Cancer Fatigue: What It Is, Causes, Symptoms & Treatment

Many people who are chronically ill feel tired. But cancer-related fatigue goes beyond the usual tiredness. People who experience cancer fatigue ... ComingtoaClevelandCliniclocation?Visitation,maskrequirementsandCOVID-19information Home / HealthLibrary / Disease&Conditions CancerFatigue Youmayhaveexpectedtofeeltiredwhenyouhavecancer.Butcancerfatiguecanmakeyoutooexhaustedtoenjoylife.Thistypeofextremefatiguedoesn’tgetbetterwithrestorsleep.Chemotherapy,radiationtherapyandothercancertreatmentscanmakecancerfatigueworse,ascandepressionandstress. CancerAnswerLine866.223.8100 Appointments&Locations RequestanAppointment DownloadaTreatmentGuide SearchClinicalTrials Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Outlook/Prognosis LivingWith CancerFatigue Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Outlook/Prognosis LivingWith BackToTop Overview Whatisfatigue? Fatiguecanbeconfusedwithtiredness.Everyonegetstired.It'sanexpectedfeelingaftercertainactivitiesorattheendoftheday.Usually,weknowwhywe'retired,andagoodnight'ssleepwillsolvetheproblem. Fatigueisdifferent.Fatigueisadailylackofenergy—anunusualorexcessivewhole-bodytirednessthatisnotrelievedbysleep.Itcanbeacute(lastingamonthorless)orchronic(lastingfromonetosixmonthsorlonger).Fatiguecanhaveaprofoundlynegativeimpactonaperson'sabilitytofunctionandqualityoflife. Whatiscancer-relatedfatigue? Cancer-relatedfatigue(CRF,sometimessimplycalled"cancerfatigue")isoneofthemostcommonsideeffectsofcanceranditstreatments.Manypeoplewhoarechronicallyillfeeltired.Butcancer-relatedfatiguegoesbeyondtheusualtiredness.Peoplewhoexperiencecancerfatigueoftendescribeitas"paralyzing."Usually,itcomesonsuddenlyandisnottheresultofactivityorexertion.Withthistypeoffatigue,noamountofrestorsleephelps.Youfeelphysically,emotionallyandmentallyexhaustedmostofthetime. Cancerfatiguemaylastafewweeks(acute)orformonthsoryears(chronic).Chroniccancerfatiguecanharmyourqualityoflife. Howcommoniscancerfatigue? Cancer-relatedfatigueaffects80%to100%ofpeoplewithcancer. Whomighthavecancerfatigue? Alltypesofcancersandcancertreatmentscancausefatigue.That’sbecauseyourbody’simmunesystemisworkinghardtofightthedisease. SymptomsandCauses Whatcausescancerfatigue? Cancertreatments,includingchemotherapy,radiationtherapy,immunotherapyandsurgery,cancausefatigue.Thesetreatmentscan: Changehowcellswork. Causeinflammation. Makeyounauseatedanddehydrated. Changehormonelevels. Damagetissuesandcells. Reducebloodcounts,leadingtoanemia. Stimulatetheproductionofcytokines(toxiccellproteins). Theexactreasonforcancerfatigueisunknown.Cancerfatiguemayberelatedtoboththediseaseprocessandtreatments,includingsurgery,chemotherapy,radiationtherapyandimmunotherapy.Cancertreatmentscommonlyassociatedwithcancerfatigueare: Chemotherapy.Anychemotherapydrugmayresultinfatigue.Thismayvaryfrompersontoperson.Somepeoplesayitlastsonlyacoupleofdays.Othersfeelthefatiguepersiststhroughandbeyondthecompletionoftreatment.Drugssuchasvincristine,vinblastine,andcisplatinoftencausecancerfatigue. Radiationtherapy.Radiationtherapycancausecumulativefatigue(fatiguethatincreasesovertime).Thiscanoccurregardlessoftreatmentsite.Cancerfatigueusuallylastsfrom3-4weeksaftertreatmentstops,butcancontinueforupto2-3months. Immunotherapy.Immunotherapystimulatesyourimmunesystemtofightcancer.Thetreatmentisalsosometimescalledbiologicaltherapy. Bonemarrowtransplant.Thisaggressiveformoftreatmentcancausecancerfatiguethatlastsuptooneyear. Biologictherapy.Cytokinesarenaturalcellproteins,suchasinterferonsandinterleukins,whicharenormallyreleasedbywhitebloodcellsinresponsetoinfection.Thesecytokinescarrymessagesthatregulateotherelementsoftheimmuneandendocrinesystems.Inhighamounts,thesecytokinescanbetoxicandleadtopersistentfatigue. Canceranditstreatmentcanalsomakeyoupronetotheseissuesthatmaycontributetocancerfatigue: