Fatigue is a common problem and also one of the most distressing symptoms associated with cancer and its treatment, yet it has been consistently under-reported. Many patients believe that feeling weak, tired or exhausted is a necessary evil when your body is fighting cancer. Cancer-related fatigue profoundly affects the quality of life of patients and their families through physical, psychosocial, and economic/occupational aspects.
The most important factors contributing to cancer-related fatigue are:
- treatment with chemotherapy or radiation therapy (RT)
- lack of exercise
- sleep disturbance
- poor nutrition
- emotional distress
Anemia is the most common reversible cause of cancer-related fatigue, particularly among patients receiving chemotherapy. Treatment includes red blood cell (RBC) transfusion, or using erythropoietin stimulating agent such as procrit.
Pain: Pain in cancer patients is also considered under-reported. If you are in pain talk with your doctor, it could be contributing to your cancer-related fatigue.
Lack of exercise: To avoid fatigue, cancer patients often are advised to rest and down-regulate their daily activities. However, because inactivity can induce muscular wasting, prolonged rest can lead to further loss of physical strength and endurance. Although you may not think so, physical exercise training programs can increase your functional capacity, leading to reduced effort in performing usual activities and a decreased sense of fatigue. Again, talk with your doctor to develop a program that is right for you.
Emotional distress and sleep disturbance: Sleep disturbance associated with fatigue is often difficult to treat and manage. It may be influenced by numerous factors including daytime naps, depression, anxiety, medication, sleep interruption because of nocturia or hot flashes, and evening food and/or beverage intake. Cognitive-behavioral therapy and stress reduction may help insomnia and sleep disorders.
Poor nutrition: One of the most common side effects of cancer is a change or loss of appetite which results in fatigue. However, your body has never needed proper nutrition more. It may be helpful to keep a journal of what you are eating. When you speak with your doctor next you can go through it together and make sure your diet is providing your body with all the essential nutrients it needs.
Medication:Psychostimulants (methylphenidate, dexmethylphenidate, or modafinil) and antidepressants may be useful if the above methods do not improve fatigue.
If you are suffering from cancer-related fatigue don’t just assume that being exhausted “goes with the territory.” Talk with your doctor to develop a plan and get you functioning at your best level.