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And you thought you were done with pimples
A great majority of cancer patients experience fatigue at some point during their illness. Cancer related fatigue is often caused by the treatments used to combat the disease. The cancer itself may also be the cause of fatigue, but it's important to understand that fatigue does not necessarily signal a tumor's progression.

Fatigue is a common side effect of immunotherapy, such as the use of interferon (IFN's), interleukin-2 (IL-2), and tumor necrosis factor (TNF). In immunotherapy, the severity of fatigue is related to the size of the dose and may increase over the course of the treatment because of the treatment's cumulative effect. Sometimes, fatigue is so severe that immunotherapy doses must be limited, or discontinued for a period of time. Fatigue is also an expected side effect of radiation therapy and many chemotherapy agents cause anemia or a drop in red blood cells, which results in fatigue. In addition, some medications prescribed for pain can increase feelings of fatigue. 

Typically, patients with blood-related cancers frequently report more debilitating fatigue than patients with solid tumors.

Unlike fatigue in healthy people, fatigue experienced by cancer patients is often "overwhelming, persistent, and relentless." But it's not impossible to overcome.

What Helps

First and foremost, let your medical team know how you are feeling and whether you're taking any dietary supplements or herbal "remedies." 

Nausea and vomiting are often cited as contributing factors to fatigue yet maintaining adequate nutrition in the diet is necessary for healing and to keep fatigue at bay. You may want to talk to your doctor about adding protein supplements to your diet. 

Sufficient fluid intake is crucial. Try to drink at least 64 fluid ounces every day to prevent dehydration, reduce the risk of constipation and wash wastes from the body.

Uncontrolled or under-controlled pain is likely to be contributing to your fatigue. If you aren't getting adequate pain control, demand it. And if you are, ask the doctor about steps you can take to offset the effects making you so tired. 

When your lab results come back, ask if there's any evidence of anemia or an electrolyte imbalance. Vitamin supplements and simple over-the-counter re-hydration liquids such as Pedialyte or Gatorade may be sufficient to combat these problems or your physician may prescribe more powerful medications. 

Cut down on unnecessary activities. While exercise is important to enhance your tolerance for cancer treatments, examine your daily schedule of activities and work schedules to eliminate the low priority activities.

Try to keep your sleep schedules consistent. Sufficient rest is imperative.

Ask the physician or the nursing staff to schedule your treatments at the best times based on your fatigue such as at the end of the day, after work or after school. 

Fatigue can be debilitating yet its onset may be gradual. Keep a log especially during and between treatments. Your nurse will want to know on a scale of 0-to-10 (where 0 is no fatigue and 10 is the most fatigue) how you were feeling each day. 

WEB RESOURCES: 

This page was last edited on 06/19/2003
Written by Rachael Myers Lowe, cancerpage.com
Reviewed by Katie Mullaly, RN, MSN and Jane Quigley, RN, BSN


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