Anemia.Anemiacanresultfrombloodcountsthatarereducedbytreatment.Theseloweredbloodcountsreducetheoxygen-carryingabilityoftheblood(hemoglobin).About7in10patientsexperienceanemiaduringchemotherapy. Combinationtherapy.Peopleexperiencingmorethanonetreatmentatthesametimeoroneaftertheothermayexperiencemorecancerfatigue. Tumor-induced"hypermetabolic"state.Tumorcellscompetefornutrients,oftenattheexpenseofthenormalcell'sgrowthandmetabolism.Weightloss,decreasedappetiteandfatiguearecommonresults. Decreasednutritionfromthesideeffectsoftreatments(suchasnausea,vomiting,mouthsores,tastechanges,heartburnanddiarrhea). Hypothyroidism.Ifthethyroidglandisunderactive,yourmetabolismmayslowsothatyourbodydoesn'tburnfoodfastenoughtoprovideadequateenergy.Thisisacommonconditioningeneralbutmayhappenafterradiationtherapytothelymphnodesinyourneck. Medicationsusedtotreatsideeffectssuchasnausea,dehydration,pain,depression,anxietyandseizurescancontributetocancerfatigue. Pain.Researchshowsthatchronic,severepainincreasesfatigue. Dailyroutine.Manypeopletrytomaintaintheirnormaldailyroutineandactivitiesduringtreatments.Youmayneedtomodifyyourroutinetoconserveenergy. Stresscanworsenfeelingsoffatigue.Thiscanincludeanytypeofstress,fromdealingwiththediseaseandtheunknownstoworryingaboutdailyaccomplishmentsorworryingaboutnotmeetingtheexpectationsofothers. Depressionandfatigueoftengohandinhand.Itmaynotbeclearwhichstartedfirst.Onewaytohelpsortthisoutistotrytounderstandhowyourfeelingsofdepression.Areyoudepressedallthetime?Wereyoudepressedbeforeyourcancerdiagnosis?Areyoupreoccupiedwithfeelingworthlessanduseless?Iftheanswerstothesequestionsareyes,youmayneedtreatmentfordepression. Insomnia.Inabilitytosleepeighthoursanightwillcausebothmentalandphysicalfatigue. DiagnosisandTests HowcanItellifIhavecancerfatigue? Thinkofyourpersonalenergystoresasa"bank."Depositsandwithdrawalshavetobemadeoverthecourseofthedayortheweektoensureabalancebetweenenergyconservation,restorationandexpenditure. Keepadiaryforoneweektoidentifythetimeofdaywhenyouareeithermostfatiguedorhavethemostenergy.Notewhatyouthinkmaybecontributingfactors. Bealerttothewarningsignsofimpendingcancerfatigue—tiredeyes,tiredlegs,whole-bodytiredness,stiffshoulders,decreasedenergyoralackofenergy,inabilitytoconcentrate,weaknessormalaise,boredomorlackofmotivation,sleepiness,increasedirritability,nervousness,anxietyorimpatience. Howiscancerfatiguediagnosed? Yourhealthcareproviderwillassessyoursymptoms.Youmaybeaskedtocompleteaquestionnaireorrateyourfatiguelevel.Yourprovidermayaskyoutokeepajournaltotrackyourleveloffatigueandfactorsthatmightcontributetofatigue. Bloodtestscancheckforanemia,signsofinfectionorotherproblemsthatcausefatigue. ManagementandTreatment HowcanIcombatcancerfatigue? Thebestwaytocombatfatigueistotreattheunderlyingcause.Unfortunately,theexactcausemaybeunknown,ortheremaybemultiplecauses.Therearetreatmentstoreducecertaincausesofcancerfatigue,suchasanemiaorhypothyroidism.Othercausesmustbemanagedonanindividualbasis. Thefollowingaretipsyoucanusetocombatcancerfatigue: