Why Does Colon Cancer Cause Fatigue

Why Do We Sweat

Sweating is how our bodies keep cool. We have sweat glands in the skin over most parts of our body. They are in the layer of the skin called the dermis. The nerve cells in the dermis control sweating.

Although we dont realise it, we are actually constantly sweating. The amount of sweat we make depends on:

• what we are doing
• the temperature around our body

We sweat more when:

• we are nervous, angry or upset
• we go through the menopause
• we are ill
• we take medicines that cause sweating

What Causes Cancer Fatigue

Cancer and its treatment often cause fatigue, known as cancer-related fatigue. Between 80 percent to 100 percent of cancer patients report experiencing fatigue, according to the American Cancer Society.

If you havent been diagnosed with cancer and youre experiencing unexplained, persistent tiredness or lack of energy, you may be wondering if your fatigue could be a symptom of cancer.

While fatigue is a common symptom of cancer, cancer rarely causes fatigue alone. Fatigue is often multifactorial, meaning more than one contributing factor may be involved, and none of them may be cancer.

No matter its cause, fatigue is one of the toughest symptoms to deal with. When patients are struggling with fatigue in their daily life, they want to feel better, and theyre looking for someone to help them. As a medical oncologist at Cancer Treatment Centers of America® , I work every day to help patients enjoy a better quality of life while we fight their cancer.

In this article, Ill cover some common factors that may contribute to cancer-related fatigue. This article examines:

• How to find help for cancer fatigue

The main focus of this article is on patients whove already received a cancer diagnosis. But first, lets briefly explore fatigue as a symptom of undiagnosed cancer.

What Can You Do About Fatigue

The first step in helping to manage fatigue is recognizing and controlling any symptoms that make it worse, like pain, nausea, neuropathy, or constipation. Another step is to try to prevent more fatigue by carefully balancing rest and activity. If you feel tired, stop and rest. Your health care team and your caregivers can help you find ways to manage the things that can make you feel more fatigued. Tell them how you feel, and try different things to see if they help you feel less tired.

Some medicines can make you feel tired, too. They may be needed, but you may want to talk with your health care team to find out if switching to new ones or taking them at different times may help. You might even be able to stop taking certain medicines that arent helping or arent needed any more.

Keep safe when youre active. If youre unsteady on your feet, make sure you have help when walking. You may feel safer if you have a walker or wheelchair. Your doctor or hospice team can help you get the equipment you need to be comfortable and safe. If you’re shaky, don’t use sharp utensils or other things that might cause injury. If you’re able to drive, be careful to not drive when you are feeling fatigue.

Plan activities around the times you feel the best and have the most energy. Sit outside, listen to music, go for a ride in the car, spend time watching a meal being prepared distractions and stimulation of your senses may help ease fatigue.

You can learn more in Cancer-related Fatigue.

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Colon Cancer And White Blood Cell Count

White blood cells are produced in the bone marrow and are easily detectable in blood tests. A specific type of white blood cell called the neutrophil is responsible for warding off infections and destroying harmful cells.

The normal neutrophil count is 1,000/1 microliter. A deficiency in neutrophils is called neutropenia. This is caused by severe infections that are too invasive.

On the other hand, neutrophil production can also be stalled by the presence of cancer. Cancer treatments can also affect neutrophil count due to radiation exposure. Keeping track of your neutrophil count can help you understand how your body works.

What Can I Do About Fatigue With Colorectal Cancer

The best way to combat fatigue while also battling colorectal cancer is to treat the underlying medical cause. Unfortunately, the exact cause is often unknown, or there may be multiple causes.

There are some treatments that may help improve fatigue caused by an under-active thyroid or anemia. Other causes of fatigue must be managed on an individual basis. The following guidelines should help you combat fatigue.

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Power Calculation And Data Analysis

We calculated that 600 patients were needed to have 80% power to detect a prevalence ratio of larger than 1.6 or smaller than 0.6, assuming that 40% of the population would suffer from fatigue and an alpha of 0.05.

Demographic, clinical, and lifestyle characteristics are presented as mean and standard deviation for continuous variables with normal distribution, median, and interquartile range for continuous variables without normal distribution or frequency and percentage for categorical variables. Differences in patient characteristics were analyzed using the independent T test or Pearson 2 test .

