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Lymphoma And Chronic Fatigue Syndrome

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

Chronic Fatigue Syndrome

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.

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

How Can Exercise Help Reduce Cancer Fatigue

You may feel ill from your cancer or treatment, which may lead to less physical activity. Decreased levels of physical activity can lead to tiredness and lack of energy. Scientists have found that even healthy athletes forced to spend extended periods in bed or sitting in chairs develop feelings of anxiety, depression, weakness, fatigue and nausea. Regular, moderate exercise can decrease the feeling of fatigue and help you feel energetic. Even during cancer therapy, it’s often possible to continue to exercise. Be sure to check with your healthcare provider before starting an exercise program.

Exercise has many health benefits. Regular exercise can:

  • Increase your appetite.

Recommended Reading: Extreme Shortness Of Breath And Fatigue

Why Does Lymphoma Cause Fatigue

Lymphoma is a malignant condition where the white blood cells develop a mutation and multiply uncontrollably. These cells have no physiological function but act as parasites in the body and compete with normal cells for oxygen and nutrition. This starves the normal cells resulting in fatigue.

  • The cancer cells may also cause a pro-inflammatory state causing the release of chemicals such as interferon-alpha and tumor necrosis factor-alpha that may result in fatigue.
  • Sometimes, the invasion of organs such as lungs, kidneys, or heart by the tumor cells may cause fatigue.
  • The cancerous invasion of the thyroid, pancreas, or chemotherapy-induced damage to the endocrine system may also cause fatigue due to hormonal imbalances.
  • The anxiety and depression associated with lymphoma diagnosis may also cause fatigue due to low moods and mental anguish.
  • The treatment with steroids may result in diabetes and suppression of adrenal hormones causing fatigue.
  • You may develop comorbid conditions such as lung fibrosis, hypertension, muscle weakness, or poor heart function due to chemotherapy that may result in fatigue.

Another important cause of fatigue is low red blood cells due to cancer and chemotherapy.

Rarely, another cancer may be present along with existing lymphoma, which may cause fatigue. Taking opioids for cancer pain may make you sluggish. The presence of infection or fever is another trigger for fatigue.

Does Chronic Fatigue Syndrome Predispose To Non

Chronic Fatigue Syndrome Shown &  Explained Using A Medical Animation


Chronic fatigue syndrome, an illness that frequently is associated with abnormalities of cellular immunity, has been reported anecdotally to be associated with an increased incidence of lymphoid hyperplasia and malignancy.

This report describes an initial analysis of population-based cancer incidence data in Nevada, focusing on the patterns of non-Hodgkins lymphoma prior to and subsequent to well described, documented outbreaks of chronic fatigue syndrome during 1984-1986. In a study of time trends in four age groups, the observed time trends were consistent with the national trends reported in the Surveillance, Epidemiology, and End Results Program.

No statistically significant increase attributable to the chronic fatigue syndrome outbreak was identified at the state level. Additional studies are in progress analyzing the data at the country level, reviewing patterns in other malignancies, and continuing to monitor the cancer patterns over subsequent years.

: Levine PH, Peterson D, McNamee FL, OBrien K, Gridley G, Hagerty M, Brady J, Fears T, Atherton M, Hoover R. Does chronic fatigue syndrome predispose to non-Hodgkins lymphoma? Cancer Res. 1992 Oct 1 52:5516s-5518s discussion 5518s-5521s.

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How Can I Combat Cancer Fatigue

The best way to combat fatigue is to treat the underlying cause. Unfortunately, the exact cause may be unknown, or there may be multiple causes. There are treatments to reduce certain causes of cancer fatigue, such as anemia or hypothyroidism. Other causes must be managed on an individual basis.

The following are tips you can use to combat cancer fatigue:

  • Conserve energy.
  • Manage your stress.

Warning Disclaimer Use For Publication

WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.

DISCLAIMER: All material available on is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.

If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.

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Questionnaires And Data Collection

The Life Situation Questionnaire addresses issues not available in other validated questionnaires including: socio-demographic data, cohabitation status and highest level of education parenthood data education, work, and insurance health situation including height, weight, and detailed information on post-treatment health disorders and current treatments and social situation . Self-reported health disorders that had occurred after the end of the lymphoma treatment were grouped as follows: cardiovascular, pulmonary, and musculoskeletal disorders severe infections anxiety depression and history of second cancer. No attempt was a posteriori made to confirm these diseases using data available in either medical records or computerized clinical data.

