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Why am I always so tired?

Published on | Eric Brown

Do you feel exhausted regularly? You may be experiencing cancer-related fatigue.

Do not ignore cancer-related fatigue

Cancer-related fatigue is the number one complaint of most cancer patients. It usually comes on suddenly, is under reported, under diagnosed and under treated. Patients may become exhausted, emotionally drained and distressed, and unable to complete their normal activities of daily living. Unlike tiredness, cancer-related fatigue does not go away with a good night’s sleep.

What are the symptoms of cancer-related fatigue?

Common symptoms include little or no energy, unusual and excessive whole-body tiredness, muscle aches and pain, weakness, trouble concentrating, and a continual disruption in a patient’s normal daily routine. 

What causes cancer-related fatigue?

Cancer-related fatigue can result from the cancer itself, the treatments and their side effects, and emotional overload. 

Cancer causes changes to the body; your body needs more energy to fight the disease and repair the damage to healthy cells and tissue.

It also can change normal protein and hormone levels; weaken muscles; and cause nausea, pain, insomnia and anemia (if too many healthy red blood cells are destroyed during treatments). 

Besides the direct effects of cancer, its side effects and treatments, patients often experience an increase in stress and worry, increasing their level of mental exhaustion, which translates to physical exhaustion.

In addition, eating habits in cancer patients can change as well as their ability to process nutrients effectively, which subsequently may lead to poor nutrition, which in turn can result in fatigue.

Patients who normally were physically active often stop exercising, which also can increase fatigue.

Is there anything a patient can do to relieve cancer-related fatigue?

Management of fatigue is an integral part of a cancer patient’s care.

You can take many steps on your own. For one, constantly reassess your fatigue levels. Set up a routine and adjust your routine according to those levels.

Here are a few more recommendations:

Conserve your energy. Many patients try to maintain their normal daily routine, but they will not have the same energy levels as they had before their cancer diagnosis. Be realistic about what you can do. Evaluate your energy level – what eats up your energy, when you have the most energy and when you have the least energy. Save your energy for when you need it most. To help maintain your energy, drink lots of water and eat a whole-food, plant-based diet to the best of your ability 

Pace yourself. Expect activities and tasks to take a little longer. Do one thing at a time and take short breaks. Set aside time in your day to rest in between activities. Take a short nap earlier in the day so you can sleep well at night.

Exercise. It will not zap your energy; in fact, research shows just the opposite – low to moderate exercise will improve energy levels. Just don’t overdo it. 

Keep a fatigue journal. Track your fatigue levels in the morning, mid-day and in the evening to determine when you are most tired. Rest when your fatigue levels are the highest. Try not to stay in bed all day. 

Eat healthy foods. Nutrient deficiencies can cause fatigue because cancer steals the body of vitamins and nutrients. Maintaining good nutrition can help you feel better and give you more overall energy. Eating a whole-food, plant-based diet with plenty of proteins will give your body the optimal resources it needs to help rebuild and repair damaged body tissue. 

Drink plenty of water and other electrolyte-infused liquids to help prevent dehydration, especially if you have excessive vomiting or diarrhea. Your physician also may recommend you talk with a dietitian who will develop a healthy eating plan for you. Processed foods are not healthy foods. Do not include these in your diet.

Practice good sleep hygiene. This means setting up a regular bedtime routine that includes relaxing activities, meditation, quiet music, simple yoga, stress reduction techniques, and a quiet environment with no computers or phones.

Ask for and accept help. Prioritize. Delegate tasks. Decide what activities are important to you, and which ones you can delegate. When friends and family offer help, allowing them to do so doesn’t make you weak, it makes you better able to conserve and direct your body’s resources. People who care about you desperately want to take away any negative feelings you may be experiencing, so by accepting their help, you are allowing them to feel useful and productive, which in turn also makes life better for you.

Because cancer-related fatigue can be caused by many factors, your physician may suggest more than one method to reduce your symptoms. Listen to your physician’s advice.

How long does cancer-related fatigue last?

In general, it can last throughout your treatment and up to 12 months or more after treatment. Some patients report that it lasts longer. The good news is that it does go away. Most patients will see a gradual decrease in fatigue and increase in energy levels.  

Not every cancer patient will experience fatigue. If you do, the level of fatigue can vary from day to day – one day you may feel mildly tired, and the next day you are completely exhausted.

Finally, expectation is everything! If you expect your fatigue to disappear and your energy level to “return to normal” three weeks after completing chemotherapy, surgery or radiation, you inevitably will be frustrated and disappointed. Have realistic expectations and BE KIND TO YOURSELF.

Make sure to tell your physician

Don’t assume the fatigue you’re experiencing is just part of the disease and you have to live with it. Often, patients don’t realize that fatigue is impacting their life because they assume what they are feeling is a sign the cancer is progressing. Your level of fatigue does not necessarily mean the cancer is advancing. That is why it is important to talk with your physician, especially if the fatigue is persistent and chronic, and interferes with your ability to perform everyday tasks.

Many patients think there is nothing the doctor can do so they just live with this condition. Your physician can help you. He/she will conduct an indepth assessment, review the medications you are taking and determine the best way to treat and manage your fatigue.

If you are concerned about cancer-related fatigue, the breast surgeons at Comprehensive Breast Care are happy to schedule a consultation. Simply call 248.687.7300. The team – comprised of Eric Brown, MD, FACS; Linsey Gold, DO, FACOS, FACS; and Ashley Richardson, DO – will listen to and hear your concerns, and use the latest medical and scientific knowledge combined with the most advanced surveillance and diagnostic methods to develop a unique treatment plan that meets your needs.

 


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