Communicating With Your Healthcare Provider About Fatigue
Many people underestimate fatigue and fail to discuss it with their practitioner. There can be underlying medical reasons for fatigue, such as anemia, that may need to be addressed. Unfortunately, there is no medication, prescription or OTC, that treats fatigue, but your healthcare provider may be able to determine what is contributing to fatigue and offer solutions specific to your situation.
What Causes Cancer Fatigue
Cancer and its treatment often cause fatigue, known as cancer-related fatigue. Between 80 percent to 100 percent of cancer patients report experiencing fatigue, according to the American Cancer Society.
If you havent been diagnosed with cancer and youre experiencing unexplained, persistent tiredness or lack of energy, you may be wondering if your fatigue could be a symptom of cancer.
While fatigue is a common symptom of cancer, cancer rarely causes fatigue alone. Fatigue is often multifactorial, meaning more than one contributing factor may be involved, and none of them may be cancer.
No matter its cause, fatigue is one of the toughest symptoms to deal with. When patients are struggling with fatigue in their daily life, they want to feel better, and theyre looking for someone to help them. As a medical oncologist at Cancer Treatment Centers of America® , I work every day to help patients enjoy a better quality of life while we fight their cancer.
In this article, Ill cover some common factors that may contribute to cancer-related fatigue. This article examines:
The main focus of this article is on patients whove already received a cancer diagnosis. But first, lets briefly explore fatigue as a symptom of undiagnosed cancer.
How Long Do Side Effects Last
Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.
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How Fertility Might Be Affected
For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.
Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.
See Fertility and Women With Cancer to learn more.
For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.
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Breast Cancer Fatigue Before Diagnosis
How do I tell when I have breast cancer? This has been the question most people ask but they dont have the most appropriate answer. Breast cancer eats slowly into the body which can make it difficult to be identified in the early stages. Breast cancer fatigue before diagnosis is common among the cancer patients and it must be monitored and managed properly.
This can be characterized by low energy in the body and weakness which are rarely experienced by healthy people. Such condition may be treated lightly before cancer diagnosis and can easily be assumed to be the normal sleep. The fatigue may be experienced as a result of breast cancer without the knowledge of an individual or may be caused by the treatment process.
Cancer diagnosis
You dont have to wait for the breast cancer condition to get worse to take the necessary steps for diagnosis and treatment. Today therere better ways for cancer diagnosis which are effective and cost effective in terms of budget. You can totally depend on the related symptoms and fatigue to tell o the cancer condition but a lot more needs to be done.
Across the world, different people have reported extreme fatigue which later turned up to be caused by the breast cancer. You should work closely with your doctor for the right diagnose when you feel extreme levels of fatigue.Impact of the breast cancer fatigue.
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Radioprotective Drugs For Reducing Side Effects
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.
How Your Doctor Can Help
The first step is to try to figure out the source or sources of your fatigue. There may be more than one reason youre feeling this way.
Your doctor can do tests to check for anemia or hypothyroidism. If you have one of these conditions, treatments can help.
If you think your cancer treatment is the cause, talk to your doctor about ways to help you manage it, or discuss other options.
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I Felt A Pea On My Ribs
I had done monthly self-breast exams since I was in my early 20s. I felt a tiny hard little bump the size of a small pea. I could only feel it because it was over my rib at the bottom of my left breast. In retrospect, my bra may have hurt a little in that area before I found the lump. I have had many lumps, bumps, and cysts biopsied, but this pea was definitely different. I scheduled my annual mammogram along with a biopsy. I received the breast cancer diagnosis within a week, just shy of my 55th birthday. Turns out, there was another in the other breast that didnt show up on a mammogram. I also discovered I was a BRCA 1 mutation carrier. I needed aggressive chemo followed by a double mastectomy. Had I not done the exam that evening, everything would be quite different.
Cynthia Bailey, MD, president and CEO of Advanced Skin Care and Dermatology, Inc., Sebastopol, California
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Physical Medicine And Rehabilitation
In cancer pre- and rehabilitation, exercise is a very suitable means to reduce fatigue and improve the overall quality of life and participation . Improvement of muscular strength, endurance capacity, sensorimotor functions, and flexibility seems to be of high clinical relevance concerning the overall quality of life, general health, survival, and return to work . There are recent international recommendations for exercise in cancer patients, which serve as a guide for the fitness and health care professionals working with cancer survivors . Cancer survivors can safely engage in exercise to restore physical functioning, enhance the quality of life, and mitigate CRF .
In some cases, cancer patients are not able to perform systematic and regular exercise due to different painful musculoskeletal conditions, such as plantar fasciitis or calcaneal spur, calcifying tendinopathy of the shoulder, tennis elbow, or Achilles tendinopathy . In most cases, such painful musculoskeletal conditions prohibit active participation in exercise programs and therefore have to be treated before starting vigorous exercise .
Table 2.
Availabletreatment options for fatigue in BC patients
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Why Noticing Cancer Symptoms Is Important
Identifying symptoms can help you and your doctor detect your cancer earlier. This is important because the sooner cancer is found, the better your prognosis.
For example, melanoma can be effectively treated if its spotted early. The five-year survival rate is around 98 percent if the cancer hasnt grown deep into the skin.
While symptoms are most likely caused by something other than cancer, you shouldnt dismiss them. This is especially true if the problem has lasted a long time or has gotten worse.
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Ways To Save Up Your Energy
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Cancer Fatigue Is Different From Fatigue That Healthy People Feel
When a healthy person is tired from day-to-day activities, their fatigue can be relieved with sleep and rest. Cancer fatigue is different. People with cancer get tired after less activity than people who do not have cancer. Also, cancer fatigue is not completely relieved by sleep and rest, interferes with daily activities, and may last for a long time. Fatigue usually decreases after cancer treatment ends, but some people may still feel fatigue for months or years.
