Can Fatigue Be A Sign Of Cancer

Problems With Blood Sugar Levels

The pancreas produces hormones including insulin and glucagon which control the amount of sugar in your blood. If you have pancreatic cancer, your pancreas may not produce enough of these hormones. This may mean that your blood sugar level is not properly controlled, which can cause diabetes.

If your blood sugar level is too high you may feel tired, lethargic and confused.

Ways To Manage Fatigue

• Keep a log of your fatigue and what you are doing to manage it daily using the My STORITM app or a journal.
• Energy conservation can help manage fatigue. To do so, mindfully plan your tasks and set realistic expectations to prevent wasting energy. Prioritize and space out activities. Delegate less essential tasks so you have energy for the things that matter most to you.
• Write down or log your fatigue symptoms so you can visualize when you have the most energy. Try to plan activities during the times you feel your best.
• Fatigue can occur with other symptoms such as pain, weakness or sleep disturbance. Be sure to track all the symptoms that you have.
• Mindfulness and stress reduction practices can help with fatigue, such as meditation, journaling, or relaxation breathing.
• Ask your doctor about possible referrals to cognitive behavioral therapy or a registered dietician to help you manage fatigue.

Some self-care activities you can do to improve your pain can include diet, exercise, sleep, or medication.

Treatment Of Fatigue In Breast Cancer Patients And Survivors

Clinical trials of treatment regimens for the alleviation and management of cancer-related fatigue have been limited compared with those focused on the alleviation of pain and suffering.3 Treatment of cancer-related fatigue can be complex because of the links observed between fatigue and various physical and psychological variables. Thus, a multidisciplinary approach to treatment and management of cancer-related fatigue is likely to be necessary for many cancer patients and survivors80 and treatments must be individualized based on underlying pathology.81

To recap, in two large studies four and five years post-diagnosis or treatment of breast cancer, survivors fatigue was most strongly linked with depressive symptoms, pain and sleep disturbance20 and with worse physical health, less physical activity, and depressive symptoms.59 Depressed mood, cardiovascular problems, and cancer treatment modality were also linked with ongoing fatigue.20 Thus, several possible underlying factors have been implicated in cancer fatigue, many of which respond well to conventional treatments.

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Certain Drugs Are Being Studied For Cancer Fatigue

The following drugs are being studied for cancer fatigue:

• Psychostimulants are drugs that improve mood and help decrease fatigue and depression. Psychostimulant drugs may help some patients have more energy, a better mood, and help them think and concentrate. The use of psychostimulants for treating fatigue is still being studied. The FDA has not approved psychostimulants for the treatment of fatigue.
• Bupropion is an antidepressant that is being studied to treat fatigue in patients with or without depression.
• Steroids are being studied in patients with advanced cancer. Dexamethasone is a steroid that reduces inflammation, but has unwanted side effects. In one clinical trial, patients who received dexamethasone reported less fatigue than the group that received a placebo.

Talk to your doctor about the risks and benefits of these drugs.

What You Need To Know

Whether youre living with or after leukaemia, lymphoma, myeloma or any other blood cancer:

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Fatigue And Memory Problems May Be Related

During and after cancer treatment, you may find that you cannot pay attention for very long and have a hard time trying to think, remember, and understand. This is called attention fatigue. Sleephelps to relieve attention fatigue, but sleep may not be enough when the fatigue is related to cancer. Take part in restful activities and spend time outdoors to help relieve attention fatigue.

Be Alert To Depression

If you feel overwhelmed by sadness or anxiety, talk to your doctor. Depression occurs in about 1 out of 4 people with cancer. Another hallmark of depression is fatigue. Your doctor may suggest antidepressant medicines and psychotherapy to ease your depression.

Show Sources

Carmelita P. Escalante, MD, professor of internal medicine at the University of Texas MD Anderson Cancer Center.MD Anderson Cancer Center: “Fatigue,” “Patient Education — Fatigue.”Alfano, C. Journal of Clinical Oncology, April 2012 vol 30: pp à 1280-1287.National Cancer Institute: “Depression, Overview.”

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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.

Take Care Of Yourself

Here are some suggestions that may help patients with CRF improve their own well-being.

A detailed record will help you when you discuss possible causes, treatments and coping strategies with your doctor or nurse.

Also note daily activities, medications and treatments, eating and sleeping habits, weight changes and emotional stressors, including financial concerns. Write down strategies that have worked to reduce fatigue, such as undertaking difficult tasks when your energy is highest, or pacing yourself and scheduling rest.

