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Patients often feel tired and weak during cancer treatment. Cancer-related fatigue is different from everyday tiredness. It does not go away with sleep or rest. Fatigue can make it hard to complete tasks or do normal activities. This can interfere with school or work, relationships, and emotional and physical health. For some patients, fatigue continues even after treatment ends.
Fatigue is one of the most common and distressing side effects of cancer and cancer treatments for patients and families. It is important for families to work closely with the care team to identify possible causes and develop a plan to address them.
Ways to help fatigue include:
Cancer-related fatigue is the feeling of low energy, tiredness, or exhaustion that is ongoing, not explained by other causes, and not relieved by rest. Fatigue has mental, physical, and emotional effects and interferes with daily life.
Fatigue during and after childhood cancer is usually due to a combination of factors. These include cancer treatments, effects of the cancer itself, and other physical, behavioral, and emotional factors.
Fatigue during chemotherapy can be up and down. Fatigue is usually worst in the days after a chemo treatment when blood counts are lowest. Energy levels may gradually increase until the next treatment. Targeted therapy and immunotherapy agents can also cause fatigue.
Anti-cancer medicines may cause fatigue in several ways. Physical changes that can contribute to fatigue include:
Patients who receive radiation therapy also report fatigue. Fatigue with radiation often gets worse over time. It usually improves after treatment ends. Radiation to the brain is especially likely to cause fatigue.
A first step in treating fatigue is to find out more about the problem and identify possible causes. This includes questions about onset, duration, effect on daily activities, and what makes fatigue better or worse. A medical history, physical exam, and laboratory tests are used to find out about underlying causes. Information about a patient’s sleep, physical activity, and eating habits can also be helpful in evaluating fatigue.
Assessment of Cancer-Related Fatigue May Include:
It can help to know that the “no energy” feeling is normal during cancer and should get better. Families should work with the care team to identify and treat medical and emotional factors that contribute to fatigue. The reasons for a patient’s fatigue might not be fully known.
Ways to manage fatigue include: