Why Do I Feel So Tired After Radiation Therapy
Most people start to feel tired after a few weeks of radiation therapy. This happens because radiation treatments destroy some healthy cells as well as the cancer cells. Fatigue usually gets worse as treatment goes on. Stress from being sick and daily trips for treatment can make fatigue worse. Managing fatigue is an important part of care.
Risk Factors And Mechanisms Of Long
Fatigue is a complex and multidimensional symptom. A number of studies have investigated and proposed a variety of risk factors and mechanisms of onset for long-term cancer-related fatigue .
2.3.1. Risk Factors of Cancer-Related Fatigue
2.3.2. Mechanisms of Cancer-Related Fatigue
Several mechanisms have been proposed to be linked with cancer-related fatigue. These include, among others, inflammation, hypothalamic pituitary adrenal dysfunction, five hydroxyl tryptophan dysregulation, alterations in the autonomic nervous system, alterations in adenosine triphosphate and muscle metabolism, changes in leukocyte subsets, reactivation of latent herpes viruses, anemia, and down-regulation of genes with response elements for the glucocorticoid receptor . The lack of longitudinal studies in this setting makes it difficult to interpret whether or not all of the cited biological changes are only driven by cancer and cancer treatment or might also be present before cancer diagnosis.
What Is Apbi In Breast Cancer
In select women, some doctors are using accelerated partial breast irradiation to give larger doses over a shorter time to only one part of the breast compared to the entire breast. Since more research is needed to know if these newer methods will have the same long-term results as standard radiation, not all doctors use them. There are several different types of accelerated partial breast irradiation:
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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.5,36 Ancoli-Israel et al.5 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.37 These data suggest that fatigue is not just a result of radiation or chemotherapy, but rather is multifactorial.
Causes Of Cancer Fatigue
- Fatigue in people with cancer may have more than one cause.
- It is not clear how cancer treatments cause fatigue.
- Fatigue related to surgery
- Fatigue caused by radiation therapy
- Fatigue caused by hormone therapy
- Fatigue caused by immunotherapy
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Radiation Therapy For Breast Cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is often used to treat breast cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is given for different reasons. You may have radiation therapy to:
- lower the risk of the cancer coming back, or recurring, after surgery
- shrink a tumour before surgery
- treat breast cancer that comes back, or recurs, in the area of a mastectomy
- relieve pain or control the symptoms of advanced breast cancer
Doctors use external beam radiation therapy to treat breast cancer. During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.
Some women may not be able to have radiation therapy because they already had radiation therapy to the chest or breast. Doctors may not offer radiation therapy to women with lung problems, damaged heart muscles and certain connective tissue diseases.
Can Stress Management Help With Cancer Fatigue
Managing stress can play an important role in combating fatigue. Here are some ways you can manage stress:
- Adjust your expectations. For example, if you have a list of 10 things you want to accomplish today, pare it down to two and leave the rest for other days. A sense of accomplishment goes a long way to reducing stress.
- Help others to understand and support you. Family and friends can be helpful if they can “put themselves in your shoes” and understand what cancer fatigue means for you. Cancer support groups can be a source of support as well. Other people with cancer truly understand what you are going through.
- Relaxation techniques including guided meditation, deep breathing or visualization can help reduce stress and minimize cancer fatigue.
- Divert your attention. Activities that divert your attention away from fatigue can also be helpful. Activities that require little physical energy but demand attention include knitting, reading or listening to music.
If your stress feels overwhelming, talk to your healthcare provider. They are there to help.
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Nerve Damage Around The Treatment Area
Scaring from radiotherapy may cause nerve damage in the arm on the treated side. This can develop many years after your treatment. Symptoms include tingling, numbness, pain, and weakness. In some people, it may cause some loss of movement in the arm and shoulder.
Speak to your doctor if you notice any of these symptoms.
Not Sleeping Well Causes Fatigue
Some people with cancer are not able to get enough sleep. The following problems related to sleep may cause fatigue:
- Waking up during the night.
- Going to sleep at different times every night.
- Sleeping duringthe day and less at night.
- Being inactive during the day.
- The time of day that cancer treatment is given.
Poor sleep affects people in different ways. For example, the time of day that fatigue is worse may be different. Some people with cancer who have trouble sleeping may feel more fatigue in the morning. Others may have severe fatigue in both the morning and the evening. People with cancer who are inactive during the day, have restless sleep, or who have obesity may have higher levels of fatigue.
Even in people with cancer who have poor sleep, fixing sleep problems does not always improve fatigue. A lack of sleep may not be the cause of the fatigue. See the PDQ summary on Sleep Disorders for more information.
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Comparison Of Pretest Scores Of Cancer
Pretest scores of cancer-related fatigue were compared to check whether the group differed in this at baseline. Mann-Whitney U-test was used to compare the two groups since the data were not following normality. Data presented in Table 3 show that there was no significant difference in the scores of cancer-related fatigue between the control group and the experimental group at the beginning of radiation therapy .
How Long Do Side Effects Last
Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.
