Part UT Health San Antonio

Definition

Cancer fatigue is a feeling of extreme weakness and exhaustion. It occurs during cancer treatment. At times, it can make it hard to do basic tasks. The fatigue can last for weeks or even years.

Chemotherapy Affects the Whole Body
Chemotherapy

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Causes

Cancer and the side effects of treatment cause the fatigue. Fatigue can be made worse by the following:

  • Anemia —drop in red blood cells
  • Poor nutrition and dehydration, often due to nausea and/or vomiting
  • Hormonal changes
  • Lack of sleep
  • Depression or anxiety
  • Stress
  • Pain
  • Side effects of medications

These are common side effects of cancer treatment. Treatment effects on some organs like kidney, liver, or heart can also increase fatigue.

Risk Factors

Factors that may increase your chances of cancer fatigue:

  • Undergoing cancer treatment
  • Worsening of cancer
  • Poor nutrition or breathing problems before treatment is started
  • Personal or family history of depression
  • Lack of physical activity
  • Being overweight
  • Being socially isolated or lonely
  • History of childhood stress, such as abuse and/or neglect
  • Genetic factors

Symptoms

Cancer fatigue may cause:

  • Extreme fatigue that is not relieved by sleep or rest
  • Lack of energy to do basic daily tasks
  • Trouble concentrating and remembering
  • Heavy feeling in the arms and legs
  • Impatience, irritability
  • Sleeping too much or not enough

Diagnosis

Your doctor will ask about your symptoms and health history. A physical exam will be done. The doctor may ask you some questions. You may also be given a questionnaire. This will help to make a diagnosis.

Treatment

Treatment will depend on your specific needs. Work with your care team to find what works best for you. Related problems like anemia will need to be treated.

Other options include medicine, therapy, and home care.

Medicine

Medicine that may help to relieve fatigue include:

  • Antidepressants
  • Stimulants
  • Corticosteroids

Therapy

Your mental health can play a role. Stress and negative thought patterns can make fatigue worse. Changes to your life can also cause stress and negative thoughts.

Therapy may help you find better ways to cope. There are different options such as one on one therapy or group sessions.

Home Care

Changes to your daily habits may also help. Options that may help include:

  • Light exercise—on days when you have more energy. Walking for 15-30 minutes a day is one good option.
  • Learn proper sleep habits. Find time to relax before bed. Avoid naps that last more than 1 hour during the day.
  • Eat a healthful diet.
  • Balance your daily life:
    • If you can, adjust your work schedule and workload.
    • Talk with a financial advisor. They can help you with your costs and future.
  • Plan steps to save your energy throughout the day. It may include:
    • Balance activity with rest periods
    • Get help for physically demanding home tasks
    • Ask your family and friends to help you with tasks at home

Prevention

It is not always possible to prevent cancer fatigue. Your care team will work to help you manage treatment and side effects.

RESOURCES:

American Cancer Society
https://www.cancer.org

National Cancer Institute
https://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
https://www.cancer.ca

Provincial Health Services Authority
http://www.bccancer.bc.ca

REFERENCES:

Anemia of cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T909257/Anemia-of-cancer. Updated December 21, 2016. Accessed January 8, 2018.

Anemia of chronic disease. Iron Disorders Institute website. Available at: http://www.irondisorders.org/anemia-of-chronic-disease. Accessed January 8, 2018.

Cancer facts: Fatigue and cancer. International Cancer Council website. Available at: http://nebula.wsimg.com/174328a6003a733c72057bf66ea199d9?AccessKeyId=4ECD43F4A65F6DBF7F21&disposition=0&alloworigin=1. Accessed January 8, 2018.

Cancer-related fatigue. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fatigue.html. Accessed January 8, 2018.

General information about fatigue. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/fatigue/fatigue-pdq. Updated June 30, 2017. Accessed January 8, 2018.

Lower EE, Fleishman S, Cooper A. Efficacy of dexmethylphenidate for the treatment of fatigue after cancer chemotherapy: a randomized clinical trial. J Pain Symptom Manage. 2009;38(5):650-662.

Minton O, Richardson A, Sharpe M, Hotopf M, Stone P. A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue. J Natl Cancer Inst. 2008;100(16):1155-1166.

Patterson E, Wan YW, Sidani S. Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. J Clin Nurs. 2013;22(19-20): 2668-2678.

Toxicities of chemotherapeutic agents. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115935/Toxicities-of-chemotherapeutic-agents. Updated January 4, 2018. Accessed January 8, 2018.

Yennurajalingam S, Frisbee-Hume S, Palmer JL, et al. Reduction of cancer-related fatigue with dexamethasone: A double-blind, randomized, placebo-controlled trial in patients with advanced cancer. J Clin Oncol. 2013;31(25):3076-3082.

Last reviewed November 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 8/8/2018