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Why Does Cancer Cause Fatigue

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How Long Will The Fatigue Last

Why do cancer patients often feel tired and weak? | Norton Cancer Institute

Cancer-related fatigue may begin to ease when treatment ends, but many people will continue to feel fatigued for some time after treatment is finished.

It is not uncommon for fatigue to go away, only to return. You may be frustrated if your recovery takes longer than you expected. Try to be patient with yourself.

How Does Exercise Impact Energy Level

Decreased physical activity, which may be the result of colorectal cancer or its treatment, 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 these feelings, help you stay active, and increase your energy. Even during cancer therapy, it is often possible to continue exercising. Exercise also improves the outcome of patients with colorectal cancer.

Here are some guidelines to keep in mind:

  • Check with your doctor before beginning an exercise program.
  • A good exercise program starts slowly, allowing your body time to adjust.
  • Keep a regular exercise schedule. Exercise at least 3 times a week.
  • The right kind of exercise never makes you feel sore, stiff, or exhausted. If you experience soreness, stiffness, exhaustion, or feel out of breath as a result of your exercise, you are overdoing it.
  • Most exercises are safe, as long as you exercise with caution and don’t overdo it. The safest and most productive activities are swimming, brisk walking, indoor stationary cycling, and low impact aerobics . These activities carry little risk of injury and benefit your entire body.

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

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Anxiety And Depression Are The Most Common Psychological Causes Of Fatigue In People With Cancer

The emotional stress of cancer can cause physical problems, including fatigue. It’s common for you to have changes in moods and attitudes. You may feel anxiety and fear before and after a cancer diagnosis. These feelings may cause fatigue. The effect of the disease on your physical, mental, social, and financial well-being can increase emotional distress.

About 15% to 25% ofpeople with cancer get depressed, which may increase fatigue caused by physical factors. Patients who have depression before starting treatment are more likely to have depression during and after treatment. The following are signs of depression:

  • Lack of energy and mental alertness.
  • Loss of interest in life.
  • Problems thinking.
  • Drowsiness.
  • Feeling a loss of hope.

Patients who have a history of stressful experiences in childhood, such as abuse and neglect, may have increased fatigue. See the PDQ summaries on Adjustment to Cancer: Anxiety and Distress and Depression for more information.

How Does Nutrition Affect Energy Level


Cancer-related fatigue is often made worse if you are not eating or drinking enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. Make an appointment with a dietitian. A registered dietitian provides suggestions to work around any eating problems that may be interfering with proper nutrition . A dietitian can also suggest ways to maximize calories and include proteins in smaller amounts of food .

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What Causes Fatigue In Colon Cancer

Fatigue is a feeling of weakness and constantly lacking energy. Tiredness should not be confused with fatigue, which is a normal sensation after doing a hectic workout. Unlike fatigue, tiredness is resolved taking a nap or having a good night sleep. Fatigue, on the other hand, is caused by physical or mental stress and is not relieved even after sleeping. It is the deprivation of energy that interferes with the life and does not let the person do daily living activities.

Communicating With Your Healthcare Provider About Fatigue

Many people underestimate fatigue and fail to discuss it with their practitioner. There can be underlying medical reasons for fatigue, such as anemia, that may need to be addressed. Unfortunately, there is no medication, prescription or OTC, that treats fatigue, but your healthcare provider may be able to determine what is contributing to fatigue and offer solutions specific to your situation.

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Exercise Has A Positive Effect On Fatigue During And After Cancer Treatment

Exercise may help people with cancer feel better and have more energy during and after treatment. The effect of exercise on fatigue in people with cancer is being studied. One study reported that breast cancersurvivors who took part in enjoyable physical activity had less fatigue and pain and were better able to take part in daily activities. In clinical trials, some people with cancer reported the following benefits from exercise:

  • More physical energy.
  • More enjoyment with life.
  • A greater sense of well-being.

Moderate activity for 3 to 5 hours a week may help cancer fatigue. You are more likely to follow an exercise plan if you choose a type of exercise that you enjoy. Your healthcare team can help you plan the best time and place for exercise and how often to exercise. You may need to start with light activity for short periods of time and build up to more exercise little by little. Studies have shown that exercise can be safely done during and after cancer treatment.

Mind and body exercises such as qigong, tai chi, and yoga may help relieve fatigue. These exercises combine activities like movement, stretching, balance, and controlled breathing with spiritual activity such as meditation.

