How Can I Tell If I Have Cancer Fatigue
- Think of your personal energy stores as a “bank.” Deposits and withdrawals have to be made over the course of the day or the week to ensure a balance between energy conservation, restoration and expenditure.
- Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors.
- Be alert to the warning signs of impending cancer fatigue tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety or impatience.
Other Possible Causes Of Fatigue During Cancer Treatment
Vitamin D deficiency is common in the general population. Correcting this deficiency in otherwise healthy people has been shown to improve self-reported fatigue. If youre fatigued due to vitamin D deficiency going into treatment, cancer therapy may be less successful and result in more side effects like peripheral neuropathy .
For example, one study of breast cancer patients being treated with paclitaxel showed that pre-treating vitamin D deficiency reduced the incidence of peripheral neuropathy and also led to fewer treatment disruptions and better treatment outcomes.
Another study showed correcting vitamin D deficiency may ease gastrointestinal mucositis, a painful inflammation and ulceration of the digestive tract, in patients undergoing chemotherapy.
Consider getting your vitamin D levels checked periodically. In my practice, I often check it at least twice a year to get a better understanding of the patient’s vitamin D rhythms from summer to winter. I recommend levels of approximately 50-80 nanograms per milliliter .
When you check your levels is important, though. Levels tend to be higher during the summer, when people are spending more time in sunlight, and lowest at the end of winter. So, if you check it in the middle of the summer and your level is 30, thats low for the targeted endpoint of 50-80 ng/ml. But if its 30 at the end of winter, that means it likely was in the therapeutic range during winter, and your levels may be sufficient.
How You Feel Emotionally
Being diagnosed with cancer can be hard to accept. Youre likely to go through a range of emotions before, during and after your treatment. This is very normal.
You might have a lot of worries, some of these might include:
- will my treatment work?
- will I be able to deal with side effects?
- how will my family and friends cope?
- will I have enough support?
- will I be able to keep working?
- how will I get to the hospital for my treatment?
- will the treatment be painful?
- what if I lose my hair?
All these worries can make you feel anxious or down. Anxiety and depression are common in people with cancer. Theyre often very draining emotions.
Fatigue can be worse if you are taking a combination of these drugs.
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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.
Inflammation From Androgen Deprivation Therapy May Cause Fatigue In Prostate Cancer Patients
TAMPA, Fla. Prostate cancer is one of the most common cancers among men in the U.S. For many patients, hormone therapy is a treatment option. This type of therapy, also called androgen deprivation therapy , reduces the level of testosterone and other androgens in the body. Lowering androgen levels can make prostate cancer cells grow more slowly or shrink tumors over time. However, patients receiving ADT often experience higher levels of fatigue, depression and cognitive impairment.
Moffitt Cancer Center researchers are investigating whether inflammation in the body, a side effect of ADT, contributes to these symptoms in prostate cancer patients. In a new study published in the journal Cancer, they pinpoint a specific inflammation marker that is associated with increased fatigue in this group of patients.
This is the first study that we know of that examines the association between inflammation and symptoms of fatigue, depression or cognitive impairment in prostate cancer patients receiving ADT, said Heather Jim, Ph.D., corresponding author and co-leader of the Health Outcomes & Behavior Program at Moffitt. Because the blocking of testosterone can increase inflammation in the body, we believe that inflammation may also be contributing to these symptoms.
The researchers say additional studies are needed to see if interventions, such as anti-inflammatory medications and exercise, can help alleviate fatigue and depressive symptoms in ADT patients.
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Fatigue Isoften Treated By Relieving Relatedconditions
Treatment of fatigue depends on the symptoms and whether the cause of fatigue is known. When the cause of fatigue is not known, treatment is usually given to relieve symptoms and teach you ways to cope with fatigue.
Treatment of anemia
Anemia causes fatigue, so treating anemia when the cause of anemia is known, helps decrease fatigue. When the cause is not known, treatment for anemia is supportive care and may include the following:
- Change in diet
Eat more foods rich in iron and vitamins combined with other treatments for anemia.
- Transfusions of red blood cells
Transfusions work well to treat anemia. Even though problems from a transfusion are low, there are risks of an allergic reaction, infection, graft-versus-host disease, immune system changes, and too much iron in the blood.
- Medicine
Drugs called erythropoiesis-stimulating agents cause the bone marrow to make more red blood cells and may be used to treat anemia-related fatigue in terminal patients receiving chemotherapy.Since ESAs increase the risk of blood clots, few patients are offered this treatment. The Food and Drug Administration has not approved these drugs for the treatment of fatigue. Discuss the risks and benefits of these drugs with your doctor.
Treatment of pain and depression
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.
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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.
Expert Review And References
- American Cancer Society. Prostate Cancer Early Detection, Diagnosis, and Staging. 2019: .
- Garnick MB . Harvard Medical School 2015 Annual Report on Prostate Diseases. 2015.
- Hermanns T, Kuk C, Zlotta AR. Clinical presentation, diagnosis and staging. Nargund VH, Raghavan D, Sandler HM . Urological Oncology. Springer 2015: 40: 697-718.
- Logothetis CJ, Kim J, Davis J, Kuban D, Mathew P, Aparicio A. Neoplasms of the prostate. Hong WK, Bast RC Jr, Hait WN, et al . Holland Frei Cancer Medicine. 8th ed. People’s Medical Publishing House 2010: 94: 1228-1254.
- PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Patient Version. Bethesda, MD: National Cancer Institute 2020: .
- PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Health Professional Version. Bethesda, MD: National Cancer Institute 2020: .