The MFI questionnaire was used to address the topic of fatigue . It consisted of 20 items, each item coded 1 to 5. From the 20 items, five scales were generated: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue. Each scale was constructed by summation of its four items the total obtained was transformed to a linear score ranging from 0 to 100. Zero indicated absence of fatigue and the higher the score, the higher the level of fatigue.

Tips To Help Manage Fatigue

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  • 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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Intracellular Immunity: Nuclear Factor Kappa Beta

Besides activating the RNase L system, IFN also activates another intracellular double-stranded RNA-detecting system, namely protein kinase R . PKR will, once activated, stimulate nuclear factor kappa beta , a group of transcriptional regulators which modulate cellular responses to environmental stimuli and cytokines. NF-B is the major upstream, intracellular mechanism which regulates inflammatory and oxidative stress mediators. NF-B would, for instance, trigger inducible nitric oxide synthetase expression. Inducible nitric oxide synthetase generates increased production of nitric oxide by monocytes/macrophages .

CFS patients. NF-B, as well as inducible nitric oxide synthetase and NO have been shown to be increased in CFS . The production of NF-B is significantly correlated to the severity of illness and symptoms, such as fatigue and pain. These correlations suggest that the symptoms of CFS, such as fatigue, pain, muscular tension and depressive symptoms reflect a genuine inflammatory response in those patients .

The produced NO, in turn, has an immunological function: it is cytotoxic by inhibiting the mitochondrial electron transport and the DNA synthesis and by influencing iron metabolism . Excessive or persistent NO production as reported in CFS , is, however, detrimental for physiological functions, as explained in earlier studies on intracellular immune dysfunctions in CFS .

Characteristics Of The Patients And Normative Population

Eight hundred and twenty-four NHL survivors completed the first questionnaire . Subsequently, 434 survivors completed this questionnaire again 1 year later, which represents 36% of the total group of NHL survivors. Of the 1731 respondents of the normative population who completed the EORTC QLQ-C30, 602 could be age- and sex-matched with the NHL survivors. Of those 602, 515 respondents completed the questionnaire again 1 year later.

Survivors with unverifiable addresses were more often female and younger compared to respondents, and non-respondents were more often diagnosed with indolent NHL and less often diagnosed with stage I disease .

Table 1.Socio-demographic and clinical characteristics of questionnaire respondents, non-respondents, and patients with unverifiable addresses.

The mean age at completion of the baseline survey was 63.5 years with a mean time since diagnosis of 4.2 years. Chemotherapy was the most frequent primary treatment . Two-thirds of survivors reported one or more comorbid conditions, the most common being arthritis, back pain and hypertension . In the age-and sex-matched normative population, the mean age at completion of the baseline survey was 63.5 years. Almost two thirds of respondents reported one or more comorbid conditions, the most common again being hypertension, back pain and arthritis .

Table 2.Socio-demographic characteristics of NHL survivors , and respondents of an age- and sex-matched normative population .

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Common Symptoms For These People *:

  • Troponin Increased: 3 people, 75.00%
  • Rashes : 3 people, 75.00%
  • Oedema Peripheral : 1 person, 25.00%
  • Muscle Aches : 1 person, 25.00%
  • Lacrimation Increased: 1 person, 25.00%
  • Joint Swelling: 1 person, 25.00%
  • Joint Pain: 1 person, 25.00%
  • Hypoaesthesia : 1 person, 25.00%
  • Blood Count Abnormal: 1 person, 25.00%
  • Abdominal Discomfort: 1 person, 25.00%
  • * Approximation only. Some reports may have incomplete information.

    How Long Does Cancer Fatigue Last

    Signs and symptoms of chronic fatigue syndrome

    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.

    Read Also: What Causes Severe Fatigue And Weakness

    Intracellular Immunity: Ribonuclease L

    CFS patients. One of the major intracellular immune dysfunctions in CFS is the dysregulation of the RNase L antiviral pathway. RNase L is the effector of the major 2-5-oligoadenylate synthetase/ribonuclease L antiviral system. It is one of the intracellular proteins activated by type I interferons and is cardinal to the cellular defence mechanisms. By regulating viral and cellular RNA expression, RNase L plays an important role in the antiviral and antiproliferative activities of IFN and contributes to innate immunity and cell metabolism. Activation of the endoribonuclease RNase L produces small RNA cleavage products not only from viral RNA but from self-RNA as well. In consequence, the 2-5A/RNase L pathway is implicated in mediating apoptosis in response to viral infections and to several types of external stimuli. The effects of the 2-5A synthetase/RNase L pathway extend beyond initially infected cells to support a broader antiviral state in the organism .

