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.
Fatigue From Prostate Radiation
Fatigue occurs in about half the men who undergo radiation therapy for prostate cancer. It is probably related to the body responding to the inflammation in the prostate. Usually it is mild, but in some cases it is moderate or severe and interferes with work and other activities. Fatigue is more common in men who already have some fatigue before they even start radiation. It is also more common and intense in patients who are simultaneously receiving testosterone-reducing hormone therapy injections like Lupron for their cancer.
The fatigue from radiation usually takes a few weeks to start, it may worsen for several weeks, and then level off during the last 3 weeks or so of treatment. The fatigue usually improves and goes away during the first 2 6 weeks after RT has ended. These time frames are quite variable from patient to patient. There are reports of some men that may have some chronic fatigue for months afterwards.
How Fertility Might Be Affected
For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.
Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.
See Fertility and Women With Cancer to learn more.
For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.
See Fertility and Men With Cancer to learn more.
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Cellular Immunity Latent Viral Reactivation And Fatigue
Cancer treatments can cause pronounced and prolonged alterations in the cellular immune system, , which may underlie alterations in inflammatory activity and associated symptoms of fatigue. Our group has documented alterations in T cell populations and myeloid dendritic cells in breast cancer survivors with persistent fatigue that are correlated with inflammatory processes, . Other groups have shown more global changes in the cellular immune system in relation to fatigue, including elevations in leukocyte numbers among fatigued breast cancer survivors, , though these effects have not been consistently replicated. One of the few longitudinal studies in this area found that elevated leukocyte counts in the post-treatment period predicted persistent fatigue over a 2â3 year follow-up in breast cancer survivors.
Another potential explanation for elevated inflammatory processes and fatigue in cancer patients is reactivation of latent herpesviruses, . A recent study conducted with breast cancer patients prior to treatment found that elevated cytomegalovirus antibody titers were associated with a greater likelihood of being fatigued, as well as higher levels of CRP. Cancer treatments such as chemotherapy promote viral reactivation and associated increases in inflammatory markers which may have long-term implications for immune regulation and recovery as well as fatigue and other behavioral symptoms.
Fatigue In People With Cancer May Have More Than One Cause
Doctors do not know all the reasons people with cancer have fatigue. Many conditions may cause fatigue at the same time.
Fatigue in people with cancer may be caused by the following:
- Cancer treatment.
- Hormone levels that are too low or too high.
- Trouble breathing or getting enough oxygen.
- Problems getting enough sleep.
- Loss of appetite or not getting enough calories and nutrients.
- Changes in how well the body uses food for energy.
- Loss of weight, muscle, and/or strength.
- Medicines that cause drowsiness.
- Tumors in certain parts of the body.
- Other medical conditions.
- Having fatigue before cancer treatment begins.
Fatigue is common in people with advanced cancer who are not receiving cancer treatment.
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Why You’re So Tired After Radiation Therapy
Brandi Jones MSN-Ed, RN-BC is a board-certified registered nurse who owns Brandi Jones LLC, where she writes health and wellness blogs, articles, and education. She lives with her husband and springer spaniel and enjoys camping and tapping into her creativity in her downtime.
When you undergo radiation therapy to treat cancer, your healthcare provider may provide you with a list of possible side effects of treatment. Things like nausea, diarrhea, and hair loss usually catch a person’s attention first because they seem to be the worst.
However, fatigue is one of the most common side effects. A lack of energy and excessive tiredness is common for cancer patients no matter their therapy, but those undergoing radiation therapy experience fatigue more frequently. It also worsens as treatment continues.
This article reviews symptoms of fatigue, why radiation causes it, tips to manage and cope with fatigue, and when to call your healthcare provider
Early And Late Effects Of Radiation Therapy
- Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
- Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. Its always best to talk to your radiation oncologist about the risk of long-term side effects.
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Proton Beam Radiation Therapy
Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.
Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.
If Youre Having Radiation Therapy To The Pelvis
Radiation therapy to the pelvis can cause side effects such as:
- Bladder problems
- Fertility problems
- Changes in your sex life
You might also have some of the same problems people get from radiation to the abdomen, such as nausea, vomiting, diarrhea, or constipation.
Bladder problems
Radiation to the pelvis can cause problems with urination, including:
- Pain or burning sensations
- Blood in the urine
- An urge to urinate often
Most of these problems get better over time, but radiation therapy can cause longer-term side effects as well:
- Radiation cystitis. If the radiation damages the lining of the bladder, radiation cystitis can be a long-term problem that causes blood in the urine or pain when passing urine.
- Urinary incontinence. Radiation treatments for certain cancers, such as prostate and bladder cancer, may make you unable to control your urine or have leakage or dribbling. There are different types and degrees of incontinence, but it can be treated. Even if incontinence cant be corrected completely, it can still be helped. See Bladder and Bowel Incontinence to learn more. This side effect is most often a problem for men being treated for prostate cancer, but some of the information might also be helpful for women dealing with treatment-related incontinence.
