Carolyn Vachani RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: April 13, 2009
Fatigue is one of the most common side effects reported by people receiving cancer treatments (surgery, chemotherapy, radiation therapy, or other drug therapy). It has been described as a feeling of exhaustion, feeling completely worn out, feeling that their body is "heavy" and difficult to move, or an inability to concentrate. Fatigue can cause physical, emotional, and mental exhaustion. This can be very distressing to the person experiencing it, as it is not caused by overactivity and is not usually relieved by rest, yet many people will suggest rest as a way to decrease the fatigue. People undergoing therapy can have ups and downs, good days and bad days in the energy department. This tip sheet is meant to give suggestions of ways to make the most of the energy they do have and attempt to prevent fatigue from occurring or from worsening.
Unfortunately, doctors do not know exactly what causes fatigue, and think it probably has several different causes, which makes finding effective treatments difficult. There are two ways to treat fatigue that have been shown to be quite effective in clinical trials: exercise and treatment of anemia.
Anemia, which is defined as a hemoglobin count of less than 12 grams per deciliter (this is a measure of red blood cells) can be a cause of fatigue. Red blood cells contain hemoglobin, which is responsible for carrying oxygen throughout the body. This oxygen is the fuel for muscles, and low levels of it can lead to fatigue.
It is important to remember that not every person with fatigue has anemia, and not every person with anemia has fatigue. Ask your doctor or nurse about your hemoglobin count to see if you are anemic. If a person has anemia, he or she may be able to receive an injection of a hormone called erythropoietin, which stimulates the body to make more red blood cells to increase the hemoglobin level.
Sounds crazy, but exercise has been shown to help relieve fatigue and improve quality of life. Now, we aren't talking about running a marathon - a walk around the neighborhood is more like it! Starting this exercise before fatigue sets in can help prevent fatigue from developing. Try to do some type of activity each day. It may help to ask a friend to join you: walk in a local park with nice scenery, listen to music while you walk, or walk to a destination (the store, dry cleaner, etc.). Make it enjoyable. If you already have fatigue, start small, walk just a few blocks and gradually increase the distance over time.