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Questions To Ask Your Health Care Team

• What is most likely causing my fatigue?
• What should I keep track of and share so we can develop a plan to help me feel better?
• What types of exercise do you recommend for me?
• How much rest should I have during the day? How much sleep should I get at night?
• What food and drinks are best for me?
• Are there treatments or medicines that could help me feel better?

Dealing With Fatigue At Work

There are laws that protect anyone who has cancer or has had cancer. Even if you no longer have cancer, you are still protected against discrimination.

If you live in England, Scotland or Wales, then the Equality Act protects your rights. If you live in Northern Ireland you have protection under the Disability Discrimination Act.

Under these laws your employer has a duty to make reasonable adjustments to where and how you work, to make sure you get the same chances as the people you work with. For example, a reasonable adjustment could be:

• giving you time off to go to medical appointments
• allowing extra breaks if you feel tired
• changing your job role to remove tasks that cause problems
• providing suitable toilet facilities.

You can find out more about your rights at work during and after cancer treatment from Macmillan Cancer Support.

What else can help?

If your employer learns more about prostate cancer and its treatment, they might be more understanding. You could show them this website or order our fact sheet, Fatigue and prostate cancer.

Take a look at your company policies and employee handbook. Talk to your occupational health service for advice.

Go to your employer with suggestions about what would help you. For example, taking extra breaks, working from home, flexible hours, or changing your job role or duties for a while.

If you are self-employed or looking for work, you can get more specific information from Macmillan Cancer Support or Disability Rights UK.

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Should I Change The Way I Eat To Combat Cancer Fatigue

Cancer fatigue may be worse if you’re not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. The following strategies can help you improve your nutritional intake.

• Basic calorie needs. A person with cancer whose weight has been stable needs about 15 calories per pound of weight each day. For example, a person who weighs 150 pounds needs about 2,250 calories per day to maintain weight. You should add 500 calories per day if you have lost weight.
• Protein rebuilds and repairs damaged body tissue. You need about 0.5-0.6 grams of protein per pound of body weight to rebuild and repair body tissue. For example, a 150-pound person needs 75 to 90 grams of protein per day. The best sources of protein include foods from the dairy group and meats .
• Fluid needs. Unless your healthcare provider tells you otherwise, you should aim for about 64 ounces per day to prevent dehydration. Fluids include juice, milk, broth, milkshakes, Jello® and other beverages. Of course, water is fine, too. Its important to note that beverages containing caffeine do NOT count. And if you are losing fluid from excessive vomiting or diarrhea, you will need extra fluids.
• Supplemental vitamins. Talk with your healthcare provider to find out if vitamin supplements are a good idea for you. Vitamin supplements don’t provide calories, which are essential for energy production. So vitamins cannot substitute for adequate food intake.

Tips To Help Manage Fatigue

• Plan and prioritise your activities and workload set realistic goals that you can break down into manageable chunks.
• Plan regular rest breaks short rests planned throughout the day are better than long ones.
• Ask family and friends for help where you can save your energy for the tasks that only you can do or for the ones you most enjoy.
• Talk to your GP or clinical nurse specialist about whether an occupational therapist could help you they can give practical advice to help you manage at work, school or home, including organising equipment and adaptations.
• Make time to keep up with fun and enjoyable parts of your life, including spending time with family and friends.
• Use devices or equipment you could use to make tasks easier or quicker.
• Try to get into a sleep routine, to help you get a restful night.
• Consider relaxation techniques and complementary therapies, for example mindfulness meditation, acupuncture, yoga or massage speak to a member of your medical team before trying one, to check its safe for you.

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Movement And Activity Helps

Its been proven that being active helps to reduce fatigue. Find out whats helped others living with or after blood cancer to keep active, even if you’re mainly staying at home.

Watch our short videos on staying active with and after blood cancer. These videos have been designed to help you build up strength and fitness at home, even if you havent been active for a while.

– Erica, 69

Cancers With No Warning Signs

While many cancers have symptoms, some forms are more discreet.

Pancreatic cancer may not lead to any signs or symptoms until its progressed to an advanced stage. A family history, as well as frequent pancreatic swelling, may increase your risk. If this is the case, your doctor may recommend regular cancer screenings.

Some cases of lung cancer may only result in subtle signs and symptoms outside of the well-known cough. Certain types may cause increased blood calcium levels, a symptom which may not be detected without lab work.

Kidney cancer, especially in its earlier stages, is another type that may not cause notable symptoms. Larger or more advanced kidney cancer may lead to symptoms such as pain on one side, blood in the urine, or fatigue. However, these symptoms are often the result of other benign causes.