Mammography Can Rupture Tumors And Spread Malignant Cells
Mammography involves compressing the breasts between two plates in order to spread out the breast tissue for imaging. Todays mammogram equipment applies 42 pounds of pressure to the breasts. Not surprisingly, this can cause significant pain. However, there is also a serious health risk associated with the compression applied to the breasts. Only 22 pounds of pressure is needed to rupture the encapsulation of a cancerous tumor . The amount of pressure involved in a mammography procedure therefore has the potential to rupture existing tumors and spread malignant cells into the bloodstream .
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Start With Small Steps
Id love totell you that fatigue will disappear as quickly as it came on. It doesnot. But it will dissipate with time.
Its alsonot the same for everyone and its hard to quantify, to judge how bad it is.Fatigue isnt like a blood test that offers measurable datapoints. But its real. Its a formidable challenge in the cancerfight, but youre not alone.
So just getgoing, and take baby steps. Walk or exercise for five minutes,seven minutes or 10 minutes, whatever you can do. Keep building a routine,perhaps going from once a day to twice a day. Judge how you feel today.Judge how you feel in a month. Keep going.
How To Find Help For Cancer Fatigue
It can be hard to pinpoint the cause of cancer-related fatigue, especially if a combination of factors is working together to cause it. There may not be one simple answer. Keep looking for help, even if initial tests for obvious sources of fatigue are negative.
Keep in mind that conventional oncologists arent usually trained on all the research thats been done on how to manage side effects and help improve quality of life. Their focus is on drugs used to treat cancer. But don’t assume your oncologist is the only one capable of managing your side effects, nor the only one who should be following your progress.
Physicians who work in integrative medicine, functional medicine and naturopathy may be more experienced with how to manage those symptoms using relatively non-toxic approaches. These providers may be more likely to know about and use strategies that show the potential to improve patients quality of life without causing harmful side effects. However, be cautious with any provider who claims their treatments will cure cancer in lieu of conventional therapy.
If youre not getting the help youre looking for, consider seeking a second opinion at an oncology center like CTCA. Cancer centers are more likely to offer resources to explore the multifactorial processes that could be affecting fatigue.
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It Is Not Clear How Cancer Treatments Cause Fatigue
It is unclear how cancer treatments such as surgery, chemotherapy, and radiation therapy cause fatigue.
When cancer treatment begins, many patients are already tired from medical tests, surgery, and the emotional stress of coping with the cancer diagnosis. Fatigue may get worse during treatment.
Different cancer treatments have different effects on a patient’s energy level. The type and schedule of treatments can affect the amount of fatigue caused by cancer treatment. Some patients have more fatigue after cancer treatments than others do.
Fatigue related to surgery
Fatigue is often a side effect of surgery, but patients usually feel better with time. However, fatigue related to surgery can be worse when the surgery is combined with other cancer treatments.
Fatigue caused by chemotherapy
Patients treated with chemotherapy usually feel the most fatigue in the days right after each treatment. Then the fatigue decreases until the next treatment. Some studies have shown that patients have the most severe fatigue about mid-way through all the cycles of chemotherapy. Fatigue decreases after chemotherapy is finished, but patients may not feel back to normal until a month or more after the last treatment.
Fatigue during chemotherapy may be increased by the following:
- Pain.
- Lack of sleep caused by some anticancer drugs.
Fatigue caused by radiation therapy
Fatigue caused by hormone therapy
Fatigue caused by immunotherapy
Is Your Fatigue A Symptom Of Cancer
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Could your fatigue be the first symptom of cancer? At one point or another, we have all experienced fatigue. For most of us, it is temporary, usually caused by stress or being overworked.
For some people, however, fatigue can become persistent, occurring daily. When fatigue becomes frequent, it is natural to be concerned about what may be causing it.
One of the first things many people think maybe the culprit for their fatigue is cancer. When might feeling tired be a sign of cancer and how often is it?
We often hear about cancer patients who are extremely fatigued, but a lot of cancer-related fatigue is caused by the side effects of cancer treatment, not always cancer itself. In other words, for people with many cancers, the fatigue begins after diagnosis.
While fatigue alone without other symptoms is uncommon in many cancers, for people with leukemias and lymphomas fatigue may well be the first symptom.
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Why You’re So Tired After Radiation Therapy
When you are prescribed radiation therapy to treat cancer, your healthcare provider will provide you with a list of possible side effects of treatment. Things like nausea, diarrhea, and hair loss usually catch a person’s attention first because they seem to be the worst. While these are side effects that can be difficult to tolerate, it is actually fatigue that affects people the most. Lack of energy and excessive tiredness seem to plague all cancer patients, but those going through radiation therapy do experience it more frequently and often chronically. Learning how to manage and cope with fatigue is essential for your quality of life during radiation therapy treatment.
Choose An Experienced Radiation Care Team That Will Help You Manage Side Effects
Radiation therapy will likely result in tiredness that progressively grows worse. However, the tiredness associated with treatment coincides with the positive results of radiotherapycancer cell destruction. By knowing more about what causes this tiredness, those living with a cancer diagnosis can make an informed decision about whether to proceed with radiotherapy, and if so, they may also apply the prevention strategies to minimize its impact.
Remember a key part of managing the side effects of cancer treatment will always involve your care team. Therefore, it is important to choose a treatment provider, such as SERO, that understands treatment side effects and how to manage them. Submit your questions and request for a consultation online today.
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