Research into cancer fatigue
This page tells you about research into cancer fatigue. There is information on
There has been a lot of research interest in cancer fatigue in the past few years. Since treatment for pain and sickness has improved, many people with cancer say that fatigue is the symptom that has the most impact on them. A UK survey, published in 2003, looked at knowledge of cancer fatigue amongst doctors and people with cancer. They found that more than half of cancer patients had fatigue at some point.
Although the doctors they interviewed said they gave advice and treatment to about half their patients, only 1 in 7 of the patients (14%) recalled having been given any. The most common advice was to improve diet, take more exercise and rest. The commonest treatment was a blood transfusion. Carers were affected too. 1 in 5 carers had to take 3 or more days a month off work because their relative needed so much help. You can read a summary of this article on line.
A UK study in 2000 had similar results. They surveyed people with cancer in 3 hospitals. They asked first how many people with cancer had fatigue
- Nearly 6 out of 10 (60%) said fatigue was their main problem
- Only 2 out of 10 (20%) said pain was their main problem
- More than 8 out of 10 (80%) felt fatigued on a few days during each month
- Just over 5 out of 10 (50%) felt fatigued most days
- Fewer than 1 out of 10 (10%) people had never had fatigue
Then the researchers asked people how they thought their fatigue had been managed
- Over a third of people with fatigue felt it wasn't managed well
- Over 5 out of 10 (50%) people had never reported fatigue to their doctor
- Fewer than 2 out of 10 people had help or advice from their doctor
- Only 1 in 5 people (22%) thought that anything could be done about their fatigue
You can read a summary of this survey on line.
So people with cancer are not getting enough help for their fatigue. In many cases they don't understand the likely causes of tiredness and don't think anything can be done. But this is changing. With more research into this important symptom of cancer, health professionals and people with cancer are becoming more aware of how fatigue can affect them and what can be done to help.
If you have cancer and have signs of fatigue, let your doctor or nurses know. There are things that can help control it. If you are not sure how to tell your doctor about your fatigue, there are some suggestions for questions to ask your doctor in this section of CancerHelp UK.
In many cancers, levels of chemicals that cells use to communicate are increased. These are called cytokines. Researchers are investigating the link between cytokines and fatigue. Cytokines include interleukins and a chemical called tumour necrosis factor (TNF). The higher than normal levels of cytokines could cause fatigue by affecting hormones and chemicals that nerves use to communicate. Interferon is a biological therapy that causes tiredness and this may be due to increasing the production of interleukin and TNF in the body. All body chemicals are finely balanced and any upset in one area can easily affect another. This theory has been suggested to explain chronic fatigue syndrome (ME) and could also apply to cancer.
Anaemia
If you are anaemic, the best treatment for fatigue is one that increases your haemoglobin and red blood cell count. Blood transfusions are commonly used to treat anaemia. A drug called erythropoietin (EPO) can also be used for some people. It boosts the production of red blood cells by the bone marrow. Some recent research has shown that EPO may also increase the chance of some types of cancer coming back after treatment. Further research is being carried out to see when EPO can be safely used.
If you are not anaemic, researchers have looked into all the other things you may be told to do. In a review of fatigue research, exercise and support seem to be most effective. You can look at this review of fatigue research on line if you'd like to.
Ritalin and modenafil
Researchers are looking into whether drugs such as ritalin or modefanil can help relieve tiredness during treatment. These drugs are usually used to treat attention and concentration problems. One small study in the US showed that ritalin (Dexmethylphenidate) can reduce tiredness due to advanced gynaecological cancer. It also and improved mood. A larger randomised study, also in the US, found that ritalin significantly improved tiredness symptoms. Because ritalin made some other symptoms worse, such as headache and dry mouth, more research is needed.
There is information about a trial of modenafil to treat extreme tiredness in people who have advanced lung cancer, on our trials database.
To find trials about extreme tiredness or fatigue go to advanced trials search, choose ‘controlling symptoms' from the trial types listed, and then type ‘fatigue’ in the search box.
Exercise
Exercise can increase your energy levels and help you to feel better about yourself and your condition. You can see progress in a short space of time. Generally speaking, the more you do, the more you are able to do. A review of studies looking at the benefit of exercise as part of cancer rehabilitation show physical and emotional benefits but we need better designed studies to fully understand the importance of exercise.
Acupuncture
Early studies suggest that acupuncture may help to reduce fatigue by stimulating ‘energy’ points in the body. Two trials, looking at acupuncture to relieve tiredness after treatment for breast cancer, are on the CancerHekp UK clinical trials database. There is more about acupuncture in our section on complementary therapies.
Support
In the research literature, support can mean anything from
- Information about cancer
- Going to a support group meeting regularly
- Individual counselling or
- Psychotherapy
A number of research reports show that support can reduce fatigue, improve anxiety and mood, and help to combat other physical symptoms, such as pain and sickness. A small study has looked at whether a telephone support service run by nurses can help people with chemotherapy related fatigue. This study is no longer recruiting patients and we are waiting for the results.
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