Why Am I So Tired?!

Why Am I So Tired?!

Cancer-related fatigue is one of the most common side effects of cancer and cancer treatment. Cancer fatigue is defined as a “persistent, subjective sense of tiredness related to cancer and cancer treatment that interferes with usual functioning.” It’s different than a normal feeling of tired because sleep or rest typically doesn’t improve the feeling. It also lasts longer. Cancer-related fatigue can last for months or even years after treatment ends. This is one of the reasons it is among the most distressing symptoms experienced by patients. Cancer fatigue is also difficult to measure. But it is real, and importantly, there are effective ways to deal with it.

Ways to Treat Cancer-Related Fatigue

While there is not currently an FDA-approved treatment specifically for fatigue, drugs including modafinil-which is used to treat narcolepsy, and buproprion-an antidepressant, are being studied as potential cancer fatigue treatments. Also, in clinical practice, steroids are sometimes given to help with fatigue.

Commonly fatigue is treated by determining and then treating the underlying cause of the fatigue.

  • One of the more common causes of fatigue is anemia, which is a decrease in the number of red blood cells in the body. Depending on the severity, anemia can be treated by diet (eating foods rich in iron), blood transfusions, or with medicines that stimulate the bone marrow to make more red blood cells.
  • Fatigue can also be caused by depression. Treating underlying depression with medication, talk therapy, or a combination can help reduce fatigue.
  • Pain and/or pain medication can also cause fatigue. If pain is not well-controlled, increasing or changing pain medication can help with fatigue. On the other hand, narcotic pain medication can also make fatigue worse, so changing the dose or the time medications are taken can sometimes help with fatigue.

Unlikely Solutions May Help

While it may seem counterintuitive, one of the most effective interventions for cancer fatigue is exercise. Moderate physical activity, for example 3-5 hours of walking per week, has been shown to increase energy levels, boost mood, and improve quality of life for people with cancer. Doing short amounts of light activity is a good way to start to build up endurance. Yoga, meditation, and tai chi are also helpful for some people in fighting fatigue.

Finally, it’s important to make sure that you are getting adequate rest on a regular schedule. Cleaning up your sleep routine, also known as “sleep hygiene” can help. Some recommendations include having a regular sleep and wake time, lying in bed only to sleep, and avoiding screen time (TV, computer, smartphone) in the bedroom and for at least one hour prior to sleeping.

Fatigue is a very real side effect of cancer treatment. It can impact your ability to do the things you enjoy doing. If fatigue is impacting your quality of life, let your care team know and ask for help. Just because it is common, doesn’t mean it should be ignored.

Comments

View Comments (2)

Poll