Restricted cubic spline analyses were used to investigate associations of SMI, SMR, VAT, and SAT with fatigue at all timepoints and to assess whether associations were non-linear. Knots were placed at the 5th, 50th, and 95th percentiles of SMI, SMR, VAT, or SAT. Prevalence ratios and 95% confidence intervals for the associations of SMI, SMR, VAT, and SAT with fatigue were estimated using RCS functions in Cox proportional hazard regression models with a fixed timepoint. PRs were chosen instead of odd ratios since the latter tend to overestimate the size of the association when the outcome is common . Median value for each body composition parameter was set as the reference in each model. As a complement to the graphic presentation of the RCS graphs, PRs with 95% confidence intervals for specific SMI, SMR, VAT, and SAT values were calculated using the RCS analyses.

Am I At Risk Of Colon Cancer

Studies show that early screening for colon cancer not only reduces its occurrence but also improves a persons overall mortality . Screening is the process of identifying colorectal changes in its earliest forms before significant symptoms even appear.

Screening is especially helpful for individuals who have a higher risk of contracting colon cancer for the following reasons:

• Colon cancer is more commonly diagnosed in adults 50 years old and above. Doctors recommend getting screened for cancer yearly
• People of African-American heritage are at a greater risk of developing colon cancer than other races
• Patients with previous histories of benign colon growths or polyps are still at risk of developing colon cancer in the future
• While colon cancer isnt hereditary, there are some inherited syndromes that can increase your risk of colon cancer. These include the Lynch Syndrome and familial adenomatous polyposis to name a few
• Lifestyle factors such as obesity and heavy alcohol and cigarette consumption
• Patients with inflammatory bowel diseases such as Crohns disease and ulcerative colitis
• Type 2 diabetes patients who have a hard time controlling their condition

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Changes In Bowel Habit

A change in bowel movements or bowel habits occurs in nearly all sufferers of colorectal cancer, either with bouts of constipation or diarrhoea without a plausible cause. People often take over the counter stool softeners or laxatives rather than seeking medical advice. But if your symptoms dont resolve quickly, see your doctor.

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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Types Doses And Forms Of Pain Medicines

The nurse or doctor will assess your pain and figure out the average level or degree of pain you have. There are a lot of different types, forms, and doses of pain medicines available.

The types of pain medicines range from acetaminophen to non-steroidal anti-inflammatories to stronger drugs called narcotics, such as opioids . Sometimes other drugs may be used. For instance, certain anti-depressants or anti-convulsants often work well to help with nerve pain. Steroids may be used to help with certain types of pain, such as that caused by swelling or inflammation. These medicines are often given along with the opioid drugs.

There are also different doses of each medicine. Some people need less, and some need more to keep pain controlled. Some may find they need to increase their dose over time. Needing larger doses of drugs has nothing to do with being unable to withstand pain, nor does it mean that you are a complainer. The body can become tolerant to a drug, and you may need to increase the dose because of that tolerance.

Other Possible Causes Of Fatigue During Cancer Treatment

Vitamin D deficiency is common in the general population. Correcting this deficiency in otherwise healthy people has been shown to improve self-reported fatigue. If youre fatigued due to vitamin D deficiency going into treatment, cancer therapy may be less successful and result in more side effects like peripheral neuropathy .

For example, one study of breast cancer patients being treated with paclitaxel showed that pre-treating vitamin D deficiency reduced the incidence of peripheral neuropathy and also led to fewer treatment disruptions and better treatment outcomes.

Another study showed correcting vitamin D deficiency may ease gastrointestinal mucositis, a painful inflammation and ulceration of the digestive tract, in patients undergoing chemotherapy.

Consider getting your vitamin D levels checked periodically. In my practice, I often check it at least twice a year to get a better understanding of the patient’s vitamin D rhythms from summer to winter. I recommend levels of approximately 50-80 nanograms per milliliter .

When you check your levels is important, though. Levels tend to be higher during the summer, when people are spending more time in sunlight, and lowest at the end of winter. So, if you check it in the middle of the summer and your level is 30, thats low for the targeted endpoint of 50-80 ng/ml. But if its 30 at the end of winter, that means it likely was in the therapeutic range during winter, and your levels may be sufficient.

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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.

