Fatigue

Tuesday 30 November, 2010

Reviewed: Annie Angle, cancer nurse (Dip. Oncology Nursing, Royal Marsden, London)

On this page: How does it feel? ι How does it affect you? ι What causes it?

Fatigue is a feeling of severe tiredness experienced by many people who have cancer and its treatment (chemotherapy, radiotherapy, hormone therapy and, sometimes, surgery). Cancer fatigue is very different from everyday tiredness.

It can happen suddenly. Unlike everyday tiredness, it is not necessarily brought on by exercise or a long day's activity. Resting does not always help relieve the fatigue. It can go on for weeks, months or even years after you finish treatment. Doctors call this ‘chronic fatigue' - long-lasting tiredness.

Most people will regain their normal energy levels between six months and a year after their treatment ends. For some people it can take longer. Fatigue can be overwhelming and frustrating. It can touch many parts of your life. 

How does it feel? 

Different people have different symptoms. People with cancer fatigue describe feeling weak, exhausted, sleepy, drowsy, weary, confused or impatient. Some describe it as a ‘whole body experience' and say they ‘just cannot move'. Others have tired or sore limbs and feel breathless, even after only a little activity.

For many people, cancer fatigue is unlike anything they have experienced. It can often be difficult to describe and hard for others to understand.

How does it affect you? 

Many people with cancer say fatigue is the most difficult of all side effects from their cancer and its treatment. Fatigue can affect how you think as well as how you feel.

  • You may need more sleep or find it hard to sleep.
  • You may have physical, emotional and/or mental exhaustion.
  • Your body, especially your arms and legs, may feel heavy.
  • You may have less desire to do normal things, like eating, chatting with friends and family or shopping.
  • You may find it hard to concentrate or think clearly.
  • You may not feel like sex (loss of libido).
  • Everything can seem like an effort. You may become low in mood because of these feelings.

Some people can even get depressed. If you have continued feelings of sadness, have trouble getting up in the morning or don't feel like doing things that you used to enjoy, talk to your doctor. You may have depression, and counselling or medication may help you.

‘I had no idea that I would still be feeling tired five months after finishing treatment ... I didn't know how to make it better and I was scared that's how it would be: that I wouldn't go back to normal, that I would never go back to having energy again.' (Georgina)

What causes it? 

Fatigue during treatment can be caused by the side effects from cancer treatments such as:

A common side effect from some of these treatments is having too few red blood cells (anaemia). Anaemia means there are fewer red blood cells to carry oxygen through your body.

The cancer itself can also cause fatigue. Some cancer tumours produce toxins. These can cause tiredness or stop cells making important minerals in our body, such as potassium and calcium. When our levels of such minerals get too low it affects our muscles and may cause weakness and tiredness.

Cancer treatment can sometimes affect hormone levels, which can also reduce energy levels. Other things related to your illness can make you feel tired: not eating well, pain, not sleeping well, feeling stressed, having depression, coping with infections, some drugs, and not exercising.

You may also be affected by other health problems; side effects from pain-relieving drugs, steroids, sleeping tablets or antidepressants; and emotional problems. Doctors are still trying to find out the exact causes and ways of managing fatigue after treatment finishes.

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