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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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • coco1101
    2 years ago

    I don’t ever complain about fatigue as I figure A) there is little that can be done for it B) I do believe exercise, walking or something can be very helpful. However, I have 1/3 of my lungs left after multiple surgeries. C) have had a hip replacement due to mets that has not gone well and isn’t properly usable without a cane or walker, etc. D) I am still taking pain med’s on a “as need” basis for hip problem … E) I am taking a Chemo that makes me sick as a dog.
    It’s hard to overcome these issues

  • Kristine Cherol moderator
    2 years ago

    @coco1101 I’m so sorry to hear about all of the issues you’re experiencing after your surgeries. Have you thought about asking your care team about Palliative Care?

    My husband was assigned a Palliative doctor from day one, and I felt it really helped with his quality of life. Since it’s their specialty, they seemed to know more medications, tips and tricks, and therapies that help with symptoms and side effects more than the oncologists. It really helped my husband manage his treatment effects. There are several articles on the site about this topic that you might find useful! Thinking of you, Kristine, Team Member

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