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What is Cancer-related Fatigue?

Signs of cancer-related fatigue

Here are some signs of cancer-related fatigue that you and your family can watch for. Talk to your someone on your cancer care team if you have any of these symptoms.

  • You feel tired and it doesn’t get better, it keeps coming back, or it becomes severe.
  • You’re more tired than usual during or after an activity.
  • You’re feeling tired and it’s not related to an activity.
  • You put less energy into your personal appearance.
  • You’re too tired to do the things you normally do.
  • Your arms and legs feel heavy and hard to move.
  • You have no energy.
  • You feel weak.
  • Your tiredness doesn’t get better with rest or sleep.
  • You spend more time in bed and/or sleep more. Or, you may have trouble sleeping.
  • You stay in bed for more than 24 hours.
  • You become confused.
  • You can’t concentrate or focus your thoughts.
  • You have trouble remembering things.
  • Your tiredness disrupts your work, social life, or daily routine.
  • You feel sad, depressed, or irritable.
  • You feel frustrated, irritable, and upset about the fatigue and its effects on your life

Even though fatigue is a very distressing symptom, doctors and nurses don’t focus on it, and patients and caregivers seldom report it.

It may be hard for you to talk about it, but tell your cancer care team about your fatigue. Tell them how it’s affecting your life. Someone on your team should be able to help you if they know you’re having this problem. Managing fatigue is part of good cancer care. Work with your cancer care team to find and treat the causes of your fatigue.

Cancer-related fatigue is different.

Fatigue is being tired – physically, mentally, and emotionally. It means having less energy to do the things you need or want to do.

The fatigue that comes with cancer, called cancer-related fatigue, is different from the fatigue of daily life.

Everyday, normal fatigue usually doesn’t last long. It often gets better when you rest. Cancer-related fatigue is worse and it causes more distress. It’s not the tired feeling people remember having before they had cancer. People describe it as feeling weak, listless, drained, or “washed out.” Some may feel too tired to eat, walk to the bathroom, or even use the TV remote. It can be hard to think, as well as move your body. Rest does not make it go away, and just a little activity can be exhausting. For some people, this kind of fatigue causes more distress than pain, nausea, vomiting, or depression.

Cancer-related fatigue is worse than everyday fatigue. It lasts longer and sleep doesn’t make it better: It’s unpredictable. People describe it as overwhelming, affecting every part of their lives.

Cancer-related fatigue can:

  • Differ from one day to the next in how bad it is and how much it bothers you
  • Be overwhelming and make it hard for you to feel well
  • Make it hard for you to be with your friends and family
  • Make it hard for you to do things you normally do, including going to work
  • Make it harder for you to follow your cancer treatment plan

Many people with cancer say fatigue is the most distressing side effect of cancer and its treatment – it can have a major effect on a person’s quality of life.

    Fatigue is the most common side effect of cancer treatment, and it often hits without warning. Everyday activities – talking on the phone, shopping for groceries, even lifting a fork to eat – can be overwhelming tasks.

How long does cancer-related fatigue last?

Cancer-related fatigue can last from months to years. It often continues after treatment ends.

For people getting chemotherapy in cycles, fatigue often gets worse in the first few days and then gets better until the next treatment, when the pattern starts again. For those getting radiation, fatigue usually gets worse as the treatment goes on.

Fatigue can affect your mood, employment, daily routines, self-care, recreation, relationships, and your sense of self.

Fatigue or depression?

Some signs of fatigue often look a lot like those of depression, and it’s easy to confuse the two. Depression involves an inability to feel pleasure – people who are depressed feel sad or unworthy. They may give up hope. You can have fatigue and not be depressed, although some people have both fatigue and depression.

Sometimes it may be hard to find a label for what you’re feeling. Your doctor might want you to see a mental health professional to get another opinion on whether depression is part of the problem. If it is, treatment can help.

Try to tell your doctor exactly how you feel and how it affects the things you do. Only you know if you have fatigue and how it’s changing your ability to enjoy life. Talk to your cancer care team so you can find ways to feel better.

References

Bower JE. Cancer-related fatigue-mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2014;11(10):597-609.

Jacobsen PB, Donovan KA, Weitzner MA. Distinguishing fatigue and depression in patients with cancer. Semin Clin Neuropsychiatry. 2003;8(4):229-240.

National Cancer Institute. Fatigue PDQ (Health Professional Version). 8/28/14. Accessed at www.cancer.gov/about-cancer/treatment/side-effects/fatigue/fatigue-hp-pdq on May 2, 2016.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Cancer-Related Fatigue – V.1.2016. Accessed at www.nccn.org/professionals/physician_gls/f_guidelines.asp on May 2, 2016.

Trudel-Fitzgerald C, Savard J, Ivers H. Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Ann Behav Med. 2013;45(3):329-337.


Last Medical Review: 05/18/2016
Last Revised: 05/24/2016