Whats Normal And Whats Not
Fatigue related to cancer and cancer treatment is not at all uncommon. Most people get over fatigue within a few months to a year following treatment. But there are a lot of moving parts to your life, so your experience will be unique to you.
With each treatment, youll have an opportunity to talk things over with your oncology team. They can gauge whether your fatigue falls within a normal range. If not, they can look for a cause and offer treatment.
A 2014 research review suggested that a quarter to a third of cancer survivors have persistent fatigue, lasting up to 10 years post-diagnosis. The longer it goes on, the more it can affect daily routines.
If youre still experiencing fatigue 6 months after treatment, follow up with your oncologist or family doctor.
How Long Does Cancer Fatigue Last
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.
Make Sleep A Priority
Although napping wont cure chronic fatigue, short naps can provide temporary relief. But napping too close to bedtime can disrupt your sleep cycle.
See if you can tweak your sleep hygiene to promote better sleep. Put out a virtual do not disturb by letting everyone in the household know that your sleep is a priority.
Think about how your energy level rises and falls throughout the day. Try to schedule the most taxing activities during peak energy times. Put less important tasks aside or ask for help.
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What To Look For
- You feel tired and it doesnt get better with rest or sleep, it keeps coming back, or it becomes severe.
- Youre more tired than usual during or after an activity.
- Youre feeling tired and its not related to an activity.
- Youre too tired to do the things you normally do.
- Your arms and legs feel heavy and hard to move.
- You have no energy.
- You spend more time in bed and/or sleep more. Or, you may have trouble sleeping.
- You stay in bed for more than 24 hours.
- You become confused or cant concentrate or focus your thoughts.
- Your tiredness disrupts your work, social life, or daily routine.
It may be hard for you to talk about it, but tell your cancer care team about your fatigue. Tell them how its affecting your life. Someone on your team should be able to help you if they know youre having this problem. Managing fatigue is part of good cancer care. Work with your cancer care team to find and treat the causes of your fatigue.
Causes Of Long Term Fatigue
Fatigue for people having treatment for cancer is different from the fatigue some people feel long after finishing their treatment. Or those living with cancer. This is also called chronic fatigue. The symptoms last for at least 6 months or more.
Things that can cause long term fatigue include:
- bone marrow transplants
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Low Levels Of Red Blood Cells
Cancer and its treatment can affect your bone marrow. The bone marrow is where your body makes red blood cells which carry oxygen around your body.
A lower than normal red blood cell count is called anaemia. Having too few red blood cells means your blood carries less oxygen and you can have:
- shortness of breath
- tiredness and lack of energy
- dizziness
- an increase in heart rate
- chest pain
Ways To Save Up Your Energy
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Constipation Is A Symptom Of Colon Cancer:
Whether there is still confusion about constipation causing cancer or not, researches prove that constipation can be caused by colon cancer. In fact, constipation can be an early symptom of colon cancer.
In colon cancer, constipation can be caused if the tumor presses the nerves in the intestine. This may affect the nerve supply of muscles that do not work adequately. Inefficient working of muscles ultimately causes constipation.
Or in another scenario, that is more likely to happen, the tumor can directly compress the wall of intestine narrowing the passage. Which, in turn, makes it difficult to pass the stool. Or you can say constipation occurs. Basically, when stool passes down in the starting of intestine, it is in a more of liquid state fluid. As it further moves down, water is absorbed in the intestine along with the salts and stool gets harder successively. If the harder stool comes across any obstruction in its pathway like a tumor, it gets difficult to pass it on. This is the reason why constipation can occur in colon cancer. The narrower stools observed in the patients of colon cancer, yet as another sign, can also be caused due to the compression by tumor.
Ways To Manage Fatigue
Tell your health care team if you feel extremely tired and are not able to do your normal activities or are very tired even after resting or sleeping. Keeping track of your levels of energy throughout the day will help your doctor to assess your fatigue. Write down how fatigue affects your daily activities and what makes the fatigue better or worse.
You may be advised to take these and other steps to feel better:
NCI’s Fatigue PDQ® summary has more information on how fatigue is assessed and treated. View the patient or health professional version.
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Can A Dietitian Help Me Fight Cancer Fatigue
Dietitians can provide suggestions to work around any symptoms that may be interfering with caloric intake. They can help you find ways to take in calories despite an early feeling of fullness, swallowing difficulty or taste changes. Dietitians can also suggest ways of maximizing calories and proteins in smaller amounts of food. They may suggest powdered milk, instant breakfast drinks and other commercial supplements or food additives.
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
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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.
