If you have mesothelioma, you have probably experienced fatigue. Fatigue is one of the most common mesothelioma symptoms, and is also one of the most common side effects of mesothelioma treatment. However, despite being experienced by almost all mesothelioma patients, fatigue is often misunderstood. In this article, we will explore mesothelioma fatigue, including how it differs from regular tiredness, what causes it, and what you can do about it.
What is fatigue?
Fatigue is an unusual lack of energy, tiredness, or exhaustion. It is different from the sort of tiredness a person feels normally, such as feeling wiped out after a long day. Rather, fatigue can make someone feel totally exhausted after only a small amount of activity or effort. In addition, someone with fatigue may continue feeling exhausted even after sleeping or resting, and may also have difficulties thinking clearly, remembering things, or otherwise going about their daily lives. People with fatigue may lose the motivation and ability to do things or complete everyday tasks—even things they normally enjoy.
Most people experience some combination of three types of fatigue:
- Physical Fatigue: This is fatigue experienced in the body. It often presents as full-body exhaustion, tired muscles, or heavy limbs that make it difficult to move. The physical symptoms of fatigue can come from very small or ordinary amounts of activity (such as taking a shower), or from no activity or exertion at all. For someone with physical fatigue, tasks like bringing in groceries or washing the dishes start to feel like running a marathon.
- Mental Fatigue: Mental fatigue affects a person’s cognitive functioning, or their ability to think and process information clearly. It can become more difficult to initiate or finish tasks, to remember things, and to pay attention. This sort of fatigue can be particularly difficult to identify, since it may happen gradually and may take additional mental effort to pinpoint and explain.
- Emotional Fatigue: Like physical and cognitive functioning, emotional functioning also requires energy, and can feel difficult or overwhelming to someone with mesothelioma fatigue. Mesothelioma can cause many difficult emotions, including anxiety, fear, sadness, anger, frustration, and grief. Carrying this huge emotional load can be especially difficult for patients, who may feel like there is no reprieve from dealing with the most draining of these emotions, and like there is little time, space, or energy for other, more positive or enjoyable emotions. For some people, having emotional conversations or interactions can be especially draining while fatigued.
How common is mesothelioma fatigue?
The vast majority of mesothelioma patients experience fatigue of some sort. Importantly, mesothelioma fatigue affects each patient differently, and may change in how it presents at different points in each patient’s mesothelioma journey.
What causes mesothelioma fatigue?
Mesothelioma fatigue has many potential causes, and is often rooted in several issues at once, to varying degrees. These can include:
- Mesothelioma Treatments: Many mesothelioma treatments cause fatigue, including chemotherapy, radiation, surgery, and immunotherapy, as well as treatment complications and mesothelioma medications. Fatigue may begin or become worse after treatments, and may continue for weeks to months afterward.
- Anemia: Mesothelioma patients may experience anemia (decreased red blood cells). Red blood cells move oxygen to different parts of the body, so a low red blood cell count means less oxygen flow, which leads to feelings of weakness, dizziness, shortness of breath, and fatigue.
- Cancer Cells and Tumors: Cancer itself can lead to fatigue. Tumors and cancer cells can release toxic chemicals and proteins (such as cytokines), leading to hormonal changes that can cause and worsen fatigue. In addition, tumors that get in the way of breathing (especially among pleural mesothelioma patients) may further decrease oxygen supply and cause fatigue.
- Nutrition and Appetite: Mesothelioma patients often struggle to maintain their appetite, leading to the body not getting the energy and nutrients it needs to fuel itself. In addition, mesothelioma sometimes makes the body need more of certain nutrients, and may also make it difficult for the body to process food. These factors can lead to malnutrition, which can cause and worsen fatigue.
- Sleep Issues: Many mesothelioma patients experience sleep disturbances—either sleeping too much or too little. Sleep cycle disruption can cause fatigue, which can lead to a vicious cycle of increasingly worsening fatigue and sleep issues.
- Pain: Many mesothelioma patients experience chronic pain and discomfort, which itself can cause both short-term and long-term fatigue in mesothelioma patients.
- Lack of activity: It can be very difficult for mesothelioma patients to stay active. However, complete lack of activity can actually worsen fatigue, as it can lead to muscle wasting and other physical and psychological effects.
- Psychological Impact: Mesothelioma can cause extreme emotional responses in both patients and their loved ones. These powerful emotions can be very taxing, and can lead to depression and anxiety—both of which can cause and exacerbate fatigue.
- Infections: Mesothelioma patients are especially vulnerable to infections, especially during treatment regimens that include therapies like chemotherapy and radiation. Infections—especially chronic infections—can lead to fatigue.
What can I do to help with mesothelioma fatigue?
- Document your fatigue and talk to your doctor. It’s essential to address your fatigue with your mesothelioma care team. To help them treat you most effectively, you should come prepared with as much information as possible about your fatigue, including:
- When it started
- How long it has lasted
- Whether it comes and goes (and if so, for how long)
- Whether certain things make it better or worse
- What specific symptoms you experience
- How it affects your life
- Your current pain levels, diet, sleep habits, and level of exercise
Your doctor will ask you questions related to your fatigue, and may do testing to see if there are underlying medical issues that can be addressed. They may adjust your treatments, medications, or care to reduce your fatigue, and may also offer tips and guidance for coping with mesothelioma fatigue they cannot treat.
- Conserve your energy and plan your activity carefully. Don’t be afraid to say no. One of the best ways to combat fatigue is to save your energy for the most important things, focusing on what you can do and what you want to do. Know your “higher energy” times, and plan activities you like and look forward to during those times. Do not be afraid to say no to stressful or unwanted activities.
- Ask for help. Do not be afraid to ask for help, and to let people help you. Rely on your support system to help you with tasks that fatigue makes difficult or impossible.
- Get enough healthy food and sleep. Stay on-track with a healthy mesothelioma diet. Your mesothelioma care team can help with your specific needs, but try to stick to a high-calorie, high-protein diet with lots of fruits and veggies, and make sure to drink enough water. You should also maintain healthy sleep: take short naps throughout the day (ideally no more than 30 minutes at a time) to maintain energy without disrupting your sleep schedule.
- Stay active if possible. Seek guidance from your mesothelioma care team about the amount of activity that is right for you, but try to maintain some level of physical activity if you can. Choose activities you like, such as going on a walk with a friend, in order to maintain muscle mass and circulation, and boost your energy levels and mood.
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