Cancer fatigue: Why it happens and how to cope

Written by Julie Taylor

Fatigue is, in my mind, the worst side effect or symptom of any illness/trauma/recovery. At the time, when we're in hospital, it's almost 'a good thing' because then you just fall asleep all the time. And I never wanted to be awake anyway! Although I think a fit body, full of energy, could fight better? I value little else higher than to feel really well.

Baldylocks told me that her cancer didn't cause her so many problems as the drugs she needed to kill it. Many - if not most - of her symptoms now are a result of her bone marrow transplant and the chemotherapy used to get rid of her cancer. This is my own recollection too, although I didn't have cancer.  Drugs and treatment caused as much discomfort and fatigue as the trauma itself.

Of all the aches and pains and symptoms, for me fatigue is the worst. I can handle anything when I have energy. When I feel 'blah', everything seems so much worse. Even a healthy body needs vitamins these days (true...) let alone a sick or recovering one. Which in itself can be a problem, I know, when your immune system is being deliberately suppressed.  My own thought (and what I did!) lead to questioning my doctors over and over about what I could do...  What could I take? Somehow we have to balance rest, vitamins, exercise and other supplements and get our doctors blessing on what we do. Especially with cancer it seems really important to always involve your doctor in everything you do?

Then of course to get well you need to balance the 5 elements - or colours - of what makes us human - the physical, the emotional, the joyful (so hard to add joy when you feel like crap), the cogitive and the financial.  A human being is so much more than grey and white.

Many people forget how important the financial is: medicine can't help you if you can't afford to buy it... How can you be joyful when your house is being repossessed?  And on and on - there are ways of planning money that are really helpful and to get some financial advice - early on in your recovery - is a great idea. Doctors tend only to concentrate on the physical, perhaps the cognitive and maybe the emotional. Joy and $$ seem to play no part at all in their concerns for us. Yet without taking all 5 elements (or colours) into account, no-one can get truly better. I found - both 25 years ago and again now - that whilst traditional medicine is vital to fight cancer and to deal with acute trauma (I'd be dead without it) alternative health is really necessary when it comes to ReBuilding health and long term getting-back-to-life care.

The next part of this article is actually written and distributed by the Mayo clinic - and starts with a very worrying sentence!  Oh Oh!!  If they don't know... I'm being silly!  Traditional doctors can't possibly be experts in everything.   The healthcare system is like a maze.  A very intricate and difficult maze.  Navigating it has become a full time job.  Doctors and hospital staff are overworked and there are just so many alternative therapists 'out there'.  How do you know which one to trust and where to turn?  That's the crux of ReBuildingYou: to share what we discover helps.  There is also a directory of therapists, with each 'section' headed by a description of the therapy from a professional viewpoint and from a patient's experience.  It's going to take me a few more months to develop this directory - the result will be invaluable.

I wish too that medical insurance would take better care of us when it comes to alternative therapists.  Unfortunately the sophisticated drug companies have a stranglehold on the money available to hospitals and doctors - and our health insurance companies. Often by the time that we're ready for 'alternative measures' we have zero cash. And many alternatives and most supplements are not covered. It took me 10 years to figure out the answer for myself - and then I was blessed with a spouse who helped me find and pay for the help I needed. CLICK HERE to read more.

Not that rehabilitation has an easy answer. You certainly have to be ready - ie sick and very tired of the medical help that's more readily available - to do it... Hold for the Mayo clinic and their article: Cancer fatigue: Why it occurs and how to cope...

...""The exact causes of cancer fatigue and how best to treat it aren't known. Find out what doctors know about cancer fatigue and what you can do about it. By Mayo Clinic staff  (so this should be accurate?!)

Fatigue, usually described as feeling tired, weak or exhausted, affects most people during cancer treatment. Cancer fatigue can result from the side effects of treatment or the cancer itself. Causes of cancer fatigue Cancer fatigue may be caused by many factors, and the factors that contribute to your cancer fatigue may be completely different from those of someone you know. However, possible contributing factors include:

* Your cancer. Your cancer itself can cause changes to your body that can lead to fatigue. For instance, some cancers release proteins called cytokines, which are thought to cause fatigue. Other cancers can increase your body's need for energy, weaken your muscles or alter your body's hormones, all of which may contribute to fatigue.

* Cancer treatment. Chemotherapy, radiation therapy, surgery, bone marrow transplantation and biological therapy may all cause fatigue. You may experience fatigue when chemotherapy or radiation therapy destroys healthy cells in addition to the targeted cancer cells. Fatigue may occur as your body tries to repair the damage to healthy cells and tissue. Some treatment side effects — such as anemia, nausea, vomiting, pain, insomnia and changes in mood — also may cause fatigue.

