Surviving Lymphoma: Post-Cancer Fatigue

Fatigue that persists after 1) cancer is in remission and 2) after your medical team rules out other treatable causes of fatigue, is called Post-Cancer Fatigue (PCF). Number two is very important: fatigue may be caused from low blood counts or other treatable causes and good patient-medical team communication is important in making sure treatable fatigue is properly

The medical community has not pinpointed the cause(s) of PCF but a possible cause are physical changes in the body and/or cells in the body.  Since it is hard to define fatigue it has been difficult to find causes to date.

This same medical community has a mixed record in acknowledging PCF - the number of journal articles and other writings in this area is increasing dramatically.   Unfortunately this information may not have reached the medical staff overseeing your post-treatment progress. 

Fatigue affects the daily lives of survivors.   Where the mind says that lifelong living patterns such as sleep and work are well known, the body returns signals that things have changed and the energy is not there when you expect it.

Some survivors describe it as now having a fixed amount of energy.  Through the day you use some of that energy and when that amount is used up there is little that can be done to replenish it again - rapid recharging of energy is extremely difficult.

Learn from your body and your lifestyle - find out how much energy you typically have and can expend in one stretch.  This may require an adjustment in how you prioritize and perform some of your daily tasks.  This has been called by Wendy Harpham "establishing your new normal" - not the same routine you had but a new one given your fatigue level.

Reference and Information

Primary Information

• US National Cancer Institute Supportive Care Papers
  • Fatigue - Patient Information (new locations)
  • Fatigue - Health Professional

Articles

• A highly recommended article: Resolving the Frustration of Fatigue by Wendy Harpham, MD (a recurrent lymphoma survivor herself) from CA - A Cancer Journal for Clinicians 1999;49:178-189 
• Fatigue Most Prevalent, Longest-Lasting Cancer-Related Side Effect, Doctor's Guide to the Internet, September 1998
• For Many With Cancer the Problem is Fatigue, Judy Foreman, Boston Globe, May 5, 1997

Studies

• Abstract - Hodgkin's Disease Survivors More Fatigued Than the General Population, Journal of Clinical Oncology, Vol 17, Issue 1 (January), 1999: 253
• Abstract - Fatigue in disease-free cancer patients in comparison to fatigue in Chronic Fatigue Syndrome patients AACFS - October 1998

• Recommended: After Cancer: A Guide to Your New Life by Wendy S. Harpham, MD. 1994, Norton. This book is available in both paperback and hardback

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Updated June 3, 2007