Conserveenergy. Eatahealthydiet. Exercise. Manageyourstress. Whatarethecomplicationsofcancerfatigue? Persistentfatiguecaninterferewithyourabilitytoparticipateinlife’sactivities.Youmaymissoutontimewithfamilyandfriends.Itcanaffectyourabilitytoconcentrateandthinkclearly.Somepeoplearetooexhaustedtocontinueworking. Asmanyas1in4peoplewithcancerdevelopdepression.Sometimes,it’shardtodetermineiffatigueleadstodepressionorviceversa. Howiscancerfatiguemanagedortreated? Thefirststepintreatingfatigueisknowingtheproblemexists.Manypeopledon'tbothertomentionfatiguetotheirdoctorsbecausetheybelieveitisnormal.It'svitalthatyoudiscussthisandallsymptomsorsideeffectswithyourhealthcareprovider.Then,effortscanbedirectedatdeterminingthecauseoftheproblemandprescribingappropriatetreatment.Yourparticularcancertreatmentregimen,withitsknownsideeffects,mayprovidecluesforyourdoctororhealthcareprofessional.Asimplebloodtest,forexample,candetermineifyouareanemic. Thereisnosinglemedicationavailabletotreatfatigue.However,therearemedicationsavailablethatcantreatsomeoftheunderlyingcauses. Whenyou’restruggling,youmaywanttoseeapalliativecarespecialist.Theseexpertshelppeoplewithcancermanagesymptomslikepain,nauseaanddepression. Yourproviderorpalliativecareteammayrecommendtheseactionstoeasefatigue: Movemore:Assurprisingasitmightsound,studiesshowthatstayingactiveisoneofthebestwaystofightfatigue.Goingforawalkoutdoorswhilebreathingfreshaircanbeespeciallyinvigorating.Physicalactivity,includinggentleexerciseslikeyogaandtaichi,mayalsohelpyousleepbetter. Seekmentalhealthsupport:Cognitivebehavioraltherapy(CBT)canhelpyoucopewiththerangeofemotionsyoumayfeel.Therapycanhelpyoumanagestressandmayevenimprovesleep.In-personandonlinesupportgroupscanalsoprovidehelp. Talktoadietitian:Anutritionspecialistcanrecommenddietarychanges,vitaminsandelectrolytesupplementstoraiseyourenergy.Youcanalsofindfoodsthatwon’taggravatecancertreatment-relatedsideeffectslikenausea,mouthsoresanddiarrhea. Usemind-bodystrategies:Researchsuggeststhatmindfulnesspractices,suchasyogaandacupuncture,lessencancerfatigue.Youmayalsoseeimprovementswithmassagetherapy,meditationandrelaxingmartialartslikeqigongandtaichi. Outlook/Prognosis Howlongdoescancerfatiguelast? Everyone’sexperiencewithcancerfatigueisunique.Forsomepeople,fatiguelastsafewweeks.Othersmayfeelexhaustedforyears.Youmayfeelbetterwhenyourcancertreatmentsstop,butoftenfatiguelingers. Bonemarrowtransplantscancauseprolongedfatiguethatlastsuptoayear. Radiationtherapyfatigueoftengetsworseastreatmentsprogress.Fatigueshouldlessenafewmonthsafteryoustoptreatment. Surgerytendstocausetemporaryfatiguethatgoesawayafteryourecover. Systemictreatments(medicationsthatcirculateinblood)cancausefatiguethatcomesandgoes.Thesetreatmentsincludechemotherapy,immunotherapyandtargetedtherapy.Youmaybeexhaustedwhiletakingthemedicationsandfeelbetterduringtherecoveryphase(nomedication).Whentreatmentresumes,youfeelexhaustedagain.Youshouldhavemoreenergywhenyoufinishthetreatment. LivingWith WhenshouldIcallthedoctor? Youshouldcallyourhealthcareproviderifyou: Can’tgetoutofbed. Experiencedepression,anxietyorothermoodchanges. Feelconfusedorhavememoryproblems. Haveseverepain. Struggletobreathe. Areunabletocontrolthesideeffects(nausea,vomiting,diarrhea,lossofappetite)ofcancertreatment. WhatquestionsshouldIaskmydoctor? Youmaywanttoaskyourhealthcareprovider: Whatiscausingmyfatigue? Whatarethebestwaystomanagecancerfatigue? Howlongwillcancerfatiguelast? ShouldIlookoutforsignsofcomplications? HowcanIconserveenergywhenIhavecancerfatigue? Planandorganizeyourwork Changestorageofitemstoreducetripsorreaching. Delegatewhenneeded. Combinemotionsandactivitiesandsimplifydetails. Schedulerest Balanceperiodsofrestandwork. Restbeforeyoufeeltired. Frequent,shortrestsarebeneficial. Paceyourself Amoderatepaceisbetterthanrushingthroughactivities. Reducesuddenorprolongedstrains. Alternatesittingandstanding. Practiceproperbodymechanicstocombatcancerfatigue