Why Am I Always So Tired: A Look Into Cancer Fatigue

Fatigue is an often-mentioned side effect from cancer and its various treatments. It is not the type of fatigue where a good night’s sleep will “cure” us. It just seems to go on and on.

A standard dictionary definition of fatigue, according to Medicine, is, “extreme tiredness resulting from mental or physical exertion or illness.” Fatigue can also be acute and come on suddenly or be chronic and persistent. This describes what many of us experience.

There are several names for fatigue in cancer patients, which include cancer fatigue, cancer-related fatigue and cancer treatment-related fatigue. Whatever it is called, I think most cancer survivors will agree that it sucks!

Cancer fatigue has made a huge change in my life. I researched various articles from the National Cancer Institute, Mayo Clinic and Cancer Network: Oncology Nursing to find out more information. As I suspected, this insidious and lingering side effect is under-reported, under-diagnosed and under-treated. The percentage of persons suffering from fatigue in breast cancer survivors may be as high as 30 percent and last as long as five years after treatment, according to the journal Oncology.

The question I have is why, and now the research is explaining some reasons. The changes to your body by the cancer can lead to fatigue. Certain cancers can weaken muscles, damage organs and alter hormones. Some cancers release proteins called cytokines which causes fatigue. All cancer treatments, including chemo, radiation, surgery, bone marrow transplants and biological destroy healthy and damaged tissue, according to the Mayo Clinic.

Obviously, there are other side effects from treatments such as nausea, vomiting and diarrhea that can also cause tiredness. Think what an episode of the flu or an intestinal bug does to our body, then imagine what survivors go through periodically. Some cancers can even cause anemia, which is bound to make the body weak.

In addition to all of the above causes, pain, lack of sleep, infections, hormonal changes and other factors increase the fatigue even more. Immunotherapy can leave flu-type symptoms, while surgery is always an assault to the body. It also makes sense that the buildup of toxic substances left in the body after treatment contributes to feeling weak. Being less active is a huge factor.

One of the most important elements of fatigue in cancer is nutrition. In cancer survivors, the body may not be able to absorb the nutrients from the food as a result of cancer, treatment or both. The patient may not feel like eating because of nausea and diarrhea. The body needs more energy because of infections and fever, which many survivors suffer.

One way to battle fatigue is to have your doctor refer you to a nutritionist. I am fortunate enough to be at a YMCA which has a LIVESTRONG program, and have received tremendous advice from two nutritionists. One of the first foods recommended to me was Kefir for my intense diarrhea. The nutritionist relates a story about a colon cancer survivor who had gone through more than a dozen medications from his doctors to control the diarrhea and nothing worked. He decided to eat the Kefir, which immediately helped him. It is available in the yogurt department of most grocery stores. I have learned to make smoothies, to try different brands of foods and to read labels from these classes.

The other major solution to fatigue is hyper kinetics or exercise! Regular and moderate exercise improves one’s capacity to move, increases muscle strength and decreases fatigue. LIVESTRONG helps with special exercises for persons recovering from cancer treatments. What survivors need to realize is we do not need to run a marathon. Even an exercise like simple chair yoga helps with fatigue.

Finally, the cancer survivor needs to learn how to pace oneself and not over exert. A number of articles have addressed this, but what I find most interesting is one from the National Cancer Institute. Research has discovered that during and after cancer treatment, patients cannot stay focused over long periods of time and have a hard time remembering. There is even a name for it — attention fatigue!

The answer to helping with this type of fatigue is to take part in restful activities, and spend time outdoors. Now I know that all that time I spend watching television and reading are good for me!

In summary, fatigue is a problem that doesn’t go away. However, we can try to make it better. Talk to your oncology nurse, navigator, doctor and people on your medical team and do not just believe that fatigue is inevitable. All of us need to have some control, and the more control we have over our bodies, the better we feel!