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Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
How Is Cancer Fatigue Managed Or Treated
The first step in treating fatigue is knowing the problem exists. Many people don’t bother to mention fatigue to their doctors because they believe it is normal. It’s vital that you discuss this and all symptoms or side effects with your healthcare provider. Then, efforts can be directed at determining the cause of the problem and prescribing appropriate treatment. Your particular cancer treatment regimen, with its known side effects, may provide clues for your doctor or health care professional. A simple blood test, for example, can determine if you are anemic.
There is no single medication available to treat fatigue. However, there are medications available that can treat some of the underlying causes.
When youre struggling, you may want to see a palliative care specialist. These experts help people with cancer manage symptoms like pain, nausea and depression.
Your provider or palliative care team may recommend these actions to ease fatigue:
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Impact On Everyday Activities
If you have no symptoms, prostate cancer should have little or no effect on your everyday activities. You should be able to work, care for your family, carry on your usual social and leisure activities, and look after yourself.
However, you may be understandably worried about your future. This may make you feel anxious or depressed and affect your sleep.
If your prostate cancer progresses, you may not feel well enough to do all the things you used to. After an operation or other treatment, such as radiotherapy or chemotherapy, youll probably feel tired and need time to recover.
If you have advanced prostate cancer that has spread to other parts of your body, you may have symptoms that slow you down and make it difficult to do things. You may have to reduce your working hours or stop working altogether.
Whatever stage your prostate cancer has reached, try to give yourself time to do the things you enjoy and spend time with those who care about you.
Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
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What Are The Signs & Symptoms Of Prostate Cancer
Prostate cancer symptoms do not usually manifest themselves in the early stages of the disease. Less than five percent of men with prostate cancer show early urinary symptoms. The condition has usually progressed to later stages when prostate cancer symptoms do arise.
Some men may experience symptoms that can indicate the presence of prostate cancer. Others may find out during a routine check-up, a blood test, or a rectal exam with their doctor. Because the symptoms of prostate cancer are similar to other symptoms patients, will need to go through further testing to determine whether they actually have prostate cancer.
What Can I Do To Combat Fatigue
The best way to combat fatigue is to treat the underlying medical cause. Unfortunately, the exact cause is often unknown, or there may be multiple causes.
Some treatments may help improve fatigue caused by an underactive thyroid or anemia. Other causes of fatigue must be managed on an individual basis. You can use the following to help combat fatigue:
Assessment. Evaluate your level of energy. Think of your personal energy stores as a “bank.” Deposits and withdrawals have to be made over the course of the day or the week to balance the amount of energy you store and the amount you need each day. Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors. Be alert to your personal warning signs of fatigue. These may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.
Energy conservation. You can conserve your energy in several ways. Here are some suggestions:
- Plan ahead and organize your work. Change storage of items to reduce trips or reaching. Delegate tasks when needed.
Other ways to combat fatigue include:
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Causes Of Prostate Cancer Related Fatigue
The following prostate cancer treatments are commonly associated with the onset of prostate cancer fatigue.
Chemotherapy
Any type of chemotherapy can potentially cause fatigue in patients. However the side effect is more common with the drugs vincristine and cisplatin. Patients often feel fatigued after undergoing several weeks of chemotherapy but this usually varies from patient to patient. Fatigue can last for as little as a few days, or may even persist throughout the course of treatment.
Radiation therapy
Radiation therapy can cause fatigue that will gradually increase over time regardless of where the treatment site is located. Fatigue usually tends to last several weeks following treatment but can continue for several months to a year even after the treatment has concluded.
Combination therapy
Undergoing more than one prostate cancer treatment at the same time will increase your chances of developing fatigue.
Additional contributing factors to fatigue include:
- Chronic or severe pain
- Poor nutrition
Why Does Chemotherapy Cause Diarrhea
The powerful anticancer medicines you take can affect the healthy cells in your body, including the cells that line the inside of your intestines. Your intestines help your body to take in food, water, and other liquids. If your chemotherapy medicines affect the cells that line the inside of your intestines, they cannot take food and water into your body very well. The food and water stay in your intestines. This causes diarrhea.
Diarrhea usually happens in the first few days after your chemotherapy treatment. It may also happen one or two weeks after you get your chemotherapy treatment. If you have diarrhea, you should tell your doctor and health care team right away. If your diarrhea is untreated, you may become dehydrated . There are medicines that your doctor or health care team can give to you that will make your diarrhea better.
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Symptoms Of Prostate Cancer
Prostate cancer may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the tumour grows and causes changes in the body such as changes in bladder habits. Other health conditions can cause the same symptoms as prostate cancer.
The signs or symptoms of prostate cancer include:
- more frequent urination , especially at night
- a strong or sudden urge to urinate
- difficulty starting the flow of urine
- weak or slow urine stream
- interrupted urine stream
- being unable to empty the bladder completely
- having difficulty controlling the bladder , which can cause urine to leak and dribble
- blood in the urine or semen
- burning or pain during urination
- discomfort or pain when sitting, caused by an enlarged prostate
- painful ejaculation
- trouble getting an erection
- pain or stiffness in back, hips or pelvis that doesn’t go away
- fatigue
In rare cases, prostate cancer can cause paraneoplastic syndrome. This is a group of symptoms including high blood pressure, fatigue and weight loss that may happen when substances released by cancer cells disrupt the normal function of nearby or distant organs or tissues.
In some cases, prostate cancer can cause serious problems. These cancer-related emergencies are uncommon but need to be treated right away and are usually a sign of advanced cancer:
Frequent Urination Burning With Urination And Difficulty Urinating
These are the most common complaints. Occasionally the urinary stream will weaken. Generally these symptoms are managed with medications to help the bladder function better or eliminate burning. Rarely, your doctor may order a urine test. Symptoms will resolve after the end of treatment. Contact your doctor if you see blood in your urine or if you are unable to urinate.
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