When people think about the side effects of cancer treatment, they usually think about hair loss (which is common with some types of chemotherapy), and nausea (which is not nearly as common as it used to be). But in my experience, fatigue is the side effect that’s most universal and least appreciated.
Fatigue is different from simply being tired. People often describe it as a complete loss of energy. I hear the phrases “dead tired” or “bone tired” all of the time. Fatigue is more than a nuisance—it can completely disrupt one’s life.
Some causes of cancer-related fatigue are organic and respond well to treatment. Anemia, for example, is sometimes caused by chemotherapy. If people don’t have enough red blood cells, they won’t feel very peppy.
Fatigue can be caused by simply not eating enough. Treatment (and cancer itself) can affect a person’s appetite or ability to swallow. Food is our fuel.
Sleep is often disrupted during cancer treatment. A person’s rhythms get out of whack—they go to bed at odd hours, nap during the day, and worry at regular intervals. The medications themselves can affect sleep cycles.
Depression is common for many people with cancer and depression affects sleep, appetite, and energy.
Being sedentary adds to the fatigue. It’s easy to become out of shape after months of surgery, chemo, and radiation. Gentle exercise, such as walking, is almost always helpful.
Even when the fatigue can’t be “fixed,” it can be managed. One nurse tells her patients that it’s like beginning each day with $100 in their energy bank. Once it’s gone for the day, it’s gone, so there is a need to prioritize activities. At the top of the list are things that have to get done as well as those things that provide the greatest pleasure. Other activities can wait or friends can be called in to shop for groceries.
Just like pain, fatigue can be overwhelming and debilitating. But steps can be taken to make it better. The first step is recognizing that fatigue, and the second is bringing it to the attention of your health care team.
Reprinted with permission of the Ithaca Journal.
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