Fatique / Cancer-related
Cancer-related Fatigue

  1. What is Fatigue?
  2. The word fatigue (fah-teeg) comes from a Greek word that means an absence or loss of strength. It is an overwhelming, daily lack of energy that can have an affect on everything you do. It is the feeling of being physically, mentally and emotionally tired. You have less energy to do things you normally do or want to do. Fatigue can occur with any tumor type, treatment and stage of illness. Fatigue can affect your sense of well being, your ability to do daily tasks and may affect disease outcome. Cancer-related fatigue does not go away if you sleep or rest. Fatigue can be overcome in an emergency (you could get out of a burning house if you needed to).

  3. What are the causes of fatigue?
  4. There are many different causes for fatigue. Some are due to your cancer or the treatment you are getting. Others are due to your mental or emotional response to your disease or treatment. Fatigue may also be due to any other illness you may have such as diabetes or high blood pressure.

    Additionally, there are other causes, such as:

    • Altered body chemistry (the substances in you body such as calcium, sodium, etc. are not at the levels they should be - too high or too low)
    • Emotional distress
    • Inability to sleep at night
    • Not eating well or drinking enough fluids
    • Poor muscle function due to staying in bed, being sick, having pain, or not getting any exercise
    • Having to travel to get to your treatments
    • Having to wait a long time to get your treatment
    • Side effects of treatment such as anemia (not enough red blood cells to carry oxygen to your tissues so they can work well), infection, pain, or nausea and vomiting
    • Too much calcium in the blood (hypercalcemia - can be caused by having cancer that has spread to the bone. The cancer breaks down the bone and calcium, which is used to make bones, is released from the bone into the bloodstream. This can make you fatigued; it can also cause nausea, problems with concentration and constipation)

    The most common cause of fatigue in cancer patients is cancer treatment. The exact reasons for the fatigue are not totally known and are often a combination of factors.

  5. How often does fatigue occur?
  6. About 80%-100% of those who have chemotherapy and 40%-93% of those who have radiation therapy will have fatigue. In over 70% of all patients, fatigue affects daily life.

  7. What are the symptoms of fatigue?
    • Symptoms include:
      • Having a hard time climbing stairs or walking short distances
      • Having a hard time paying attention or concentrating
      • Being short of breath after walking or moving about
      • Difficulty doing simple tasks such as cooking, cleaning, taking a shower
      • Unable to do as much as usual during the day
      • A desire to sleep more
      • Slower speech
      • Feeling like crying or feeling you are sad or depressed
      • Being pale
      • Feeling very weak, weary, or listless (don't have energy to do anything or become tired very easily)
      • Having more physical complaints than usual (headache, achy joints)
      • Feeling happy one minute; crying the next; angry the next
      • Having a hard time paying attention when reading, watching TV or listening to others talking
      • Losing interest in your surroundings

  8. What are the types of fatigue?
    • There are 4 types of fatigue. They include:
      • Acute Fatigue is intermittent and can be expected. It has happens rapidly and lasts a short period of time. It is caused by staying up too late or not getting enough sleep over a period of time. It usually gets better with sleep.
      • Chronic Fatigue is long-lasting and one of the types of fatigue that cancer patients get. It is likely to be due to having cancer, being treated for cancer and having to deal with cancer and its treatment. It does not get better with sleep or rest.
      • Attentional Fatigue makes you unable to concentrate or pay attention to things you want to. You may not be able to read, watch a movie or listen closely to a conversation. For cancer patients who take chemotherapy, this is known as "Chemo Brain." It may last up to 3 years following completion of treatment.
      • Neuromuscular Fatigue is when your muscles are exhausted. You get this type of fatigue if run a marathon or lift very heavy weights. It goes away when you rest the muscles that are fatigued.

  9. What is Chemotherapy-related Fatigue?
  10. Chemotherapy-related fatigue is an expected side-effect. It is noticeable within the first few days of each treatment. It is more obvious by 10 days after treatment. It slowly lessens until the next treatment. Over time the fatigue increases with each treatment and does not go away between treatments. It usually goes away in 12 to 18 months after you finish treatment. Some will have fatigue longer than others.

  11. What is Radiation-related Fatigue?
  12. Fatigue is also an expected side-effect of radiation therapy. It increases over the time of therapy. Most patients will be feeling tired by the 3rd week of treatment. It continues over the course of treatment. The fatigue does not end immediately when treatment is over. It slowly goes away over time.

  13. What is Surgery-related fatigue?
  14. Fatigue you experience with surgery is due to how well your heart is working, your nutritional status and how well your muscles work before and after surgery. It also can be caused by any fear or anxiety you may have about the surgery and the possible outcomes. It may be increased by medications for pain or nausea that you receive after your surgery. This fatigue usually goes away rapidly as you recover from your surgery.

  15. Are there other cancer treatments that cause fatigue?
  16. Some treatments, called Biotherapy and including such drugs as Interferon and thalidomide, cause severe fatigue. The fatigue is a likely side effect that is related to type of drug, the dose of the drug and time schedule on which the drug is given. It will get worse as you continue the treatment. It usually goes away 12 to 18 months after you finish your treatments. Combination treatment with more than one chemotherapy drug or both radiation therapy and chemotherapy will also be a cause of fatigue. This fatigue can be severe and last a long time (more than a year) after treatment is done.

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