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How Long Does Your Physical Energy Last
One of the things that I noticed during radiation treatment was that my physical energy didnt last very long. I couldnt do anything physical for much longer than 15 minutes. That meant that I needed to be aware of how long things took to plan effectively.
Make a Cup of Tea
I am not a huge tea drinker. But, I found that drinking a cup of tea in the morning was therapeutic and comforting. Plus, I used the time it took to make a cup of tea to do the morning kitchen jobs.
I would set the teapot to boil, then start to empty the dishwasher. As I was finishing up, the water would start to boil. So, I would prepare my tea and then complete the morning kitchen tasks while it was steeping. I would use the tea timer to help me complete the job. I knew that I had just enough energy to work until the timer was done.
Then, I would stop. Wherever I was in the job, it was time to take a break. I sat down on the couch and enjoyed my cup of tea. If the boys needed any help, this was a good time for them to come over and ask for it.
I had just enough physical energy to make a cup of tea. Then, I would rest while drinking it.
Use a Timer
How To Help Someone With Cancer
Some people with cancer find relief from fatigue through meditation, yoga and other mindfulness practices that encourage relaxation. Massage and acupuncture can be helpful, too. But check with your doctor to make sure these are safe, especially if your blood counts are low or if youre taking blood thinners.
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What Day Of The Week Is It
Radiation fatigue is cumulative. At the beginning of the week, I would have more energy. Monday was usually my best day because I had Saturday and Sunday off of treatment.
I ended up using that day to do a few of my more difficult homemaking tasks. On Mondays, I would look at my meal planning app and make sure that I placed grocery orders for the weeks breakfasts and lunches. Thankfully, our church brought us dinners during my radiation treatment, so I wasnt cooking.
Take note of when you have more energy and use that day to do some of the more challenging things on your schedule.
Why Does Breast Cancer Cause Fatigue
Fatigue is often listed as a symptom during the initial diagnosis of breastcancer. This may be caused by an imbalance of hormones resulting from the cancer, and/or an interruption of normal biologic functions caused by the presence of cancer in the body. Fatigue is a commonly reported side effect for patients undergoing cancer treatments
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What Are The Complications Of Cancer Fatigue
Persistent fatigue can interfere with your ability to participate in lifes activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working.
As many as 1 in 4 people with cancer develop depression. Sometimes, its hard to determine if fatigue leads to depression or vice versa.
If Youre Getting Radiation Therapy To The Abdomen
If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:
Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.
These problems should get better when treatment is over.
Managing nausea
Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.
If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.
Managing diarrhea
Many people have diarrhea at some point after starting radiation therapy to the abdomen. Your cancer care team may prescribe medicines or give you special instructions to help with the problem. Diet changes may also be recommended, such as:
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Inflammation And Immune Response
The individualâs inflammatory response is a main mechanism that is proposed to contribute to the experience of RIF. An increased serum level of IL-6sR was significantly associated with fatigue symptoms in women with stage 0-IIA breast cancer receiving 40 Gy of RT for 15 sessions . Increased serum concentrations of IL6 were significantly associated with fatigue symptoms in individuals with unresectable non-small-cell lung cancer receiving curative conventional external beam RT with concurrent chemotherapy . RIF was significantly associated with serum sTNF-R1and IL-6 levels after controlling for numerous covariates in locally advanced colorectal and esophageal cancer receiving concurrent chemoradiation therapy . Homozygous alleles of IL-6 were associated with higher levels of evening and morning fatigue symptoms among cancer patients before, during, and those actively receiving RT .
Microglial and glial cells in the central nervous system also produce cytokines especially in response to stressful conditions caused by RT . The inflammatory cytokines from these cells are thought to communicate with CNS structures causing fatigue by altering neurotransmission in the CNS through the afferent vagus nerve root . For example, the neurons of the preoptic nucleus that synthesize IL-1β have processes that have ramifications for other CNS structures, including the limbic system and the brainstem causing modulation of the neural response leading to significant fatigue .
Your Healthcare Team Will Continue To Look For Patterns Of Fatigue
A fatigue assessment is repeated to see if there is a pattern for when fatigue starts or becomes worse. The same method of measuring fatigue is used at each assessment. This helps show changes in fatigue over time. The healthcare team will check for other causes of fatigue that can be treated. See the Causes of Cancer Fatigue section.
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What Is The Best Treatment For Radiation
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
How To Cope With Cancer Fatigue
There are many things you can do to help cope with cancer fatigue: Ask for help and accept it when it is offered. Dont let pride get in the way of asking for help. Also, accept help when it is offered to you. Tasks like mowing the lawn, grocery shopping, and cleaning may be impossible when you are fatigued.
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Fatigue Can Decrease Your Quality Of Life
Cancer fatigue can affect all areas of your life by making you too tired to take part in daily activities, relationships, social events, and community activities. You might miss work or school, spend less time with family and friends, or spend more time sleeping. In some cases, physical fatigue leads to mental fatigue and mood changes. This can make it hard for you to pay attention, remember things, and think clearly. If you suffer from cancer fatigue, you may need to take leave from a job or stop working completely. Job loss can lead to money problems and the loss of health insurance. All these things can lessen your quality of life and self-esteem.
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 bodys 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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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> .
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