When To Call Your Doctor
Although cancer-related fatigue is a common side effect of cancer and its treatments, you should mention any of your concerns to your doctor. There are times when fatigue may be a clue to an underlying medical problem. Other times, there may be things your doctor can do to help control fatigue.
Be sure to let your doctor or nurse know if you have:
- Shortness of breath
- Side effects from treatments
- Anxiety or nervousness
Stiff Joints And Muscles
Radiotherapy can sometimes make your joints and muscles in the area being treated feel stiff, swollen and uncomfortable.
Exercising and stretching regularly can help to prevent stiffness.
Tell your care team if joint or muscle stiffness a problem. They may refer you to a physiotherapist, who can recommend exercises for you to try.
How Can I Manage My Symptoms
- Manage your fatigue. Do short periods of physical activity to help decrease fatigue. Walk for 15 to 30 minutes each day. You can also take a short bike ride or ride an exercise bike. Take short naps throughout the day. Do not sleep for more than 1 hour at a time during the day. Ask for help from family or friends with chores and other activities that cause fatigue. Ask your healthcare provider for other ways to manage fatigue.
- Care for your skin as directed.
- Wear loose-fitting clothing over the area being treated.
- Use a mild soap and warm water to bathe. Do not use very hot or very cold water on areas of your skin being treated.
- Do not rub or scratch the area of skin being treated.
- Wear sunscreen, hats, and clothing to protect your skin when you are outside.
- Apply lotions, creams, or ointments as directed. Do not put anything on your skin before you ask your healthcare provider.
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Current Treatment Of Rif
There is no optimal pharmacologic therapy for RIF. NCCN Practice Guidelines in Oncology currently recommend five non-pharmacological interventions to manage fatigue related to cancer and/or cancer therapy, which include activity enhancement, psychosocial improvement, attention-restoring therapy, nutrition, and sleep . For pharmacologic interventions, the NCCN guidelines recommend that after ruling out other causes of fatigue, the use of psychostimulants should be considered. Methylphenidate has been recommended, but available literature reports conflicting results in methylphenidateâs ability to improve fatigue in two small, randomized clinical trials . Recent studies have shown that another psychostimulant, modafinil, does not significantly improve fatigue or HRQoL of glioma patients undergoing RT .
A broad range of non-pharmacological interventions to alleviate fatigue have been evaluated. These include psychosocial interventions , complementary and alternative therapies , physical exercise interventions . However, even if non-pharmacological interventions reduced RIF, the mechanism behind the effect of these interventions on CRF remains unclear and the effect sizes of these treatments on CRF are small.
Can Sleep Be Improved To Reduce Cancer Fatigue
Sleep is an important part of wellness. Good sleep can improve your mental and physical health. Several factors contribute to how well you sleep, and there are things you can do to improve your sleep, including:
- Doing relaxation exercises, meditation or relaxation yoga before going to sleep.
- Avoiding long afternoon naps.
- Going to bed only when sleepy. Use your bedroom only for sleep and sexual activities.
- Setting a consistent time to lie down and get up.
- Avoiding caffeine and stimulating activities in the evening.
- Establishing a relaxing pre-sleep routine.
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How Long Do Side Effects Last
Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.
Should I Change The Way I Eat To Combat Cancer Fatigue
Cancer fatigue may be worse if you’re not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. The following strategies can help you improve your nutritional intake.
- Basic calorie needs. A person with cancer whose weight has been stable needs about 15 calories per pound of weight each day. For example, a person who weighs 150 pounds needs about 2,250 calories per day to maintain weight. You should add 500 calories per day if you have lost weight.
- Protein rebuilds and repairs damaged body tissue. You need about 0.5-0.6 grams of protein per pound of body weight to rebuild and repair body tissue. For example, a 150-pound person needs 75 to 90 grams of protein per day. The best sources of protein include foods from the dairy group and meats .
- Fluid needs. Unless your healthcare provider tells you otherwise, you should aim for about 64 ounces per day to prevent dehydration. Fluids include juice, milk, broth, milkshakes, Jello® and other beverages. Of course, water is fine, too. Its important to note that beverages containing caffeine do NOT count. And if you are losing fluid from excessive vomiting or diarrhea, you will need extra fluids.
