Fatigue is a continuous lack of energy which prevails over the entire body and does not go away even after sufficient rest. Cancer related fatigue does not arise from exertion or too much physical activity. A cancer patient may be persistently fatigued.
Almost all cancer patients experience cancer related fatigue, in varying degrees. Fatigue could be caused by the disease itself, or from the treatments. As defined by the National Comprehensive Cancer Network, cancer related fatigue is a persistent sense of tiredness or exhaustion caused by cancer or cancer treatment, which hampers regular activities and can have physical, emotional or cognitive manifestation.
Patients who undergo multiple treatments after surgery are more prone to fatigue. It is an accepted side-effect of treatments like radiation, chemotherapy and bio-therapy. Fatigue may be mild or severe and the patient might not get relief from it even after taking considerable rest. Fatigue may last for as little as few days to as long as some months or a year.
What causes fatigue?
The cause of fatigue cannot be exactly pinpointed but it is a universal symptom among nearly all cancer patients. Some of the possible causes could be anemia, pain, disturbed sleep, less physical activity, emotional turmoil, poor nutrition, side effects of medication, alcohol abuse, infections or heart problems.
Chemotherapy drugs cause fatigue, and the degree may vary from individual to individual. Patients may feel more fatigue during and just after the treatment and may recover over time. In case of radiation, fatigue is found to increase with time, and can continue up to three months after the treatment is over. Bone marrow transplant is an aggressive treatment which may cause long lasting fatigue.
Treatments also cause nausea, mouth sores, diarrhea, heartburn, change in taste or loss of appetite. This results in poor nutrition, leading to fatigue.
For patients nearing the end of life, fatigue may be linked to anemia, side effects of treatment, poor nutrition and patient may experience pain and difficulty in breathing along with fatigue. This may keep increasing as the person’s health keeps deteriorating and may keep him or her sleeping for long hours.
Treatment for fatigue
Cancer experts are of the opinion that careful examination and evaluation can help identify the cause of fatigue and patient can be given appropriate treatment to manage fatigue. The overall condition of the patient must also be considered when determining the right treatment for fatigue. For instance, if the patient is still undergoing treatment, it may be more important to treat cancer than treat fatigue. But if the patient has completed treatment and is nearing the end of life, treating fatigue may help improve the quality of whatever life is left for him.
Antidepressants are not useful if the fatigue is not caused by depression. Ritalin or methylphenidate is a stimulant which might reduce fatigue in some patients.
If the fatigue is because of anemia, treatment might be of help. Cancer causes considerable loss of red blood cells which are responsible for carrying oxygen, resulting in fatigue. Blood transfusion as well as blood production boosting medication can help.
For pain induced fatigue, pain relieving medication should improve the patient’s condition.
How patients can manage fatigue
Patients can learn to understand their body rhythm and plan their tasks accordingly to save their energy- attempting more important tasks at that time of the day when they feel less tired, using gadgets which save their time and effort, enlisting the help of caregivers for some tasks and avoiding those tasks which are unimportant.
Organizing the living space in a manner which requires the patient to spend as less energy as possible to reach essential things is also important. Maintaining a balance between rest and work can help. Long strains and sudden movements must be avoided.
It is also important to engage in some physical activity to reduce fatigue, provided the patient is not at the last stage of life.
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