Prognostic Factors For Fatigue

Adjusted for group, time point, and interaction effect, younger patients, men, those not married/common-law, more comorbidities, lower FACT-G , more anxiety/depression), lower FACT-COG , lower albumin, higher neutrophils, higher platelet count, and higher interleukin-1 were associated with increased levels of fatigue . A multivariable analysis was carried out, adjusting for group, visit, and interaction effect, by selecting factors hypothesized a priori to be prognostic for fatigue. Treatment group, GHQ, FACT-G, FACT-COG, and number of comorbidities remained statistically significant . Patients with metastatic disease, followed by patients with localized disease who received chemotherapy, had greater fatigue.

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Seeing A Healthcare Provider For Fatigue

When your chief complaint is fatigue, cancer isn’t likely to be the first thing on your healthcare provider’s mind. Fatigue is related to many other conditions, and your healthcare provider will want to rule out the most common causes first.

This will be accomplished through a physical and routine blood work. Your healthcare provider will likely order a few different blood tests, especially tests to check on your thyroid function.

During your visit, your healthcare provider may ask several questions relating to your quality of life and what factors may contribute to your fatigue. Possible questions include:

• How many hours do you work? Are you stressed at work?
• Have you had any major life changes, such as marriage, birth, or death?
• How often do you exercise?
• Do you sleep well? How much sleep do you get?
• How is your diet?
• Do you have a family history of thyroid disease?

It is important to remember that fatigue is not exclusive to cancer. If you are experiencing fatigue, it may be related to a less serious condition or have a lifestyle cause.

What Other Factors Contribute To Fatigue

Several other factors could contribute to fatigue, including:

• Tumor cells compete for nutrients, often at the expense of the normal cells’ growth.
• Decreased nutrition from the side effects of treatments can also cause fatigue.
• Cancer treatments, specifically chemotherapy, can cause reduced blood counts, which may lead to anemia, a blood disorder that occurs when the blood cannot adequately transport oxygen through the body. When tissues don’t get enough oxygen, fatigue can result.
• Medicines used to treat side effects such as nausea, pain, depression, anxiety, and seizures can also cause fatigue.
• Research shows that chronic, severe pain increases fatigue.
• Stress can worsen feelings of fatigue. Stress can result from dealing with the disease and the “unknowns,” as well as from worrying about daily tasks or trying to meet others’ needs.
• Fatigue may result when you try to maintain your normal daily routines and activities during treatments. Modifying your schedule and activities can help conserve energy.
• Depression and fatigue often go hand-in-hand. It may not be clear which started first. One way to sort this out is to try to understand your depressed feelings and how they affect your life. If you are depressed all the time, were depressed before your cancer diagnosis, or are preoccupied with feeling worthless and useless, you may need treatment for depression.

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What Can You Do About Appetite Changes

Its important to recognize changes in appetite so that you can get help when its needed. Talk to your medical team about how much youve been eating and whether you need to do something about it. For example:

• Some causes of poor appetite can be managed with medical treatment. There are medicines that can help stimulate your appetite, decrease nausea, and help food move through your stomach more quickly.
• A nutritionist might be able to offer tips on how to get the most out of each bite you take.
• Supplemental drinks or shakes can sometimes help you get needed nutrition more easily.
• You might find that youre able to eat more when others are at the table.
• You might find it easier to eat small frequent meals or snacks during the day instead of trying to eat full meals 3 times a day.

These measures may work for some, but they wont help most people who are very close to the end of life. At later stages, these efforts can even make the person feel worse.

What Can You Do About The Colon Cancer Associated Fatigue

Colon cancer associated fatigue poses great challenges to keep up the pace of life. The best way to combat fatigue, is to resolve the underlying causative factors. However, in many cases, it is difficult to isolate or determine the specific cause. Many times there are multiple factors contributing to fatigue. There are some general steps you can take to feel better and cope up with life

• Conserve Energy:

The most effective step you can take is to access your fatigue and conserve the energy that your body is able to produce. First, identify the factors that aggravate your fatigue like specific tasks, body postures or time of the day. Also, identify what makes it better. Then, try to avoid the aggravating factors or substitute alternative tasks or postures.

To conserve energy, the most efficient way is to organize your work. It can be done by arranging the items easy to reach, using long handled tools or storing the items lower to reduce tripping. The other way to conserve energy is to take frequent rest breaks. Maintain a balance between the periods of work and rest. Take rest before you get fatigued rest periods should be short and frequent. You can also delegate the tasks if needed while doing the important tasks by yourself.

• Meet Nutritional Demand:

• Use Proper Body Mechanics:

• Pace Yourself:

References:

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