- Supplemental vitamins. Talk with your healthcare provider to find out if vitamin supplements are a good idea for you. Vitamin supplements don’t provide calories, which are essential for energy production. So vitamins cannot substitute for adequate food intake.
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Prevalence Of Cancer Related Fatigue
About 50%90% of cancer patients worldwide experience cancer-related fatigue.
The following symptoms begin after a week or so of the first radiation treatment:
- Feeling tired or lethargic throughout the day
- Reduced energy
Walking from the parking lot to your office may take longer and it may be difficult to accomplish physical tasks. Fatigue can be extremely frustrating because you aren’t quite sleepy, but you just don’t have enough energy to do much.
Fatigue does affect everyone differently. Some may experience mild fatigue, while others may suffer from severe chronic fatigue that affects their quality of life considerably. Your fatigue may increase over time as you undergo more radiation therapy treatments.
Pain And Skin Changes
During and just after treatment, your treated breast may be sore. Talk with your health care provider about using mild pain relievers such as ibuprofen, naproxen or acetaminophen to ease breast tenderness.
The treated breast may also be rough to the touch, red , swollen and itchy. Sometimes the skin may peel, as if sunburned. Your health care provider may suggest special creams to ease this discomfort.
Sometimes the skin peels further and the area becomes tender and sensitive. Its most common in the skin folds and the underside of the breast. If this occurs, let your radiation team know. They can give you creams and pads to make the area more comfortable until it heals.
Fatigue is common during radiation therapy and may last for several weeks after treatment ends.
Fatigue is mainly a short-term problem, but for some, it can persist .
You may feel like you dont have any energy and may feel tired all of the time. Resting may not help.
Regular exercise, even just walking for 20 minutes every day, may help reduce fatigue . Getting a good nights sleep is also important.
Talk with your health care provider if you are fatigued or have insomnia .
Learn more about fatigue and insomnia.
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What Are The Late Side Effects From Radiation Therapy
Late side effects from radiation therapy take months and sometimes years to show up and usually donât go away. But not everyone will have them.
These problems happen when radiation damages your body. For example, scar tissue can affect the way your lungs or your heart works. Bladder, bowel, fertility, and sexual problems can start after radiation to your belly or pelvis.
Another possible late effect is a second cancer. Doctors have known for a long time that radiation can cause cancer. And research has shown that radiation treatment for one cancer can raise the risk for developing a different cancer later. Factors that can affect that risk include the amount of radiation used and the area that was treated. Talk with your doctor about the potential risk and how it compares to the benefits youâll get from radiation therapy.
How Does Radiotherapy Contribute To Fatigue
The cancer itself may contribute to your sense of fatigue as well. While radiotherapy seeks to eradicate cancer by destroying cancer cells with radiation, it also increases the level of fatigue a person feels.
Lets take a moment to think about how radiation therapy works. A team of experts use technology to provide a lethal dose of radiation to a targeted area of cellular tissue. In those living with cancer, radiation leads to cellular death at the target site. As a result, the immune system responds to repair the damage. In this case, the remnants of cancerous tissues are removed from the body.
Unfortunately, some healthy cells near the target area may also receive this dose of radiation. Although technology has advanced light-years in terms of focusing radiation on a specific area, the destruction of healthy cells will naturally lead to an increase in fatigue. For instance, radiotherapy for prostate cancer may result in fewer healthy cells affected than treatment on another area, such as the lungs.
Now, everyone responds to radiation therapy differently, and the exact type of cancer will affect your sense of tiredness as well. For example, if treatment destroys too many red blood cells, a person may develop anemia. Anemia, as a medical condition, is associated with increased fatigue. Meanwhile, larger cancers, requiring a prolonged dose of radiation, will lead to excessive tiredness too.
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What Are Common Side Effects Of Radiation Therapy
Radiation therapy is called a local treatment. This means that it only affects the area of the body that is targeted. For example, radiation therapy to the scalp may cause hair loss. But people who have radiation therapy to other parts of their body do not usually lose the hair on their head.
Common physical side effects of radiation therapy include:
Skin changes. Some people who receive radiation therapy experience dryness, itching, blistering, or peeling. These side effects depend on which part of the body received radiation therapy and other factors. Skin changes from radiation therapy usually go away a few weeks after treatment ends. If skin damage becomes a serious problem, your doctor may change your treatment plan. Lotion may help with skin changes, but be sure to check with your nurse or other health care team about which cream they recommend and when to apply it. It is also best to protect affected skin from the sun. Learn more about skin-related side effects.
