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Always Tired?

Fatigue is the most common symptom in people with advanced cancer.  This is not normal tiredness. The fatigue associated with advanced cancer can range from feeling tired to being absolutely exhausted. As well, cancer related fatigue is less likely to be relieved by rest or sleep and it can disrupt everyday life.

Cancer related fatigue may result from the sheer duration of your illness, stress and anxiety, treatment or its side-effects, lack of appetite and therefore nourishment or additional medical conditions (eg. cardiac disease). Other symptoms such as ongoing pain, vomiting, diarrhoea and breathing difficulties can also lead to fatigue.

When fatigue is related to treatment, it will often vary according to when you receive chemotherapy or radiotherapy. It is normal to feel most fatigue a few days after chemotherapy, whereas fatigue may peak several weeks after radiotherapy. Typically, fatigue will decrease after that, but it may persist for some time after treatment.

Regardless of its cause, fatigue may make you emotional and impatient, which can test your relationship with family and friends. You may also find that you no longer enjoy what you do, that you want to isolate yourself from friends and family and that you have trouble thinking, speaking or making decisions.

Some specific signs of cancer-related fatigue include:

  • Feeling much more fatigued than usual, feeling like you have less energy or needing to rest often.
  • Feeling weak or feeling like your limbs are just too heavy.
  • Not being able to concentrate or pay attention as much as you used too.
  • Not finding interest in your usual activities.
  • Having difficulty sleeping (insomnia), or sleeping too much (hypersomnia).
  • Not feeling as rested as you would expect after a good night’s sleep.
  • Finding it really difficult to overcome inactivity.
  • Being really upset because you are always fatigued.
  • Having difficulty completing your daily tasks.
  • Perceived problems with short-term memory.
  • Feeling unwell for several hours after activity.  

Fatigue is a very subjective experience, which means that only you really know how it feels and you may find it difficult to describe your fatigue to others. You can complete the fatigue assessment (74kb pdf) to help you communicate with your family, friends and health care providers about fatigue.   

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Life, Hope & Reality was developed and written by Afaf Girgis, Claire Johnson, and Sylvie Lambert with funding from the NHMRC and Cancer Council NSW.

Last updated 30 August 2015