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by Cresse M

Cancer Fatigue

(Fatigue, Cancer)

Definition

Cancer fatigue is when you feel very weak and exhausted during cancer treatment. You may struggle to complete daily tasks. Fatigue can last for weeks or even years.
Chemotherapy Through Cardiovascular System
Chemotherapy
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Causes

Cancer and the side effects of treatment cause this condition. If your body is already weakened by cancer when treatment begins, then it is even more difficult to handle the side effects.
These conditions are caused by cancer or cancer treatment and can add to fatigue:
  • Anemia—due to chemotherapy, which can kill red blood cells and affect the blood-forming cells in bone marrow
  • Poor nutrition and dehydration—due to loss of appetite, nausea, and vomiting
  • Lack of oxygen—due to fewer red blood cells, which carry oxygen
  • Hormonal changes—due to hormonal therapies, side effects of treatment, or type of cancer, such as thyroid cancer
  • Other factors:
    • Lack of sleep
    • Depression
    • Stress
    • Pain
    • Side effects of medicines

Risk Factors

These factors increase your chance of developing cancer fatigue:
  • Undergoing cancer treatment (such as chemotherapy, radiation, biologic response modifier therapy)
  • Worsening of cancer
  • Having a pre-existing condition (such as poor nutrition, breathing impairment)
  • Having a history of depression or having family members with depression
Tell your doctor if you have any of these risk factors.

Symptoms

If you have any of these symptoms do not assume it is due to cancer fatigue. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
  • Extreme fatigue that is far worse than ordinary fatigue and that is not relieved by sleep
  • No energy to do basic tasks, such as cooking dinner, making the bed, or answering the door
  • Trouble concentrating and remembering
  • Dizziness
  • Heaviness of arms and legs
  • Poor balance
  • Shortness of breath
  • Impatience, irritability

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam. You may be asked:
  • Have your symptoms been worsening? When do your symptoms appear and how long do they last?
  • What medications are you taking?
  • How often do you sleep and for how long?
  • What are you eating?
  • What makes you feel better? Worse?
  • Have you been depressed?
  • How has your work status and financial condition been affected by cancer?
  • What kind of support system do you have?
Your doctor may also use a questionnaire to assess your fatigue.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Medications

Your doctor may prescribe:
  • Medicines to treat the underlying condition (such as anemia)
  • Antidepressants
  • Stimulants
  • Corticosteroids

Therapy

Your doctor may advise that you participate in therapy. Talk with your therapist about whether cognitive behavioral therapy is right for you.

Home Care

Your doctor may recommend that you try these approaches:
  • Exercise:
    • Do a light to moderate program. This may be to walk 15-30 minutes a day.
    • Learn your exercise limits.
    • Identify the times of day when you have the most energy.
  • Follow proper sleep and relaxation techniques:
    • Relax before bed by listening to music or reading.
    • Try not to nap for more than one hour.
    • Get at least eight hours of sleep.
  • Eat a healthy diet.
  • To help you have more control, schedule time to:
    • Talk with a therapist to help you cope with your diagnosis.
    • Talk with your employer about your work schedule and workload.
    • Talk with a financial advisor to help you with your costs and to plan for the future.

Prevention

Cancer fatigue is one of the most common side effects of cancer. Because there are so many causes of cancer fatigue, there may not be a way to prevent it. But, there may be ways to reduce it. Talk to your doctor. Also talk to your family and friends to help you cope with your condition.

RESOURCES

American Cancer Society
http://www.cancer.org
National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES

Canadian Cancer Society
http://www.cancer.ca
National Cancer Institute of Canada
http://www.ncic.cancer.ca

References

Cancer, chemotherapy, anemia and fatigue: what’s the connection? Anemia Institute website. Available at: http://www.anemiainstitute.org/index.php/en/Patient/Anemia-and-Cancer/Cancer,-Chemotherapy,-Anemia-and-Fatigue-What%E2%80%99s-the-Connection . Accessed November 19, 2008.
Cancer fatigue: it’s more than just being tired. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/nursing/products/patient-education-reference-center. Updated January 2007. Accessed November 8, 2008.
Cancer fatigue: why it occurs and how to cope. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/cancer-fatigue/CA00032. Accessed November 19, 2008.
Coping with fatigue from chemotherapy. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/nursing/products/patient-education-reference-center. Updated July 2008. Accessed November 8, 2008.
Fatigue and cancer. International Cancer Council website. Available at: http://www.iccnetwork.org/cancerfacts/FatigueFactSheetJan2011RevPost.pdf. Accessed November 19, 2008.
Feeling tired vs. cancer-related fatigue. American Cancer Society website. Available at: http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/fatigue/feeling-tired-vs-cancer-related-fatigue. Updated October 2008. Accessed November 8, 2008.
Lower EE, Fleishman S, et al. Efficacy of dexmethylphenidate for the treatment of fatigue after cancer chemotherapy: a randomized clinical trial. J Pain Symptom Manage. 2009 Nov;38(5):650-662.
Minton O, Richardson A, et al. A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue. J Natl Cancer Inst. 2008 Aug 20;100(16):1155-1166.
Radiation therapy. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/nursing/products/patient-education-reference-center. Updated March 2008. Accessed November 8, 2008.
Stedman’s Medical Dictionary. 28th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005; 298.
What to do when you feel weak or tired. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/coping/radiation-side-effects/fatigue.pdf. Accessed November 8, 2008.
10/1/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Patterson E, Wan YW, Sidani S. Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. J Clin Nurs. 2013 Oct;22(19-20): 2668-2678.
11/4/2013 DynaMed's Systematic Literature Surveillance. Available at: http://dynamed.ebscohost.com/about/about-us: Yennurajalingam S, Frisbee-Hume S, 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 Sep1;31(25):3076-3082.

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