What is fatigue? What may contribute to fatigue?
What is fatigue?
Fatigue as a symptom of cancer or side effect of treatment goes well beyond simply feeling temporarily tired or worn out, such as from a sleepless night. It is “unexplained, persistent, and relapsing exhaustion,”1How Tired Is Too Tired? Web MD. April 21, 2021. Viewed May 11, 2022. and it “lasts longer, is more profound and isn’t relieved by rest.”2Mayo Clinic staff. Fatigue. Mayo Clinic. December 2, 2020. Viewed May 11, 2022.
Caregivers can also experience fatigue. Caregiver fatigue occurs when the caregiver feels physically, emotionally, and physically exhausted, often leading to a change in attitude. Neglecting your mental and physical health and allowing long-term stress to linger can result in caregiver burnout.3Stringfellow A. What is Caregiver Fatigue? Seniorlink Blog. March 11, 2019. Viewed May 17, 2022. Caregivers often give priority to the health and well-being of their loved one needing care, forgetting to care for themselves. Preventing fatigue or addressing it when it first arises with good self care is essential for the well-being of both you and your loved one.
What are the signs or symptoms of fatigue?
Warning signs of impending cancer-related fatigue:4Cancer Fatigue. Cleveland Clinic. September 8, 2021. Viewed May 24, 2022.
Tired eyes
Tired legs
Whole body tiredness
Stiff shoulders
Decreased energy or lack of energy
Inability to concentrate
Weakness or malaise
Boredom or lack of motivation
Sleepiness
Increased irritability
Nervousness, anxiety or impatience
Symptoms of fatigue
From the Moffitt Cancer Center5Cancer-Related Fatigue. Moffitt Cancer Center. July 15, 2015. Viewed May 24, 2022.
Chronic tiredness or sleepiness unrelieved by a good night’s sleep
Feeling tired even after having slept
No energy to perform regular activities
Difficulty concentrating or remembering things
Feeling negative, irritable, impatient, or unmotivated
Lacking interest in everyday activities
Less than your usual attention to your personal appearance
Sleeping more or spending more time in bed
Symptoms associated with caregiver fatigue
From the Seniorlink Blog6Stringfellow A. What is Caregiver Fatigue? Seniorlink Blog. March 11, 2019. Viewed May 24, 2022.
Feeling overwhelmed and constantly worried
Feeling tired often
Withdrawal from friends and family members
Lack of motivation for caregiving and for trying new things
Losing interest in things you used to enjoy
Excessive alcohol or drug use, including sleeping pills
Having frequent headaches, bodily pain or other physical symptoms
Missing doctor’s appointments and other responsibilities
Being unable to fall and stay asleep or sleeping too much
Feeling angry
Feeling sad or depressed—hopelessness, alienation, helplessness, irritability
Resentment toward the person you care for, possibly leading to anger
What may contribute to fatigue?
These situations may trigger or worsen fatigue among people with cancer:
- Alcohol or drug use
- Excess physical activity
- Lack of physical activity
- Medications, such as antihistamines, cough medicines, or sedatives
- Not enough sleep
- Unhealthy eating habits
- Consuming excess caffeine
- Metabolic or hormone imbalances
- Infection
Pain may worsen fatigue.7Charalambous A, Giannakopoulou M, Bozas E, Paikousis L. Parallel and serial mediation analysis between pain, anxiety, depression, fatigue and nausea, vomiting and retching within a randomised controlled trial in patients with breast and prostate cancer. BMJ Open. 2019 Jan 24;9(1):e026809. Inflammation, which can also lead to pain, is also independently linked to fatigue.8Wang A, Ling Z et al. Gut microbial dysbiosis may predict diarrhea and fatigue in patients undergoing pelvic cancer radiotherapy: a pilot study. PLoS One. 2015 May 8;10(5):e0126312. Alleviating either fatigue or pain to interrupt the feedback loop between them may provide relief of both symptoms.
Medications and therapies
Some medications used during cancer treatment or for other conditions may trigger fatigue. Check the inserts with any prescription medications you use or ask your pharmacist if you have concerns.
Some cancer treatments can cause fatigue, such as radiation therapy, surgery, and some drugs, hormone therapies, and immunotherapies.
Drowsiness is a side effect of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) and many other prescription medications.
Some complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies may contribute to fatigue:
- Fatigue or lack of energy (lethargy) is a side effect of cannabis; strong evidence shows higher risks of sleepiness or drowsiness among people using cannabis ›
- Fatigue is a side effect of copper chelation ›
- Lack of energy (lethargy) or fatigue is a side effect of a ketogenic diet ›
Other therapies that may contribute to short-term fatigue:
Risk factors for fatigue
In addition to cancer and treatment-related risk factors, people with these conditions are at higher risk of fatigue:
Overweight or obesity
Grief
Heart disease
Mental health issues, such as depression or anxiety
Sleep problems
Illness:
- Cancer
- Rheumatology illnesses such as rheumatoid arthritis and systemic lupus
- Fibromyalgia
- Chronic fatigue syndrome
Caregiver fatigue
Risk factors for caregiver fatigue:9Mayo Clinic staff: Caregiver stress: tips for taking care of yourself. Mayo Clinic. March 22, 2022. Viewed May 24, 2022.
Being female
Having fewer years of formal education
Living with the person you are caring for
Social isolation
Having depression
Financial difficulties
Higher number of hours spent caregiving
Lack of coping skills and difficulty solving problems
Lack of choice in being a caregiver
Situations that may trigger or worsen caregiver fatigue:10Stringfellow A. What is Caregiver Fatigue? Seniorlink Blog. March 11, 2019. Viewed May 24, 2022.
Role strain, feeling overwhelmed and unable to perform a caregiver role to the best of your ability
Unreasonable demands from your care recipient, other family members, work, or other sources)
Unrealistic expectations
Lack of control including lack of resources for caregiving, such as time or money
Poor health
Continue exploring
References