Fatigue

Fatigue is the most common side effect of lymphoma treatment. This can be very different from normal tiredness as it does not necessarily go away with more rest or sleep. It can last for weeks or months after treatment and can arise as a result of, or be exacerbated by, physical and psychosocial issues.

From a physical perspective, it can arise as a result of anemia (low levels of red blood cells) that persists well after treatment, reduced thyroid gland function (a gland in your body that makes a metabolism-controlling hormone), deconditioning (reduced physiological function after a period of reduced physical activity), and nutritional deficiencies. Fatigue can be accentuated by other underlying health issues.

From a psychosocial perspective, during treatment your body was in a heightened “fight-or-flight” mode to “attack” and “battle with” your lymphoma. However, once treatment stops, your mind and body begin to relax and you begin to feel the symptoms of fatigue. Other social stressors may begin to arise such as friends and family withdrawing physical and emotional support (as they may perceive that you are now able to cope on your own), financial concerns, and work-related stress. These may lead to other issues such as stress, difficulty sleeping, depression, and anxiety which can further worsen your symptoms of fatigue and can have a serious impact on your quality of life.

You may feel too tired to participate in daily work or school activities or spend time with friends or family. Your fatigue can lead to mood changes that can lead to memory problems and confusion.

There are some things that you can do to help alleviate your symptoms of fatigue:

  • Ask for help: many of your supporters may assume that their help is no longer needed especially once treatment is over
  • Accept help: allow others to assist you with daily tasks that may still be too difficult for you to do
  • Plan ahead: participate in activities when you have the most energy, have rest periods between activities, and choose activities that you enjoy the most
  • Exercise regularly: fatigue tends to be less common in those who exercise regularly
  • Eat well: make healthy food choices to optimize your energy levels

If you don’t notice an improvement, be sure to talk to your doctor about your fatigue before it affects other areas of your health – there are other techniques that can help or your doctor may refer you to other specialists such as physical therapists, occupational therapists, nutritionists, or counselors.

References:

Canadian Cancer Society. Late and long-term effects of treatment
Accessed June 3, 2014

Gillis A and MacDonald B. Deconditioning in the hospitalized elderly.
Can Nurse 2005 Jun;101(6):16-20

Lymphoma Association. Late effects of lymphoma treatment
Accessed June 3, 2014

National Cancer Institute. General Information About Fatigue
Accessed June 3, 2014

National Cancer Institute. Facing Forward: Life After Cancer Treatment. Ways to Manage Physical Changes
Accessed June 3, 2014