Cognitive behavior therapy

  • Stress from coping with cancer.
  • Fear that the cancer may come back.
  • Feeling hopeless about fatigue.
  • Lack of social support.
  • A pattern of sleep and activity that changes from day to day.

Other ways to manage fatigue

Risk Factors For Cancer

What causes fatigue in cancer patients?

As noted previously, fatigue typically increases during cancer treatment and improves in the year after treatment completion. However, there is considerable variability in the experience of fatigue before, during, and after treatment, , suggesting that certain individuals may be at particular risk for this disabling symptom. Of note, there is also variability in the inflammatory response to treatment, which is correlated with variability in fatigue . Over the past several years, longitudinal studies have begun to examine risk factors for cancer-related fatigue, and particularly fatigue that persists for months or years after cancer treatment. Studies in this area have focused primarily on demographic, medical, behavioral, and psychosocial predictors, but genetic risk factors are of growing interest. Identification of these factors is important for advancing our understanding of this symptom and for improving identification and treatment of vulnerable patients. In this section, we review this growing literature and suggest pathways through which these factors may influence fatigue.

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When Should I Call My Doctor

Although cancer-related fatigue is a common, and often an expected side effect of cancer and its treatments, you should feel free to mention your concerns to your health care providers. Fatigue may be a clue to an underlying medical problem. Other times, there may be treatments to help control some of the causes of fatigue.

Finally, there may be suggestions that are more specific to your situation that would help in combating your fatigue. Be sure to let your doctor or nurse know if you have:

  • Increased shortness of breath with minimal exertion
  • Uncontrolled pain

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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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.

Is Your Fatigue A Symptom Of Cancer

Symptoms Poster · Pancreatic Cancer Action

Could your fatigue be the first symptom of cancer? At one point or another, we have all experienced fatigue. For most of us, it is temporary, usually caused by stress or being overworked.

For some people, however, fatigue can become persistent, occurring daily. When fatigue becomes frequent, it is natural to be concerned about what may be causing it.

One of the first things many people think maybe the culprit for their fatigue is cancer. When might feeling tired be a sign of cancer and how often is it?

We often hear about cancer patients who are extremely fatigued, but a lot of cancer-related fatigue is caused by the side effects of cancer treatment, not always cancer itself. In other words, for people with many cancers, the fatigue begins after diagnosis.

While fatigue alone without other symptoms is uncommon in many cancers, for people with leukemias and lymphomas fatigue may well be the first symptom.

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The Different Stages Of Bladder Cancer

In most cases, bladder cancer cells start to grow in the urothelium, which is the thin layer of cells that line the inside of the bladder. The cancer cells can gather to form tumors, and in early-stage or non-muscle invasive bladder cancer, the tumors are located only in the bladder lining. In more advanced bladder cancer, the tumors may have grown into the muscles of the bladder or the bladder cancer cells may have spread to other organs or parts of the body, which is called metastatic bladder cancer.

Treatment Of Secondary Fatigue


Methyl phenidate is an amphetamine derivative acting on synaptic monoamine receptors and facilitates the release of catecholamine release. The onset of action is fast and it has a half life of ~2 hrs. It is metabolized in liver and excreted through kidneys. It is particularly useful in depression in palliative care settings. Its value in opioid sedation is also well established. The usual prescribed dosage is 5-10 mg orally in morning which can be titrated up to 40-60 mg per day with dose limiting side effects like loss of appetite, slurring of speech, nervousness, and cardiac symptoms. Role of methyl phenidate in relieving cancer related fatigue is still under exploration as the available results are not favorable.

Megestrol acetate, in the dose range of 480-800 mg has been FDA approved for cachexia related to HIV/AIDS and cancer related-fatigue. The drug improves appetite, increases activity, and contributes to overall well being in advanced cancer patients, though the precise mechanism is not known. Hypertension, sweating, hot flashes, weight gain, mood swings, and GIT upset are the common side effects.

The centrally acting acetyl cholinesterase inhibitor drug Donepezil was found to be effective in opioid induced sedation. However, the protracted half life of 70 hours makes its use problematic in palliative care setting.


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What Is Fatigue And How Is It Different From Being Tired

Fatigue is not the same thing as normal tiredness.3 Fatigue is chronic lack of energy on a regular basis, and it is not remedied by resting or a good nights sleep. Fatigue can make it very difficult to carry out your normal, day-to-day activities. It can happen very quickly and often does not seem to have a specific reason.

