Most mesothelioma sufferers complain about fatigue during and after treatment. It’s a normal symptom of treatment.

Fatigue is defined as weariness, lack of energy or exhaustion after exertion. Normal fatigue goes away with periods of rest or with effective stress management.

However, cancer-related fatigue (CRF) lasts longer, and it doesn’t resolve itself with rest or sleep. CRF is unpredictable because a mesothelioma patient may one day feel energetic but fatigued another day without any change in activity or rest patterns.

The National Cancer Institute reviewed many studies investigating CRF that indicated between 20 and 90 percent of patients on active treatment experience symptoms of fatigue. Studies show that 20 to 80 percent of cancer survivors reported fatigue after finishing treatment.

Symptoms of Cancer-Related Fatigue

Most cancer treatments lead to fatigue during and after treatment.

Some of these symptoms may include:

• Spending more time resting and sleeping
• Feeling too tired to work, clean, cook or engage in fun activities
• Tiredness after adequate sleep
• Feeling lethargic after minimal exertion
• Sudden and overpowering fatigue

For example, chemotherapy patients usually report fatigue a day or two after their treatments. The feeling of tiredness may improve during the chemo cycle or become worse with subsequent treatments. Post-chemotherapy fatigue may continue for up to a year or two after finishing chemotherapy.

Radiation therapy
causes cumulative fatigue as treatment progresses week by week. Post-treatment fatigue can last for a few weeks up to a few months after completing radiation therapy.

Bone marrow transplants (BMT) are challenging treatments, and patients report profound fatigue during their transplant. That fatigue can last up to a year.

There are many other potential contributors to CRF:

• Pain medication
• Nausea medications
• Treatment-related weight loss
• Stress
• Poor Sleep
• Depression
• Anemia or other blood component imbalances

How Can You Combat Cancer-Related Fatigue?

Discuss your fatigue with your oncologist and ask about determining its cause. If you are anemic, then you may need iron supplements or a transfusion. This may help your fatigue. If pain is leading to poor sleep, then perhaps improved pain control may help reduce fatigue.

Conserving your energy

Ration your energy. It is helpful to think of your energy like money in the bank.

You are on a tight energy budget because you have less energy in your bank. Most of us are used to spending our energy all day until we get everything done and then go to bed.

Most mesothelioma patients have to prioritize the activities they spend their energy on because there isn’t enough of it to do all the things they used to do.

Keep track of your energy levels throughout your chemo cycle. You will learn there may be certain times of the day — or days during your chemo cycle — when you have more energy. It is helpful to plan energetic activities during those times.

Do not use all your energy on housework or chores. It is important to give yourself permission to spend your energy on fun or pleasurable activities that improve your quality of life.

Schedule rest periods or naps instead of waiting until you feel very tired to rest.

Ask for help with long, arduous chores like vacuuming, yardwork and laundry.

Avoid long, hot showers as they sap your energy and make you want to crawl in bed.

Exercise

Oncologists recommend regular mild to moderate exercise to prevent cancer-related fatigue.

Activities such as walking, yoga and light weight training are suggested. Exercise minimizes the loss of muscle mass which is very common in cancer patients. When we lose muscle mass, we simply don’t have the strength to do things we used to do.

Cancer patients who regularly exercise during treatment report less pain and better sleep. Exercise is also great stress reliever.

Realistic expectations

Most mesothelioma patients struggle to accept that fatigue is part of their treatment and disease. Some expect they should be able to do more chores or social activities than their energy allows them.

It is helpful for mesothelioma patients to have realistic expectations of their energy levels and allow themselves to rest or take a nap when their bodies need it.

Nutrition

Nausea or lack of appetite contributes significantly to fatigue because you are not eating enough.

Part of the reason cancer patients lose muscle mass is because of insufficient caloric intake. Instead of burning calories for fuel, the body consumes muscle as fuel.

Oncology dietitians recommend high protein and high calorie foods to combat fatigue. Seek consultation from an oncology-registered dietitian to personalize dietary recommendations for your fatigue.

Using energy conservation, good nutrition and engaging in mild exercise will help reduce the impact of fatigue.

Having realistic expectations of how mesothelioma and its treatments affect energy will help cancer patients and their caregivers understand and cope with the usual tiredness.