    After its discovery by Suhadolnik and colleagues , hyperactivation of the 2-5 A synthetase/RNase L antiviral pathway and the abnormal low molecular weight RNase L in a subset of CFS patients has been reported at length in the scientific literature .

    Cancer patients. Besides antiviral activity, RNase L has been suggested to function as a tumour suppressor based on its roles in mediating apoptosis and antiproliferative activity of IFN . RNase L is able to inhibit tumour formation/growth in vivo .

    Me/cfs And The Risk Of Cancer

    The fact that ME/CFS has an infectious onset in many cases, and is associated with abnormalities of cellular immunity, raises the question of whether people with the illness are at an increased risk of developing cancer. There is certainly no definitive evidence that this is the case principally because the large-scale epidemiological studies needed to establish a link have not been conducted. Yet, over the years, there have been intriguing, if inconclusive, hints that there may be an association between ME/CFS and cancer. For example, a survey of deaths from a memorial list in the USA found that one-fifth of the ME/CFS patients listed had died of cancer. And an analysis in 1998 of data from the Nevada Cancer Registry, found the incidence of non-Hodgkin lymphoma and primary brain tumours to be comparatively higher in two northern Nevada counties where well-documented outbreaks of CFS had occurred between 1984 and 1986.

    The National Cancer Institutes Surveillance, Epidemiology, and End Results program provided the cancer data from registries across the US, with cases defined as people aged 66 to 99 years with first cancers from 1992 to 2005. The occurrence of CFS was assessed from Medicare claims using ICD codings. For analysis, a combined SEER-Medicare data set was created electronically to allow the link between cancer and ME/CFS to be explored.

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    Cancer Drug Rituximab Has No Effect On Chronic Fatigue Syndrome According To A Norwegian Study

    Now we can put this to rest, says researcher Øystein Fluge.

    He is referring to the idea that the cancer drug rituximab, which affects certain cells of the immune system, was thought to be helpful in treating chronic fatigue syndrome .

    Recently, Fluge and his colleagues published the results of the latest study of this drug in Annals of Internal Medicine. It marked the end of a nearly 15-year-long research story that began with great hope and enthusiasm, but ended in disappointment.

    Now, the researchers have to look for other possibilities.

    You have to respect the results you get and adjust course, says Fluge, who still believes it would be interesting to do more research on the immune system’s role in ME/CFS.

    Random discovery

    It all began in 2004 when Fluge and his colleague Olav Mella stumbled upon an interesting coincidence.

    Both are oncologists and at that time they were treating a patient with lymphoma. The treatment included a type of chemotherapy that also suppresses immune cells.

    The patient also had ME/CFS. And, surprisingly, it seemed that the treatment relieved the chronic fatigue. A while after the treatment ended, the ME/CFS symptoms returned.

    In 2008, Fluge and Mella saw another lymphoma patient with long-standing ME/CFS. The patient received chemotherapy combined with the drug rituximab, which specifically inhibits B-lymphocytes, a type of immune cell.

    She also experienced clear improvement of her ME/CFS symptoms.

    Promising study
    Blind study
    No difference

    How Can I Conserve Energy When I Have Cancer Fatigue

    Mayo Clinic Explains Lymphoma

    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.


    • Use your energy on important tasks.

    Read Also: Can Low Hormones Cause Fatigue

    How Can I Prevent Cancer Fatigue

    You cant do much to prevent cancer-related fatigue. But these strategies may help minimize the problem:

    • Adopt healthy sleep habits: To build better sleep habits, keep phones and TVs out of the bedroom, go to bed at the same time every night and sleep in a dark, quiet room.
    • Ask for help: Let family and friends run errands, fix meals or help with housework or child care.
    • Cut back on caffeine:Caffeine provides a temporary pick-me-up. But it can also keep you up at night.
    • Drink plenty of fluids: Its important to stay hydrated and eat nutritious foods.
    • Set priorities: Be realistic about what you can do. Save your energy for the things that matter most.
    • Stay physically active: Go for a walk or try yoga or tai chi. Dont exercise too late in the evening. The activity may make it harder to fall asleep.
    • Take 30-minute rest breaks: During the day, dont sleep longer than 30 minutes or you could have trouble falling asleep at night. Rest breaks can help if you have an upcoming event that requires a lot of energy.

    A note from Cleveland Clinic

    A chronic illness like cancer can bring many unwanted challenges. Cancer fatigue is one of them. It makes sense that fighting off cancer can tire out your body. Cancer treatments can also be physically and mentally exhausting. Still, you shouldnt hesitate to let your healthcare provider know how cancer fatigue is affecting your life. You can take steps to bring more energy back into your days.


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