Fatigue

Fatigue for cancer patients is more severe and longer lasting than for healthy people.  Cancer patients commonly cannot relieve fatigue with sleep.  It is important to manage fatigue effectively and to communicate with health care professionals about symptoms.

 

Who does fatigue affect?

Fatigue is a side effect of all types of cancer treatments.  During treatment the body requires more energy for repairing damage to healthy tissues caused by treatment.  This can occur with surgery, chemotherapy, radiation therapy, bone marrow transplantation, immunotherapy, and targeted biologic therapy.  Pain, nausea, and vomiting or any other side effects that use energy can cause fatigue to be more severe.   Anemia, a low level of red blood cells, may also play a role in fatigue.

Medications may be a significant factor in fatigue.  Sometimes two or more medications interacting may cause fatigue.  The following drugs may cause fatigue:

• Strong pain relievers
• Medications for insomnia
• Anti-nausea medication
• Anti-seizure drugs
• Antidepressants

 

Why does fatigue occur?

Almost all people will experience fatigue during cancer and its treatments.  However, which type of cancer and which method of treatment used may affect how severe it is.  Age, general health status, and normal level of activity before treatment also play a role in how a person is affected by fatigue.

 

When do patients experience fatigue?

When fatigue occurs varies depending on the individual.  Anesthesia and strong pain relievers used during surgery may cause fatigue.  Also after surgery, many are limited in physical activity, which can make a person feel weak for a few days and possibly a few weeks.

Chemotherapy patients tend to feel the most tired about 2 hours after treatment.  However, after a few days fatigue usually resolves until the next treatment cycle begins.  For radiation therapy patients, fatigue may not begin until a few weeks after treatment and will diminish after treatment ends.

If fatigue that is fairly constant for one year or more after treatment, it is considered longer-term fatigue.  This is more likely to occur in cases on bone transplantations and high-dose chemotherapy.   However, it may take only a few months for others to feel better.  Some feel better immediately after the end of treatment.

 

Fatigue Management

It is important for patients to communicate regularly with their doctor about their level of fatigue.  Physicians will be able to determine whether fatigue is mild, moderate, or severe.  Also, physicians will uncover any underlying specific cause for fatigue.  Doctors will then prescribe appropriate treatment.  Sometimes certain drugs or supplements interacting with one another can also cause fatigue.  Therefore, it is important for physicians to be aware of what medications a patient is taking, including any over-the-counter drugs, vitamins or supplements.

Although fatigue causes a lack of energy, it is important to continue being active.  Studies have found that regular exercise can greatly reduce fatigue.  Aerobic exercise, such as walking, bicycling, or swimming can be significantly beneficial.  It may be easier to exercise in the beginning of treatment before peak levels of fatigue occur.  However, consulting a doctor before starting a regular exercise routine is suggested.

Strategic use of energy can also minimize fatigue.  Cancer patients should focus on tasks important to them when energy levels are high during the day.  Family and friends may also be able to help with specific tasks in needed.

Patients should also make sure they rest or take a nap during their day.  If still employed, a nap during lunch or break time can be beneficial.  Multiple shorter naps are more effective than one long sleep.  However, if one naps too much during the day, sleep at night may be difficult.

 

Ways to Manage Treatment-related Fatigue

 

 

When should a doctor be consulted?

Patients should contact a doctor in the case of any of the following symptoms:

• Confusion
• Dizziness
• Too tired to get out of bed for more than 24 hours
• Loss of balance
• Sudden decrease in energy level

Breathlessness or rapid heart beat after mild activity