Whensitting,useachairwithgoodsupport. Adjustworkheights−workwithoutbendingover. Bendatyourkneesandhips,notatyourback. Carryseveralsmallerloadsoruseacart. Limitoverheadwork Uselong-handledtools. Storeitemslower. Delegate. Limitisometricwork Donotholdyourbreath. Wearcomfortableclothestoallowforfreeandeasybreathing. Identifyanythinginyourenvironmentthatmaycontributetocancerfatigue Avoidextremetemperature. Eliminatesmokeornoxiousfumes. Avoidlong,hotshowersorbaths. Prioritize Decidewhatactivitiesareimportanttoyou,andwhatcouldbedelegated. Useyourenergyonimportanttasks. ShouldIchangethewayIeattocombatcancerfatigue? Cancerfatiguemaybeworseifyou'renoteatingenoughorifyouarenoteatingtherightfoods.Maintaininggoodnutritioncanhelpyoufeelbetterandhavemoreenergy.Thefollowingstrategiescanhelpyouimproveyournutritionalintake. Basiccalorieneeds.Apersonwithcancerwhoseweighthasbeenstableneedsabout15caloriesperpoundofweighteachday.Forexample,apersonwhoweighs150poundsneedsabout2,250caloriesperdaytomaintainweight.Youshouldadd500caloriesperdayifyouhavelostweight. Proteinrebuildsandrepairsdamaged(andnormallyaging)bodytissue.Youneedabout0.5-0.6gramsofproteinperpoundofbodyweighttorebuildandrepairbodytissue.Forexample,a150-poundpersonneeds75to90gramsofproteinperday.Thebestsourcesofproteinincludefoodsfromthedairygroup(8ouncesofmilk=8gramsprotein)andmeats(meat,fish,orpoultry=7gramsofproteinperounce). Fluidneeds.Unlessyourhealthcareprovidertellsyouotherwise,youshouldaimforabout64ouncesperdaytopreventdehydration.Fluidsincludejuice,milk,broth,milkshakes,Jello®andotherbeverages.Ofcourse,waterisfine,too.It’simportanttonotethatbeveragescontainingcaffeinedoNOTcount.Andifyouarelosingfluidfromexcessivevomitingordiarrhea,youwillneedextrafluids. Supplementalvitamins.Talkwithyourhealthcareprovidertofindoutifvitaminsupplementsareagoodideaforyou.Vitaminsupplementsdon'tprovidecalories,whichareessentialforenergyproduction.Sovitaminscannotsubstituteforadequatefoodintake. Canadietitianhelpmefightcancerfatigue? Dietitianscanprovidesuggestionstoworkaroundanysymptomsthatmaybeinterferingwithcaloricintake.Theycanhelpyoufindwaystotakeincaloriesdespiteanearlyfeelingoffullness,swallowingdifficultyortastechanges.Dietitianscanalsosuggestwaysofmaximizingcaloriesandproteinsinsmalleramountsoffood.Theymaysuggestpowderedmilk,instantbreakfastdrinksandothercommercialsupplementsorfoodadditives. Howcanexercisehelpreducecancerfatigue? Youmayfeelillfromyourcancerortreatment,whichmayleadtolessphysicalactivity.Decreasedlevelsofphysicalactivitycanleadtotirednessandlackofenergy.Scientistshavefoundthatevenhealthyathletesforcedtospendextendedperiodsinbedorsittinginchairsdevelopfeelingsofanxiety,depression,weakness,fatigueandnausea.Regular,moderateexercisecandecreasethefeelingoffatigueandhelpyoufeelenergetic.Evenduringcancertherapy,it'softenpossibletocontinuetoexercise.Besuretocheckwithyourhealthcareproviderbeforestartinganexerciseprogram. Exercisehasmanyhealthbenefits.Regularexercisecan: Lowerbloodpressure. Improveyourheart'spumpingability. Giveyoumoreenergy. Increaseyourendurance. Strengthenyourtendons,ligaments,jointsandbones. Easethepainandstiffnessofarthriticjoints. Leadtoamorepositiveoutlook. Improveyoursleeppatterns. Increaseyourappetite. Whatistherightkindofexerciseforcancerfatigue? It'simportantforyoutoexerciseyourwholebodyeveryday,oratleasteveryotherday.Agoodexerciseplanstartsslowly,allowingyourbodytimetoadjust.Anykindofexerciseisacceptable,includingwalking,ridingastationarybike,yogaorswimming(iftheimmunesystemisOK),andstrengthtraining.Whateverkindofexerciseyoudoshouldbeatamoderateintensitysoyoucansaytoyourself"Iamworkingsomewhathard."Avoidexercisethatmakesyoufeelsore,stifforexhausted. Whatisthewrongkindofexerciseforcancerfatigue? Exercisingonlyoccasionallyordoingtoomuchtoofastcanbedangerous.Ifyouexperiencesoreness,stiffness,exhaustionorfeeloutofbreathasaresultofyourexercise,youareoverdoingit. Canstressmanagementhelpwithcancerfatigue? Managingstresscanplayanimportantroleincombatingfatigue.Herearesomewaysyoucanmanagestress: