Cancer fatigue: What you need to know!

Cancer fatigue: What you need to know!

Tiredness, lack of energy and exhaustion, fatigue is a condition that you can feel either due to lack of sleep, restlessness, jet lag, aging or due to some kind of illness like anemia, thyroid problem, diabetes and heart problems. It is also known to be a very common symptom among cancer patients.

Cancer fatigue or Cancer-related fatigue (CRF) is different from general fatigueness as it is not alleviated by rest. According to the National Comprehensive Cancer Network (NCCN), ‘CRF is defined as persistent, distressing, subjective sense of emotional, physical or cognitive exhaustion or tiredness associated with cancer or cancer treatment.’

Cancer and associated treatments are the main triggers of CRF. However, the prevalence of CRF differs in persistence and severity, depending on whether it is during the treatment or after the completion of the treatment.

Prevalence of Cancer-related Fatigue

  • About 65% of cancer patients get affected with CRF. Over 2/3rd of these patients report severe CRF (remains for at least 6 months) and 1/3rd patients report persistent fatigue for several years following the treatment.
  • Forty-percent of patients suffer from CRF during the diagnosis, 17 to 21% of patients report fatigue during chemotherapy (ChT) and 33-53% during concurrent ChT and radiotherapy. Other cancer therapies like immunotherapy, hormonal therapy and targeted therapy also experience fatigue. Around 12 to 37% of patients experience fatigue during immunotherapy.
  • This percentage can rise up to 71% in the case immunotherapy given together with chemotherapy, antiangiogenic agents, monoclonal antibodies or targeted therapies.

It is essential to cope with fatigue for proper adherence to the cancer treatment and recovering the lost quality of life. For this, knowledge about Cancer-related fatigue is necessary. Let's read what symptoms, risk factors associated with CRF and how to cope with it.

Signs and Symptoms of Cancer-related fatigue

Cancer patients with chronic fatigue generally feel physically and mentally defeated. Patients may have issues like -

Physical signs and symptoms of fatigueness

  • Muscle weakness
  • Intolerance of cold
  • Difficulty in walking or climbing stairs
  • Anemia
  • Weight loss or gain
  • Low thyroid function
  • Sleep disturbances
  • Hair loss or Dry skin

Mental signs and symptoms of fatigueness

  • Lack of motivation
  • Negative thinking
  • Irritability
  • Depression
  • Anxious mood
  • Loss of mental alertness
  • Inability to concentrate
  • Withdrawal from social activities

Causes of Cancer-related fatigue

Many factors can contribute to fatigue in cancer patients. It can be cancer itself or the type of treatment the patients are receiving.

Major causes of CRF -

  • Types of blood cancer including lymphoma, myeloma, bone marrow cancer and leukemia.
  • Side effects of cancer treatments
  • Old age
  • Increased immune inflammatory activity
  • Circadian rhythm disruption
  • Pituitary, hypothalamic and adrenal axis dysfunction

Risk Factors of Cancer-related fatigue

Risk factors that can lead to fatigue in cancer patients can be biological, psychological or behavioral factors like:

  • Genetics
  • Pre-treatment fatigue
  • Anemia
  • Depression
  • Sleep disturbances
  • Autonomic nervous system dysregulation
  • Physically inactivity
  • Obesity
  • Childhood stress
  • Neuroendocrine alterations
  • catastrophizing and loneliness

How to manage Cancer related fatigue?

The very first thing that can be done to manage the problem is to avoid risk factors that can worsen the situation. CRF is generally caused by multiple problems. Therefore, by treating its accompanying psychological or physical symptoms, fatigue among cancer patients can be managed.

The very first step is to find and address the treatable factors which cause fatigue among cancer patients like pain, anemia, nutritional inadequacies, sleep disturbance, emotional distress and comorbidities. Let's explore the ways to manage Cancer related fatigue:

Treating Anemia

Managing anemia can aid in reducing fatigue. For this, first you need to bring change in your diet. Eat foods that are rich in vitamins and iron like spinach, legumes, white beans, lentils, soy products, colorful fruits, and vegetables. Other than this, doctors can prescribe you erythropoiesis-stimulating agents (ESAs) and blood transfusions to get rid of anemia.

Start Doing Exercise

Exercises including walking, yoga, riding stationary bicycles, tai chi, strength training, and swimming can help to reduce the CRF by raising the energy levels. It is assessed from many studies that patients who exercise on regular basis are found to be less tired, less depressed, have high stamina, and get better sleep. It is also said that increased physical activities can help to raise blood circulation, reduce inflammation, thereby lower fatigue.

Out of all exercises, yoga, qigong, and tai chi have been found to have a significant impact in reducing fatigue in cancer patients. These actually involve physical components like balancing, stretching, movement, and controlled breathing along with managing stress via meditation. These improve the overall well-being of the patients.

Treatment of Depression

You should also take proper treatment and counseling for depression. Further stress management techniques, training, and support groups can help patients to relax and lower their depression. Do mindfulness-based stress therapies like meditation with breath awareness, insight meditation, mindful yoga to improve mood, sound sleep, psychological functioning, and lowering stress and anxiety. This can further work to manage depression.

Try Cognitive Behavioral Strategies

Enhancing psychological support involving coping strategies and counseling can help to overcome the problem of fatigue and improving body energy levels. Cognitive-behavioral strategies like relaxation breathing, progressive muscle relaxation, and other prescribed therapies can help to reduce CRF because these address the cognitive processes, behaviors, and emotions of the person. Such activities also help to lower the catastrophizing thoughts, which ultimately bring a new ray of hope for living and getting well.

Nutritional Counseling

Nutrition holds an important space in improving the quality of life among cancer patients. A cancer patient must keep a record what they are eating. Healthy diet is very important to alleviate fatigue. Food can provide you all the needed nutrients and this will bring immunity and strength to cancer patients.

For instance, increasing protein intake improves the lean mass. Plant-based and mediterranean diets provide high levels of antioxidants to the body and reduce inflammation. Foods like probiotics, ginger and other herbs help to boost energy.

Other than these self-coping techniques, you should also take proper consultation from your doctor to reduce the problem of CRF. The physician or a certified dietician can prescribe certain medications or dietary supplements as per the condition of the patients.


Fatigue can be a serious illness as it affects overall well-being and patients start losing the positive attitude. Self-coping techniques like mindfulness therapies, exercises, nutrition, cognitive behavioral strategies all work well to regain strength. It is very important to keep yourself active, busy, and healthy to kick off fatigue. Fight and recover from cancer with a healthy body and healthy perspective.

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