Reviewed: Annie Angle, cancer nurse (Dip. Oncology Nursing, Royal Marsden, London)
Fatigue is a feeling of severe tiredness. Many people who have cancer and cancer treatment have fatigue. This information addresses common questions about cancer-related fatigue.
Cancer fatigue means tiredness and lack of energy. Fatigue is the most common side effect of cancer and its treatment.
Cancer fatigue is different from everyday tiredness. It can happen suddenly. Unlike everyday tiredness, it can happen even if you haven't been doing exercise or had a long day. Resting doesn't always help.
Cancer-related fatigue can go on for weeks, months or even years after you finish treatment. Doctors call this ‘chronic fatigue' – long-lasting tiredness.
Most people will get their normal energy levels back between six months and a year after their treatment ends. For some people it can take longer.
Fatigue can be overwhelming and very frustrating. It can touch many parts of your life, such as your work and social life, relationships and general day-to-day living (eating, washing and cleaning).
People can feel fatigue in different ways. 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 can't 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've had before. It can be difficult to describe and hard for others to understand.
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:
Everything can seem like an effort. You may become low in mood because of these feelings. Some people can 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, cancer patient
Fatigue can be a side effect of:
Some of these treatments reduce red blood cells. This is called called anaemia. Anaemia means there are fewer red blood cells to carry oxygen through your body.
The cancer itself can also cause fatigue:
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 the exact causes of and ways to manage fatigue after treatment finishes.