* Anemia. You might develop anemia if your treatment destroys too many healthy red blood cells. You can also develop anemia as a result of the cancer itself if the cancer has spread to your bone marrow and interferes with blood cell production or causes you to lose blood. Anemia may also result from unrelated medical conditions, such as thyroid problems.

* Pain. If you experience chronic pain, you may be less active, eat less, sleep less and become depressed, all of which may add to your fatigue.

* Emotions. Anxiety, stress or depression associated with your cancer diagnosis also may lead to fatigue.

* Lack of sleep. If you're sleeping less at night or your sleep is frequently interrupted, you may experience fatigue.

* Poor nutrition. In order to work efficiently, your body needs the energy that a healthy diet provides. When you have cancer, changes can occur in your body's need for and ability to process nutrients. These changes can lead to poor nutrition, resulting in fatigue. For example, your body may need more nutrients than usual or it may not be able to process nutrients adequately. You may also take in fewer nutrients if your appetite wanes or treatment side effects, such as nausea and vomiting, make it difficult to eat.

* Medications. Certain medications, such as pain relievers, can cause fatigue.

* Lack of exercise. If you're used to being on the go, slowing down can make you feel fatigued. Though you will have good days and bad days, try to maintain your normal level of activity if you can.

* Hormonal changes. Many hormonal changes can occur during cancer treatment. Hormonal therapies may alter hormones as a way to treat cancer. Hormonal changes may occur as side effects of treatments, such as surgery, radiation therapy or chemotherapy. Changes to the thyroid gland, adrenal glands, testes or ovaries can all cause fatigue.

Not everyone who has cancer experiences fatigue. And if you do, the level of cancer fatigue you experience can vary — you may feel a mild lack of energy, or you may feel completely wiped out. Your cancer fatigue may occur episodically and last just a short while, or it may last for several months after you complete treatment. When to contact your doctor Some fatigue during cancer treatment is to be expected. But if you find that cancer fatigue is persistent, lasting weeks, and interferes with your ability to go about your everyday tasks, tell your doctor. Tell your doctor right away if you experience:

* Confusion

* Dizziness

* Loss of balance

* Inability to get out of bed for more than 24 hours

* Severe shortness of breath

* Worsening signs and symptoms

What to tell your doctor If you're fatigued, your doctor may examine you and ask you questions to assess the severity and nature of your symptoms. This gives your doctor clues about what's causing your cancer fatigue and how to treat it. Your doctor might ask questions such as these:

* When did you begin experiencing fatigue?

* Has it progressed since your diagnosis?

* How severe is it?

* How long does it last?

* What eases it?

* What makes it worse?

* How does it affect your daily life?

* Do you experience shortness of breath or chest discomfort?

* How well are you sleeping?

* How and what are you eating?

* How are you feeling emotionally?

In addition to these questions, your doctor will likely conduct a physical exam and further evaluate your medical history, the type or types of treatment you are receiving or have received in the past, and any medications you're taking. He or she may recommend some tests, such as blood tests or X-rays, specific to your condition.

Coping strategies: Medical treatments and self-care Because cancer-related fatigue may be caused by many factors, your doctor may suggest more than one method to reduce and cope with your symptoms. These may include self-care methods and, in certain cases, medications or medical procedures. Medical interventions Medications may be available to treat the underlying cause of your fatigue. For instance, if your fatigue is the result of anemia, blood transfusions may help. Medications that stimulate your bone marrow to produce more red blood cells might be another option, though this is controversial. If you're depressed, your doctor might suggest medications that can help reduce fatigue, increase appetite and improve your sense of well-being.

Self-care options Coping with fatigue might require things you can do on your own. You might try to:

* Take it easy. Set aside time in your day to rest. Take short naps — no longer than an hour — throughout the day rather than resting for one long period.

* Conserve your energy. Save your energy for your most important activities. Keep track of the times when you feel your best, and plan to do your important activities during those times. Ask for help when needed.

* Maintain your energy by eating. Drinking lots of fluids and eating well will help keep your energy reserves up. Limit or avoid caffeine and alcohol. If nausea and vomiting make it hard to eat, talk to your doctor about these side effects.

* Get moving. When you feel up to it, light exercise throughout the week may help you preserve your energy level. But keep in mind that once you start feeling fatigued, it may be too late to start an exercise program because it's hard to find the energy to get going. Instead, exercise regularly as you start treatment. You'll get in the routine of exercising, and it may even help you prevent fatigue during treatment.

Speak up about your fatigue Don't assume the fatigue you're experiencing is just part of the cancer experience. If it's frustrating you or affecting your ability to go about your day, it's time to talk with your doctor. Though fatigue is a common symptom when you have cancer, there are steps you can take to reduce or cope with your condition. If you're feeling fatigued, talk with your doctor about what factors might be causing your fatigue and what you can do to improve them.