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Stress Mental And Emotional Changes

Having cancer can cause stress, sleeping problems, moodiness, and depression. Stress by itself can cause emotional, mental, and physical fatigue.

Both cancer itself and stress can cause dysregulation of cortisol. Increased levels of cortisol put your body in a high-alert state. This burns a lot of energy and can lead to mental and emotional changes and sleeping problems which all lead to fatigue.

How Long Does Fatigue Last

Cancer-related fatigue is different to normal tiredness as it doesnt always go away after sleep or rest. Fatigue can continue throughout your treatment and even for some time after it. Most people will start to feel better 6-12 months after treatment ends but some may find the fatigue continues for longer than that.

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Are There Any Supplements I Can Take To Help With My Fatigue

If you are able to, the general guidance is to eat a healthy balanced diet. If you have difficulties eating, you might be advised by a member of your medical team to take an additional multivitamin and mineral supplement. Its important to check with consultant or CNS before taking supplements. Some are harmful if taken in high doses and can react with other medications and treatment for lymphoma.

How Cancer Treatment Causes Fatigue

Radiation therapy, chemotherapy, surgery, hormone therapy, immunotherapythese treatments and their common side effects challenge the body, and the body needs energy to recover.

When you start a new treatment, the body produces cytokines to help boost the immune response. When cells die, the body works to clean up those dying cells, causing inflammation. Its a desirable response in this case, but inflammationboth acute and chronicalso causes fatigue.

You can compare this fatigue to how you feel when your body fights the flu or another infection, like COVID-19. While your bodys working hard to fight the infection, you feel tired.

How and when you experience fatigue from cancer treatment may vary according to the treatment youre receiving and its side effects.

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How Can I Conserve Energy When I Have Cancer Fatigue

Plan and organize your work

• Change storage of items to reduce trips or reaching.
• Delegate when needed.
• Combine motions and activities and simplify details.

Schedule rest

• Balance periods of rest and work.
• Rest before you feel tired.
• Frequent, short rests are beneficial.

Pace yourself

• Do not hold your breath.
• Wear comfortable clothes to allow for free and easy breathing.

Identify anything in your environment that may contribute to cancer fatigue

• Avoid extreme temperature.
• Eliminate smoke or noxious fumes.
• Avoid long, hot showers or baths.

Prioritize

• Use your energy on important tasks.

Summary And Future Directions

While research into the etiology, course, and treatment of cancer-related fatigue is relatively new, much progress has been made in recent years however, considerable opportunities remain. While some well-powered studies have examined risk factors for fatigue in breast cancer patients and survivors, most studies examining underlying mechanisms have involved small to very small sample sizes. While a few studies employing repeated-assessments have been conducted, most have been cross-sectional in design. Thus, more longitudinal studies that involve assessment of cancer patients pre-/post-completion of initial treatment and into survivorship are needed. While multiple factors have been observed to be linked with cancer-related fatigue, it has yet to be determined which factors predispose, precipitate or exacerbate/maintain the patients experience of fatigue. For example, longitudinal studies examining and comparing the effects of chemotherapy- and radiation-induced inflammation on functioning during survivorship are warranted. Also, additional studies employing statistical analytic techniques that can evaluate hypotheses about causal pathways are needed. These will require multiple assessments of established or promising biomarkers of fatigue. Such studies should also assess fatigue using multidimensional scales normed on and/or tailored to breast cancer patients.

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How We Treat Cancer At Ctca

We only treat cancer at CTCA. Our team of multidisciplinary cancer experts takes a personalized, patient-centered approach to treating cancer and its side effects.

In addition to using conventional cancer treatments to attack the cancer itself, we provide evidence-informed supportive care therapies to help patients tolerate treatment and reduce side effects, including:

• Nutritional support, which includes the option of meeting with a registered dietitian wholl develop a personalized plan for your nutritional needs
• Behavioral health care, which may include working with therapists to help with depression, anxiety and stress, and using techniques such as talk therapy, mindfulness and relaxation techniques
• Access to professionally led support groups for patients and their loved ones, both in-person and online, including our Cancer Fighters community, where you can connect with cancer survivors
• Naturopathic support, which includes consultations with our naturopathic providers who counsel patients on the use of natural, non-toxic techniques to support the healing process

Providers at CTCA work together under one roof, providing convenient access for patients.

If youd like to get a second opinion or talk to someone at CTCA about getting help for fatigue or other cancer-related side effects youre experiencing, or chat online with a member of our team.

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