- Fatigue that is not proportional to recent activity
- Fatigue that interferes with usual functioning
- A good night sleep or rest does not reduce the fatigue
- Associated muscle weakness
- Difficulty in concentration
- Confusion or mental fog
- Reduced sex drive
- Irritability or depressed mood
People often describe lymphoma fatigue (or treatment-related fatigue) as feeling:
- Extremely tired
- Like they have no energy to get-up-and-go
Such fatigue is often more severe compared to the usual fatigue in healthy people. The lymphoma fatigue may persist for months to years even after the cancer is in remission.
How do you know if the fatigue is cancer?
If your fatigue is accompanied by the symptoms and signs mentioned below, these may be the danger signs of cancer.
If you experience any of the following, you should visit your doctor and get tests done:
- Unexplained weight loss
- Fever in the absence of a definitive cause
- Body or bone pain
- Skin changes such as unusual bruising, rashes, and bleeding spots
- Change in bowel habits
- Abnormal bleeding from any orifice (mouth, vagina, nose, or anus)
- Pain during or after passing stools, urine, or sexual intercourse
- Any mole, ulcer, scar, or wound that looks abnormal, itches, and refuses to heal
- Unexplained swellings or enlarged glands in groin, armpits, or neck
- Bloating or palpable mass in the abdomen
The list above is not exhaustive. It is advisable to visit your doctor if you have a high risk of developing cancer (due to family history or lifestyle) and get yourself regularly screened.
Why does lymphoma cause fatigue?
Lymphoma is a malignant (cancerous) condition where the white blood cells develop a mutation (DNA alteration) and multiply uncontrollably. These cells have no physiological function but act as parasites in the body and compete with normal cells for oxygen and nutrition. This starves the normal cells resulting in fatigue.
- The cancer cells may also cause a pro-inflammatory state causing the release of chemicals such as interferon-alpha and tumor necrosis factor-alpha that may result in fatigue.
- Sometimes, the invasion of organs such as lungs, kidneys, or heart by the tumor cells may cause fatigue.
- The cancerous invasion of the thyroid, pancreas, or chemotherapy-induced damage to the endocrine system may also cause fatigue due to hormonal imbalances.
- The anxiety and depression associated with lymphoma diagnosis may also cause fatigue due to low moods and mental anguish.
- The treatment with steroids may result in diabetes and suppression of adrenal hormones causing fatigue.
- You may develop comorbid conditions such as lung fibrosis, hypertension, muscle weakness, or poor heart function due to chemotherapy that may result in fatigue.
Another important cause of fatigue is low red blood cells due to cancer and chemotherapy.
Rarely, another cancer may be present along with existing lymphoma, which may cause fatigue. Taking opioids for cancer pain may make you sluggish. The presence of infection or fever is another trigger for fatigue.
Chemotherapy-related fatigue is often long-standing and common. It may be present for months after the sessions are terminated. Fatigue is also common in people with advanced cancer who are not undergoing active cancer treatment.
How to manage lymphoma-related fatigue
Treatment often aims to treat the underlying cause of fatigue, if possible. You may discuss the options with your physician. Fatigue-related anemia may get better with blood transfusion. Infection management may require an antibiotic course.
- A diet rich in vitamins (including vitamins D and B12), proteins, and other nutrients may help alleviate symptoms in some cases.
- Adequate hydration to flush through toxins and waste products can help with fatigue.
- Counseling and drugs to help with cancer-related depression.
- Regular meditation and physical exercise as per your physician’s recommendation.
- Management of associated symptoms such as pain, vomiting, or nausea may help with fatigue as well.
- Maintain a regular sleep schedule and make sure you sleep well.
- Diagnosis of thyroid disorder and diabetes and maintenance of blood sugar levels will also help.
- For patients who have advanced lymphoma or those who are currently receiving cancer treatments, some psychostimulant drugs such as methylphenidate or modafinil may help with mental sluggishness. Discuss the same with your doctor.
- Avoid excess caffeine, alcohol, and sodas
- Find a support group and make friends who understand what you are going through.
- Short naps in the noon may help a lot of people.
Here are some other tips that may help you if the underlying cause of fatigue is not diagnosed:
- Keep notes: Keep a diary to highlight the times of the day or times related to treatment cycles when you have maximum energy. You can mark these times for work or as family time.
- Document: Does gardening make you feel better? Do you feel exhausted after cooking? Note which activities make you feel fatigued. Plan your day accordingly. Include activities that make you feel happier.
- Delegate: Ask family or friends for help where you cannot cope. They will be happy to help with chores and other everyday tasks. Make sure you schedule an appropriate time to rest between your daily activities.
- Prioritize: Accept the fact that you cannot manage everything at once. Do only what is essential and within your stamina.
- Organize: Keep the items you need most frequently where you can find them.
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