Summary And Future Directions

What are the causes of fatigue after cancer treatment?

While research into the etiology, course, and treatment of cancer-related fatigue is relatively new, much progress has been made in recent years however, considerable opportunities remain. While some well-powered studies have examined risk factors for fatigue in breast cancer patients and survivors, most studies examining underlying mechanisms have involved small to very small sample sizes. While a few studies employing repeated-assessments have been conducted, most have been cross-sectional in design. Thus, more longitudinal studies that involve assessment of cancer patients pre-/post-completion of initial treatment and into survivorship are needed. While multiple factors have been observed to be linked with cancer-related fatigue, it has yet to be determined which factors predispose, precipitate or exacerbate/maintain the patients experience of fatigue. For example, longitudinal studies examining and comparing the effects of chemotherapy- and radiation-induced inflammation on functioning during survivorship are warranted. Also, additional studies employing statistical analytic techniques that can evaluate hypotheses about causal pathways are needed. These will require multiple assessments of established or promising biomarkers of fatigue. Such studies should also assess fatigue using multidimensional scales normed on and/or tailored to breast cancer patients.

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Fatigue And Memory Problems May Be Related

During and after cancer treatment, you may find that you cannot pay attention for very long and have a hard time trying to think, remember, and understand. This is called attention fatigue. Sleephelps to relieve attention fatigue, but sleep may not be enough when the fatigue is related to cancer. Take part in restful activities and spend time outdoors to help relieve attention fatigue.

How Does Cancer Cause Fatigue

, cancer is the uncontrolled growth of abnormal cells in the body. That growth requires energy, and cancer absorbs energy that would normally travel to the rest of the body.

Its uncommon to notice this energy drain, however, unless the cancer has metastasized to organs such as the liver, where it may affect metabolism, or the bone marrow.

When cancer invades the bone marrow, it affects the production of blood cells. White blood cells help fight infection. Red blood cells contain hemoglobin and carry oxygen to and from organs and tissues throughout the body, providing energy and removing waste from cells. Cancer may cause a reduction in the production of red blood cells, resulting in anemia, which causes fatigue.

Inflammation caused by cancer may be another key contributor to cancer-related fatigue. When your body is fighting a disease, it releases chemicals like cytokines to trigger the immune response, but these chemicals may also cause fatigue.

In patients with advanced cancer, the disease may produce cachexins, which reduce your appetite and may result in cachexia, a serious cancer-related condition that causes substantial weight loss and muscle wasting.

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How Is Cancer Fatigue Diagnosed

Your healthcare provider will assess your symptoms. You may be asked to complete a questionnaire or rate your fatigue level. Your provider may ask you to keep a journal to track your level of fatigue and factors that might contribute to fatigue.

Blood tests can check for anemia, signs of infection or other problems that cause fatigue.

What Are The Long Term Side Effects Of Radiation Treatments

Cancer: What To Expect : Why does cancer cause fatigue ...

Short-term side effects

  • Pain and skin changes. During and just after treatment, your treated breast may be sore.
  • Fatigue. Fatigue is common during radiation therapy and may last for several weeks after treatment ends.
  • Breast and skin changes.

But if radiation therapy is aimed at a part of the body that grows hair, such as the scalp, a person may have hair loss.

  • Skin problems. Some people who receive radiation therapy experience dryness, itching, blistering, or peeling.
  • Fatigue.

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How Fatigue Can Affect Your Daily Life

Fatigue can be very frustrating. You and your relatives might underestimate how much it can affect daily life.

Everyday life can be hard work and you might not have the energy to cook, clean, bathe or go shopping. You might not even feel up to a chat. Things that you used to find second nature or easy are now a task and can be hard work.

You and your doctor can sometimes overlook fatigue, especially if you have other side effects. Its important to tell your doctor or nurse about how youre coping day to day and if you are struggling.

Fatigue can affect the way you feel about yourself and your relationships with other people. You can feel very down and not want to go out or be with people which can be hard for them to understand.

You might have to stop working or cut down your hours. This can affect how much money you have.

You might feel like fatigue is a constant reminder of your cancer and this can be hard to accept.

You might worry that because you feel so tired all the time your cancer could be getting worse. But it is more likely to be a side effect of treatment, or due to the fact that cancer can cause fatigue.

Fatigue is very real and can have a big impact on your life. Let your doctor or nurse know if you think you have symptoms of fatigue. There are ways of managing it and your medical team will try to help you.

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