Tiredness and fatigue Hiamoe

The difference between fatigue and tiredness

Fatigue is often confused with tiredness.

Everyone feels tired, especially after physical activity or at the end of the day. Usually, you know why you are tired and a good night’s sleep solves the problem.

Fatigue is overwhelming tiredness and lack of energy. It does not get better after rest or sleep. 

Fatigue is one of the most common side effects of cancer and its treatment. It can happen to anyone, with any type of cancer, at any time during or after treatment. 

The symptoms of fatigue for people affected by cancer can range from mild to severe and make your daily activities hard to do.

Causes of cancer-related fatigue

The exact reason for fatigue is often unknown, but it is thought to have a combination of causes, such as:

• the cancer itself
• the treatment you are having
• other health conditions you may have 

Other causes can include:

Infection
Chemotherapy can weaken your body’s ability to fight off infections. Fatigue may be one of the first signs of infection, especially if fatigue comes on quickly. If you have a body temperature of over 38°C or other fever symptoms, follow your treatment team's advice.

Anaemia
Anaemia is when there is not enough haemoglobin (a substance in red blood cells that carries oxygen around the body) in your blood. Anaemia can cause fatigue, but it is treatable.

Low levels of thyroid hormones (hypothyroidism)
This can occur after radiation treatment to the lymph glands in the neck, including the thyroid gland. It can be treated with medication.

Medications
Some medications used to treat side effects can cause fatigue, and some medications for other conditions you might have.

Pain
Dealing with pain can make you feel very tired, so managing your pain can help.

Stress and anxiety
Stress and anxiety can increase fatigue levels. You may find counselling or relaxation exercises useful. 

Depression
Fatigue is a common symptom of depression. If your mood is low, and you have lost interest in things you used to enjoy, you may benefit from treatment for depression.

Interrupted sleep
Interrupted sleep can occur due to pain, being in hospital, worry and nausea.

What you can do about cancer-related fatigue

• be aware of your own warning signs of fatigue, for example, a loss of appetite, low mood, difficulty concentrating
• help others to understand and let them support you
• talk to family/whānau and friends, and don’t be afraid to ask for help
• pace yourself, think about your energy levels and balance activity and rest
• if you need time to rest during the day, don’t be afraid to say no to visitors
• have lots of nutritious snacks and meals
• regular moderate exercise can help with tiredness and a lack of energy

How long will the fatigue last?

Cancer-related fatigue may begin to ease when treatment ends, but many people will continue to feel fatigued for some time after treatment is finished.

It is not uncommon for fatigue to go away, only to return. You may be frustrated if your recovery takes longer than you expected. Try to be patient with yourself.