Why Does Cancer Cause Fatigue
Cancer-related fatigue is a condition that can be caused by cancer and/or cancer treatment. Unlike the moderate fatigue you may feel after a busy day, cancer-related fatigue is severe. Many people report that it feels paralyzing.
CRF, which is also referred to as chronic fatigue syndrome, typically comes on quickly, isnt the result of physical activity or exertion, and doesnt resolve with rest or sleep.
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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:
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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Assessment Of Physical Activity
At baseline, information on retrospective PA was collected by trained interviewers in a personal interview for each age decade between 20 and 80years, depending on participants age at diagnosis. Patients were asked for the hours per week they had engaged in different activities. One question was asked to estimate the amount of time spent on hard work-related PA , one question on light work-related PA , one question on walking , one question on cycling , and one question on sports . These retrospective data have been used to address the prognostic impact of PA in recent papers . Five years after CRC diagnosis, information on average PA during the past week was assessed with a mailed questionnaire that included the short-form of the International Physical Activity Questionnaire . The questionnaire asks for the number of days and minutes per week spent with vigorous PA e.g. jogging, moderate PA e.g. swimming, walking, and sitting.
From the baseline assessment, activity-specific lifetime MET-h/wk were derived from the MET-h/wk spent at ages 20, 30, 40, 50, 60, 70, and 80 , considering the current age at diagnosis of the patient and the years spent in each decade. Information from the age decade preceding the patients current age at diagnosis was used to calculate the activity-specific MET-h/wk for the last age decade . The activity-specific MET-h/wk were summed up to create the variables baseline PA lifetime and last decade.
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Finding The Cause Of Your Fatigue
If youre experiencing unexplained fatigue thats concerning you and interfering with your daily activities, start with a visit to your primary care physician to investigate more common reasons for fatigue.
Your physician will probably ask about the level of fatigue youre experiencing and when it began. He or she should evaluate medications you may be taking for other health conditions because fatigue is a side effect of some medications.
Some common blood tests your doctor may order include:
- A blood chemistry panel to check for kidney disease, liver disease, electrolyte imbalance and signs of cardiovascular disease
- A complete blood count to screen for conditions such as anemia, immune deficiency or infection
- Thyroid function tests to evaluate thyroid gland function
- A vitamin D test to determine whether you have vitamin D deficiency
Other screenings may include a psychological analysis to determine whether youre depressed or a sleep study to see whether youre at risk for obstructive sleep apnea.
If those tests are negative, your physician should start looking for another possible underlying cause of fatigue.
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Managing Work If You Have Fatigue
You may find that you cant continue working due to fatigue, or that you have to reduce the amount of time you spend at work.
It can help to talk to your employer or personnel/human resources department and let them know that you may need some time off.
Dont feel that you have to work if youre too tired. If you do want to carry on working, you may be able to find ways of making your work less tiring for a while.
Anyone with cancer is protected by the Equality Act 2010, which prevents employers from victimising or discriminating against people with a disability. The act also states that employers are expected to make reasonable adjustments to support employees in the workplace. You may want to make suggestions for adjustments that could help to support you. Things that your employer can do to help include:
- changing your hours so that you can travel to and from work at less busy times
- asking colleagues to be supportive and to help with some of your work
- finding you a parking place near to your place of work
- letting you take short breaks to lie down and rest
- allowing you to work from home
- finding you lighter work if your job involves physical exertion or heavy lifting
If youre self-employed, it can help to talk to the Department of Work and Pensions about benefits that you may be entitled to claim.
Causes Of Cancer Fatigue
Many things can cause fatigue in people with cancer. This includes the cancer itself and the type of treatment you might have.
Doctors don’t fully understand what causes cancer related fatigue. But we know that a number of things can make it worse. Fatigue is often worse in people who:
- are having a combination of treatments
- have advanced cancer
- are elderly
It’s important that you know you may be more likely to suffer from fatigue if you fall into one of these groups.
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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.
Hormonal Changes During Breast Cancer Treatment
Doctors may prescribe hormone therapy to treat breast cancer or to decrease the risk of its recurrence.
The hormone estrogen feeds some types of breast cancer. Suppressing estrogen may reduce the risk of such breast cancers recurring. Treatment may include hormonal therapies, such as:
Fatigue is among the most common side effects of chemotherapy.
According to The National Cancer Institute , the cause of fatigue during cancer treatment is not always clear and may involve more than one factor.
For example, chemotherapy may decrease red blood cell and then white blood cell levels, which may cause fatigue. Chemotherapy can also trigger nausea and vomiting, which may cause dehydration and associated fatigue.
According to the chemotherapy and other cancer treatments can also cause fatigue in the following ways:
- by altering levels of hormones and proteins that contribute to inflammation
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