Adjustyourexpectations.Forexample,ifyouhavealistof10thingsyouwanttoaccomplishtoday,pareitdowntotwoandleavetherestforotherdays.Asenseofaccomplishmentgoesalongwaytoreducingstress. Helpotherstounderstandandsupportyou.Familyandfriendscanbehelpfuliftheycan"putthemselvesinyourshoes"andunderstandwhatcancerfatiguemeansforyou.Cancersupportgroupscanbeasourceofsupportaswell.Otherpeoplewithcancertrulyunderstandwhatyouaregoingthrough. Relaxationtechniquesincludingguidedmeditation,deepbreathingorvisualizationcanhelpreducestressandminimizecancerfatigue. Divertyourattention.Activitiesthatdivertyourattentionawayfromfatiguecanalsobehelpful.Activitiesthatrequirelittlephysicalenergybutdemandattentionincludeknitting,readingorlisteningtomusic. Ifyourstressfeelsoverwhelming,talktoyourhealthcareprovider.Theyaretheretohelp. Cansleepbeimprovedtoreducecancerfatigue? Sleepisanimportantpartofwellness.Goodsleepcanimproveyourmentalandphysicalhealth.Severalfactorscontributetohowwellyousleep,andtherearethingsyoucandotoimproveyoursleep,including: Doingrelaxationexercises,meditationorrelaxationyogabeforegoingtosleep. Avoidinglongafternoonnaps. Goingtobedonlywhensleepy.Useyourbedroomonlyforsleepandsexualactivities. Settingaconsistenttimetoliedownandgetup. Avoidingcaffeineandstimulatingactivitiesintheevening. Establishingarelaxingpre-sleeproutine. HowcanIpreventcancerfatigue? Youcan’tdomuchtopreventcancer-relatedfatigue.Butthesestrategiesmayhelpminimizetheproblem: Adopthealthysleephabits:Tobuildbettersleephabits,keepphonesandTVsoutofthebedroom,gotobedatthesametimeeverynightandsleepinadark,quietroom. Askforhelp:Letfamilyandfriendsrunerrands,fixmealsorhelpwithhouseworkorchildcare. Cutbackoncaffeine:Caffeineprovidesatemporarypick-me-up.Butitcanalsokeepyouupatnight. Drinkplentyoffluids:It’simportanttostayhydratedandeatnutritiousfoods. Setpriorities:Berealisticaboutwhatyoucando.Saveyourenergyforthethingsthatmattermost. Stayphysicallyactive:Goforawalkortryyogaortaichi.Don’texercisetoolateintheevening.Theactivitymaymakeithardertofallasleep. Take30-minuterestbreaks:Duringtheday,don’tsleeplongerthan30minutesoryoucouldhavetroublefallingasleepatnight.Restbreakscanhelpifyouhaveanupcomingeventthatrequiresalotofenergy. AnotefromClevelandClinic Achronicillnesslikecancercanbringmanyunwantedchallenges.Cancerfatigueisoneofthem.Itmakessensethatfightingoffcancercantireoutyourbody.Cancertreatmentscanalsobephysicallyandmentallyexhausting.Still,youshouldn’thesitatetoletyourhealthcareproviderknowhowcancerfatigueisaffectingyourlife.Youcantakestepstobringmoreenergybackintoyourdays. Share Facebook Twitter LinkedIn Email Print Getuseful,helpfulandrelevanthealth+wellnessinformation enews ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. Policy RelatedInstitutes&Services ClevelandClinicCancerCenter ClevelandClinicCancerCenterprovidesworld-classcaretopatientswithcancerandisattheforefrontofnewandemergingclinical,translationalandbasiccancerresearch. ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. Policy Morehealthnews+info ShowMore CancerAnswerLine866.223.8100 Appointments&Locations RequestanAppointment DownloadaTreatmentGuide SearchClinicalTrials Facebook Twitter YouTube Instagram LinkedIn Pinterest Snapchat