You may have expected to feel tired when you have cancer. But cancer fatigue can make you too exhausted to enjoy life. This type of extreme fatigue doesn’t get better with rest or sleep. Chemotherapy, radiation therapy and other cancer treatments can make cancer fatigue worse, as can depression and stress.
Fatigue can be confused with tiredness. Everyone gets tired. It's an expected feeling after certain activities or at the end of the day. Usually, we know why we're tired, and a good night's sleep will solve the problem.
Fatigue is different. Fatigue is a daily lack of energy — an unusual or excessive whole-body tiredness that is not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from one to six months or longer). Fatigue can have a profoundly negative impact on a person's ability to function and quality of life.
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Cancer-related fatigue (CRF, sometimes simply called "cancer fatigue") is one of the most common side effects of cancer and its treatments. Many people who are chronically ill feel tired. But cancer-related fatigue goes beyond the usual tiredness. People who experience cancer fatigue often describe it as "paralyzing." Usually, it comes on suddenly and is not the result of activity or exertion. With this type of fatigue, no amount of rest or sleep helps. You feel physically, emotionally and mentally exhausted most of the time.
Cancer fatigue may last a few weeks (acute) or for months or years (chronic). Chronic cancer fatigue can harm your quality of life.
Cancer-related fatigue affects 80% to 100% of people with cancer.
The exact reason for cancer fatigue is unknown. Cancer fatigue may be related to both the disease process and treatments, including surgery, chemotherapy, radiation therapy and immunotherapy. Cancer treatments commonly associated with cancer fatigue are:
Cancer and its treatment can also make you prone to these issues that may contribute to cancer fatigue:
Your healthcare provider will assess your symptoms. You may be asked to complete a questionnaire or rate your fatigue level. Your provider may ask you to keep a journal to track your level of fatigue and factors that might contribute to fatigue.
Blood tests can check for anemia, signs of infection or other problems that cause fatigue.
The best way to combat fatigue is to treat the underlying cause. Unfortunately, the exact cause may be unknown, or there may be multiple causes. There are treatments to reduce certain causes of cancer fatigue, such as anemia or hypothyroidism. Other causes must be managed on an individual basis.
The following are tips you can use to combat cancer fatigue:
Persistent fatigue can interfere with your ability to participate in life’s activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working.
As many as 1 in 4 people with cancer develop depression. Sometimes, it’s hard to determine if fatigue leads to depression or vice versa.
The first step in treating fatigue is knowing the problem exists. Many people don't bother to mention fatigue to their doctors because they believe it is normal. It's vital that you discuss this and all symptoms or side effects with your healthcare provider. Then, efforts can be directed at determining the cause of the problem and prescribing appropriate treatment. Your particular cancer treatment regimen, with its known side effects, may provide clues for your doctor or health care professional. A simple blood test, for example, can determine if you are anemic.
There is no single medication available to treat fatigue. However, there are medications available that can treat some of the underlying causes.
When you’re struggling, you may want to see a palliative care specialist. These experts help people with cancer manage symptoms like pain, nausea and depression.
Your provider or palliative care team may recommend these actions to ease fatigue:
Everyone’s experience with cancer fatigue is unique. For some people, fatigue lasts a few weeks. Others may feel exhausted for years. You may feel better when your cancer treatments stop, but often fatigue lingers.
You should call your healthcare provider if you:
You may want to ask your healthcare provider:
Cancer fatigue may be worse if you're not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. The following strategies can help you improve your nutritional intake.
Dietitians can provide suggestions to work around any symptoms that may be interfering with caloric intake. They can help you find ways to take in calories despite an early feeling of fullness, swallowing difficulty or taste changes. Dietitians can also suggest ways of maximizing calories and proteins in smaller amounts of food. They may suggest powdered milk, instant breakfast drinks and other commercial supplements or food additives.
You may feel ill from your cancer or treatment, which may lead to less physical activity. Decreased levels of physical activity can lead to tiredness and lack of energy. Scientists have found that even healthy athletes forced to spend extended periods in bed or sitting in chairs develop feelings of anxiety, depression, weakness, fatigue and nausea. Regular, moderate exercise can decrease the feeling of fatigue and help you feel energetic. Even during cancer therapy, it's often possible to continue to exercise. Be sure to check with your healthcare provider before starting an exercise program.
Exercise has many health benefits. Regular exercise can:
It's important for you to exercise your whole body every day, or at least every other day. A good exercise plan starts slowly, allowing your body time to adjust. Any kind of exercise is acceptable, including walking, riding a stationary bike, yoga or swimming (if the immune system is OK), and strength training. Whatever kind of exercise you do should be at a moderate intensity so you can say to yourself "I am working somewhat hard." Avoid exercise that makes you feel sore, stiff or exhausted.
Exercising only occasionally or doing too much too fast can be dangerous. If you experience soreness, stiffness, exhaustion or feel out of breath as a result of your exercise, you are overdoing it.
Managing stress can play an important role in combating fatigue. Here are some ways you can manage stress:
If your stress feels overwhelming, talk to your healthcare provider. They are there to help.
Sleep is an important part of wellness. Good sleep can improve your mental and physical health. Several factors contribute to how well you sleep, and there are things you can do to improve your sleep, including:
You can’t do much to prevent cancer-related fatigue. But these strategies may help minimize the problem:
A note from Cleveland Clinic
A chronic illness like cancer can bring many unwanted challenges. Cancer fatigue is one of them. It makes sense that fighting off cancer can tire out your body. Cancer treatments can also be physically and mentally exhausting. Still, you shouldn’t hesitate to let your healthcare provider know how cancer fatigue is affecting your life. You can take steps to bring more energy back into your days.
Last reviewed by a Cleveland Clinic medical professional on 09/08/2021.
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