Fatigue. Fatigue is a term used to describe feeling tired or exhausted almost all the time. Many patients experience fatigue. Your level of fatigue often depends on your treatment plan. For example, radiation therapy combined with chemotherapy may result in more fatigue. Learn how to cope with fatigue.
Risk Factors And Prevention
Pretreatment fatigue levels have been proposed as an essential risk factor for fatigue development during RT . Diagnosing fatigue and recognizing it as a predictor for this condition during treatment within the first appointments seems to be of uttermost importance. Other factors influencing the grade of severity of RIF that have been described in the literature include the diurnal rhythm, where morning fatigue appears to be more affected by biologic factors and evening fatigue by behavioral factors. Another factor is smoking, with smokers experiencing considerably more fatigue than non-smokers. Time-to-hospitalization appears to influence the grade of severity of RIF, with significantly worse symptoms of fatigue in patients who had to travel 2 or more hours compared to patients who had to travel < 2 h . Factors such as stress, anxiety, depression, a weakened physical condition, diarrhea, malnourishment, and anemia possibly further deteriorate fatigue . Geinitz et al. observed a significant increase in pretreatment fatigue levels compared to posttreatment values. In women with depression and anxiety, fatigue levels were reported to persist for more than 2 years after the termination of RT. Contrary to that, disease staging and neoadjuvant chemotherapy did not impact the severity of fatigue in a study performed by Lavdaniti et al. .
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When To See Your Healthcare Provider
Many people underestimate fatigue and fail to discuss it with their practitioner. Severe fatigue that does not resolve with the tips above should be reported to your healthcare provider.
There can be underlying medical reasons for fatigue, such as anemia, that may need to be addressed. Your healthcare provider may be able to determine what is contributing to your fatigue and offer solutions.
- Memory problems, confusion, or brain fog
- Cant get out of bed
- Severe pain
Home Remedies For Radiation
A few principles that may help as well include:
- Rest when you are tired.
- Pace yourself throughout the day.
- Eat healthful, well-balanced meals.
- Accept help from others.
- Exercise daily, even a few minutes of light exercise, such as walking, may help. It may sound counterintuitive, but small amounts of exercise can significantly reduce cancer fatigue.
- Try to get plenty of sleep at night, and nap during the day, if needed.
- Check out these tips for coping with cancer fatigue.
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If Youre Getting Radiation Therapy To The Abdomen
If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:
Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.
These problems should get better when treatment is over.
Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.
If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.
Take Charge Of Your Stress
Managing stress can play an important role in fighting fatigue. Here are some suggestions that may help.
- Adjust your expectations. For example, if you have a list of 10 things you want to accomplish today, pare it down to two and leave the rest for other days. A sense of accomplishment goes a long way toward easing stress.
- Help others understand and support you. Family and friends can be helpful if they can put themselves in your shoes and understand what fatigue means to you. Cancer support groups can be a source of strength, too. Other people with the disease may understand what you’re going through.
- Relaxation techniques like deep breathing or visualization can lower stress, too. Or just do low-key things that are fun for you: read, listen to music, or knit, for example.
Let your doctor know if your stress seems out of control. They can help you feel better.
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Questions To Ask The Health Care Team
What physical side effects are likely based on my specific radiation therapy treatment plan? When will they likely begin?
How can these side effects be prevented or managed?
How can I take care of the affected skin during my treatment period?
Who should I tell when a side effect appears or gets worse?
Are there specific side effects I should tell the doctor about right away?
Who can I talk with if I’m feeling anxious or upset about having this treatment?
If I’m having side effects that affect my nutrition, can you recommend an oncology dietitian?
What are other ways I can take care of myself during the treatment period?
Are there any restrictions on exercising or other physical activity during this treatment?
Could this treatment affect my sex life? If so, how and for how long?
Could this treatment affect my ability to become pregnant or have a child? If so, should I talk with a fertility specialist before cancer treatment begins?
What are the potential long-term effects of this type of radiation therapy?
If I’m worried about managing the financial costs of cancer care, who can help me?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
After radiation therapy is completed, what will my follow-up care plan be?
Why is follow-up care important for managing side effects of treatment?