Treatment Side Effects - Fatigue

Reviewed by: HU Medical Review Board | Last reviewed: March 2018

Fatigue is a sense of extreme tiredness, weakness, or lack of energy that is not improved by resting or sleeping, and it is a common side effect of many treatments for blood cancer. Fatigue has a great impact on quality of life, potentially compromising physical functioning and the ability to do everyday activities.1

Fatigue is experienced by virtually all patients who undergo treatment for cancer: up to 90% of patients treated with radiation therapy and up to 80% of patients treated with chemotherapy report experiencing fatigue. For some people, fatigue can continue for months or years after treatment is concluded.2

What causes fatigue in people with blood cancer?

Many of the treatments for blood cancer can cause fatigue as a side effect, including chemotherapy, immunotherapy, radiation, and surgery. The cancer itself may also cause fatigue, as the cancerous cells can use up much of the body’s energy supplies. Cancerous cells can grow quickly, draining energy from the body’s normal functions.3

Fatigue can also occur with weight loss and lack of appetite, other general symptoms that can be caused by blood cancer or by treatments for blood cancer. When the body isn’t getting the proper nutrition it needs, fatigue can be a result.4

Anemia, which is a low red blood cell count, can also cause fatigue. Anemia can develop from blood cancer, as cancerous cells crowd out healthy blood cells, or as a side effect of treatment.1Pain can cause or worsen fatigue. Many people with blood cancer experience pain, both as a result of the cancer itself as well as potentially from procedures and treatment.1,5

In addition, the emotional stress of having blood cancer and dealing with treatment can contribute to fatigue. Depression can cause fatigue, and fatigue may also put a person at an increased risk for depression.4,5

Managing fatigue

The first step in treating fatigue is treating the cause of the fatigue, such as:

  • For anemia, a person may be given a diet high in iron to encourage production of hemoglobin, a part of red blood cells that helps carry oxygen through the body, or they may receive a blood transfusion or a medication that stimulates the creation of red blood cells.
  • For those experiencing depression, treatment may include medication, therapy, or a combination of both.
  • For pain, there are medications and strategies that can help relieve or manage chronic pain.4

In addition, there are ways to manage fatigue, including:

  • Diet – Proper nutrition is important to maintaining energy levels. Consulting with a registered dietitian can be helpful.1
  • Resting – Sleep and downtime are important to help the body heal, and resting is also important for stress relief.1
  • Physical activity – Getting regular movement and activity can help relieve fatigue (check with your doctor if you have an exercise restriction).1,4
  • Counseling – It can be helpful to meet with a psychologist or therapist to get professional help with coping skills and dealing with the stress of having blood cancer.1,4
  • Complementary approaches – Many people find that complementary strategies help them cope with treatment side effects like fatigue, including acupuncture, massage, music therapy, or yoga.4

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