests are negative, your physician should start looking for another possible underlying cause of fatigue.
How Does Cancer Cause Fatigue
, cancer is the uncontrolled growth of abnormal cells in the body. That growth requires energy, and cancer absorbs energy that would normally travel to the rest of the body.
Its uncommon to notice this energy drain, however, unless the cancer has metastasized to organs such as the liver, where it may affect metabolism, or the bone marrow.
When cancer invades the bone marrow, it affects the production of blood cells. White blood cells help fight infection. Red blood cells contain hemoglobin and carry oxygen to and from organs and tissues throughout the body, providing energy and removing waste from cells. Cancer may cause a reduction in the production of red blood cells, resulting in anemia, which causes fatigue.
Inflammation caused by cancer may be another key contributor to cancer-related fatigue. When your body is fighting a disease, it releases chemicals like cytokines to trigger the immune response, but these chemicals may also cause fatigue.
In patients with advanced cancer, the disease may produce cachexins, which reduce your appetite and may result in cachexia, a serious cancer-related condition that causes substantial weight loss and muscle wasting.
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Causes Of Long Term Fatigue
Fatigue for people having treatment for cancer is different from the fatigue some people feel long after finishing their treatment. Or those living with cancer. This is also called chronic fatigue. The symptoms last for at least 6 months or more.
Things that can cause long term fatigue include:
- bone marrow transplants
How Fatigue Can Affect Your Daily Life
Fatigue can be very frustrating. You and your relatives might underestimate how much it can affect daily life.
Everyday life can be hard work and you might not have the energy to cook, clean, bathe or go shopping. You might not even feel up to a chat. Things that you used to find second nature or easy are now a task and can be hard work.
You and your doctor can sometimes overlook fatigue, especially if you have other side effects. Its important to tell your doctor or nurse about how youre coping day to day and if you are struggling.
Fatigue can affect the way you feel about yourself and your relationships with other people. You can feel very down and not want to go out or be with people which can be hard for them to understand.
You might have to stop working or cut down your hours. This can affect how much money you have.
You might feel like fatigue is a constant reminder of your cancer and this can be hard to accept.
You might worry that because you feel so tired all the time your cancer could be getting worse. But it is more likely to be a side effect of treatment, or due to the fact that cancer can cause fatigue.
Fatigue is very real and can have a big impact on your life. Let your doctor or nurse know if you think you have symptoms of fatigue. There are ways of managing it and your medical team will try to help you.
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How Does Bladder Cancer Cause Fatigue Or Weakness
Patients with advanced bladder cancer may experience the symptoms of fatigue and weakness.3,4 One reason is that cancer cells use up many of the nutrients in the body, which can prevent healthy cells from growing and functioning as they should. The cancer cells may also be affecting the function of other organs and systems in the body, such as the lymph nodes, kidney, liver, or lungs. Fatigue and weakness can also be symptoms of bladder cancer treatments, such as chemotherapy, radiation therapy, and biological therapies.
How Would You Describe Fatigue Associated With Pots
People with POTS experience fatigue differently. Many describe it as feeling beyond exhausted. Its as if your energy is completely depleted. The fatigue is probably hundreds of times worse than your worst flu. People with POTS may also have trouble concentrating and thinking straight. Doing simple tasks may feel like youve just run a marathon.
This fatigue might come and go, hitting you without warning daily, weekly or less frequently. For some people, extreme fatigue lasts for days. Others may experience periodic attacks. It can come on at any moment even if you just woke up. And there is no amount of sleep or coffee that can make it go away.
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The Most Common Symptoms
The most common symptom of bladder cancer is blood in the urine that is visible to the eye, which occurs in between 80% and 90% of patients diagnosed. It is usually the first symptom and may be the only symptom that a person experiences. Around 20% to 30% of patients diagnosed with bladder cancer experience problems or changes related to urination, such as
- The need to urinate more often than usual
- Pain or burning before, during, or after urination
- Feeling the urgent need to urinate despite having a bladder that is not full
- Inability to urinate despite a full bladder
Start By Taking A Walk
The first thing that I advise people that are dealing with this, is to take a nice walk outside in the morning. Waking up with some fresh air and exercise will drive up the energy levels in the body. People will feel better throughout the day. It also contributes to how well the biorhythm is working.
When the sun is out, it will also give them a nice boost of vitamin D which we need to feel healthy. Of course, I urge them to wear a hat and apply sunscreen before going out.
Dr. Haley advises this because the UV exposure from the sun is the most common cause of skin cancer. So this tip does not only apply to people that are being treated for skin cancer, but also for people that are healthy. Make sure to be aware of the risks of the sun so you can enjoy it, without taking a risk.
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What Else Can Cause Fatigue
Many other factors can make you feel tired and fatigued if you have cancer. Some of these include:
- not sleeping well at night or sleeping too much during the day
- treatment may be harder for you to cope with especially if you’re elderly
- your tiredness may make it harder for you to concentrate so everything seems more difficult making you feel even more tired
- travelling to and from the hospital for treatment
- having a lot of visitors when you are staying in hospital
- looking after children
- other health problems such as diabetes, problems with your lungs, heart problems and being overweight
You can ask your nurses to tell your visitors that they can only stay with you for a short time. Don’t feel bad if you have to do this. You need a lot of rest and your friends and family will understand.
Chronic Stress Causes Adrenal Exhaustion:
- The top 4 causes of cortisol imbalances: #1) emotional stress, #2) dietary stress/poor diet, #3) pain, #4) hidden sources of systemic inflammation
Normally, when the stress goes away, the adrenal glands have time to rest and prepare for the next stressful event. However, if your stress levels remain chronically high , your adrenal glands will continue to produce higher than normal levels of these hormones. This can lead to:
- Impaired immune system strength
- Increased production of free radicals
- Insulin resistance
- Increase bone breakdown
- Etc
So far, the majority of medical doctors will agree with what I have written.
The following is where most medical doctors begin to disagree
Theoretically , if your stress hormone levels remain elevated for extended periods of time , the ability of your adrenals to make cortisol and DHEA can be compromised. If this stress continues, the high levels of cortisol and DHEA begin to drop as the adrenals eventually burn out. At this point, the adrenals become exhausted/fatigued and can no longer sustain an adequate response to stress. Although they continue to produce these hormones, they do so at much lower levels. This is can lead to the following:
Thanks in part due to the new field of Functional Medicine I have been better able to understand the affects of chronic stress on the body and the adrenal glands, as well as how to diagnose and treat adrenal exhaustion.
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