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Why am I always tired?

Note: This post is written by the team of The ONE Group (Oncology – Nutrition – Exercise) at Penn State College of Medicine as part of a first-person blog about their work. Learn more about the group here.

Do you sometimes experience constant and debilitating fatigue? Do you feel as though rest doesn’t help alleviate this fatigue? If you are a patient with cancer or a cancer survivor, you might be experiencing cancer-related fatigue, which is a common side effect of cancer and its treatment.

Cancer-related fatigue is very different from fatigue experienced by people who haven’t had cancer. It is much more pervasive and debilitating. Indeed, cancer-related fatigue can make you too exhausted to enjoy life. This type of extreme fatigue doesn’t get better with rest or sleep, and can sometimes last for months or years.

There are some factors that increase cancer-related fatigue over which you have no control.

  • Women are more prone to experiencing cancer-related fatigue than men.
  • Cancer type and treatment you received can also impact your levels of fatigue.

The good news, however, is that you may have control over other factors that are associated with level of fatigue. Research has found that people who experience symptoms of depression, anxiety, and distress report higher cancer-related fatigue. Meeting with a psychologist can help you manage these symptoms, which can in turn reduce cancer-related fatigue. Having comorbid medical conditions (e.g., heart disease, respiratory impairments, depression) can also exacerbate cancer-related fatigue. Managing these conditions with your care team, or, seeking an expansion of your care team, can help you feel less fatigued.

One of the factors that has the biggest impact on levels of cancer-related fatigue is a lack of physical activity. Engaging in physical activity can not only help you feel less tired but has the added benefit of improving your mobility and physical function (e.g., going up stairs and other activities of daily living). Additionally, evidence has shown that in cancer patients, exercise improves anxiety and symptoms of depression (which are intertwined with cancer-related fatigue). Clinical practice guidelines recommend the use of moderate-intensity physical activity, such as brisk walking or using a stationary bike to reduce fatigue. For more information, I invite you to read our October post: “But I’m tired, why should I exercise?”

If you are tired of feeling tired, try focusing on modifying factors that can worsen fatigue, such as depression symptoms, anxiety, and physical activity level! If you’d like help in figuring out ways to safely increase your physical activity level, visit the Cancer Assistance and Resource Education (CARE) Center on the second floor of the Penn State Cancer Institute.

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