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Prostate Cancer And Fatigue
Men who have been diagnosed with prostate cancer may experience fatigue as a serious side effect of both their prostate cancer and its associated treatments. Physically speaking, being fatigued can leave your body feeling drained, lethargic and weak. It can also adversely affect your energy levels as well as your ability to maintain daily normal function. The specific reason for cancer related fatigue is unknown. However when being treated for prostate cancer your body will undergo a number of physical changes and any one factor by itself or combined can contribute to prostate cancer fatigue.
Intensity Modulated Radiation Therapy
IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.
Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.
A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.
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How Might Fatigue Make Me Feel
You might use some of these words to describe how fatigue makes you feel: tired, exhausted, weak, lethargic, drained, knackered, shattered, whacked, beat, spent, weary, drowsy, weighed down, done in
Fatigue can make it hard to carry out your daily activities. It can make it difficult to do some things, such as:
- everyday tasks, such as getting dressed, having a shower or preparing food
- social activities, such as seeing friends and family
Travelling to the hospital or GP surgery for treatments and check-ups can make your fatigue worse.
Symptoms of advanced prostate cancer
Some problems that can be caused by advanced prostate cancer, such as pain or anaemia, can cause fatigue.
Pain
Pain caused by your cancer, treatment or another health problem can make your fatigue worse.
Medicines
Some medicines, such as pain-relieving drugs, can also cause fatigue. Speak to your doctor about changing your medicines this could help improve your fatigue.
Other health problems
Some other health problems, such as kidney disease or arthritis, can cause fatigue.
Not sleeping well
Not sleeping well at night can make your fatigue worse. And having fatigue can make it harder to sleep well. You might have worries that keep you awake at night. Or you might wake up in the night because of symptoms of prostate cancer or side effects from your treatment, such as having a hot flush or needing to urinate.
Lack of physical activity
Other things that use up energy
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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If Youre Getting Radiation Therapy To The Head Or Neck
People who get radiation to the head and neck might have side effects such as:
- Soreness in the mouth or throat
How to care for your mouth during treatment
If you get radiation therapy to the head or neck, you need to take good care of your teeth, gums, mouth, and throat. Here are some tips that may help you manage mouth problems:
- Avoid spicy and rough foods, such as raw vegetables, dry crackers, and nuts.
- Dont eat or drink very hot or very cold foods or beverages.
- Dont smoke, chew tobacco, or drink alcohol these can make mouth sores worse.
- Stay away from sugary snacks.
- Ask your cancer care team to recommend a good mouthwash. The alcohol in some mouthwashes can dry and irritate mouth tissues.
- Rinse your mouth with warm salt and soda water every 1 to 2 hours as needed.
- Sip cool drinks often throughout the day.
- Eat sugar-free candy or chew gum to help keep your mouth moist.
- Moisten food with gravies and sauces to make it easier to eat.
- Ask your cancer care team about medicines to help treat mouth sores and control pain while eating.
If these measures are not enough, ask your cancer care team for advice. Mouth dryness may be a problem even after treatment is over. If so, talk to your team about what you can do.
How to care for your teeth during treatment
Radiation treatment to your head and neck can increase your chances of getting cavities. This is especially true if you have dry mouth as a result of treatment.
How Long Does Fatigue Or Weakness Last
Fatigue that is due to cancer and its treatment can last for weeks, months, or years. It often continues after treatment ends.
- For people who have surgery for cancer with no other treatment, fatigue often decreases or goes away over time as they recover from surgery.
- For people getting chemotherapy, targeted therapy, or immunotherapy in cycles, fatigue often gets worse at first and may get better until the next treatment, when the pattern starts again.
- For those getting radiation therapy, fatigue usually gets worse as the treatment goes on and often lessens within a few months after treatment is complete.
Fatigue can:
- Differ from one day to the next in how bad it is and how much it bothers you
- Be overwhelming and make it hard for you to feel well
- Make it hard for you to be with your friends and family
- Make it hard for you to do things you normally do, including going to work
- Make it harder for you to follow your cancer treatment plan.
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What Reduces The Severity Of Tiredness
The level of tiredness a person experiences relates closely to other activities during treatment. What a person eats, how much they sleep, their level of pain and mental stress affect the body and result in fatigue. Those with a cancer diagnosis and receiving treatment, including radiotherapy, should follow the advice of their board-certified radiation therapy oncologist to combat fatigue. Some common methods for reducing fatigue include:
What Will I Learn By Reading This
When you have chemotherapy to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. You will learn:
- What fatigue or tiredness is
- How to know if you have fatigue
- Things you can do to help manage your fatigue
- When to call your doctor
It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.
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