Persistent, severe fatigue is a common symptom among people with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Fatigue can be caused by lymphoma itself, or it can be a side effect of lymphoma treatments like chemotherapy and radiation therapy. Fatigue from cancer or cancer treatment is called cancer-related fatigue. Unlike other tiredness, cancer-related fatigue cannot be resolved with a good night’s sleep.
Cancer-related fatigue can significantly impact day-to-day life. MyLymphomaTeam members share how fatigue interferes with daily activities:
Cancer-related fatigue is the result of many intersecting variables. “Fatigue is tricky,” explained Dr. Timothy Fenske, a hematologist-oncologist who specializes in treating people with Hodgkin and non-Hodgkin lymphoma. “It can be a symptom of lymphoma. It can be a side effect of treatment. It can also be a sign of other problems that may be related or unrelated.”
The following factors can contribute to fatigue in people with HL or NHL:
Life circumstances, like undergoing treatment while working and raising children, were found to increase fatigue in a study of women with breast cancer.
In some cases, fatigue persists for months or even years after the end of lymphoma treatment. Persistent fatigue after treatment is a particular problem for lymphoma survivors who’ve received high-dose chemotherapy followed by stem cell transplants.
“Sometimes post-treatment, people will have some fatigue that can linger for months or even in some cases a year later,” Dr. Fenske said. “Some people might be in remission, they're done with treatment, but they never quite got back to where they were pretreatment.”
Members of MyLymphomaTeam report lingering fatigue after completing treatment. “Hubby is FINALLY starting to get his energy back six months after his last chemo,” a spouse on MyLymphomaTeam wrote. Another member commented, “I have been tired for six years. I don't think you ever get over that.”
When discussing fatigue with your doctor, they will try to understand the various aspects of your overall health, your treatment, and your lifestyle that may be contributing to your tiredness. Your doctor will ask questions to understand how fatigue is impacting your daily activities. You may be asked to rank your fatigue levels, and the doctor may order a blood test to check for anemia.
Dr. Fenske explained, “We have to separate out what's just normal fatigue because the person’s got three little kids or a stressful job, and now they have cancer on top of it, and what's actually a serious side effect, or maybe even a sign of their lymphoma coming back.”
“You have to put it in context to try to figure out what level of fatigue we are dealing with and how persistent it is,” Dr. Fenske added.
Depending on your circumstances, treatment for cancer-related fatigue may include:
Your doctor may recommend strategies like regular exercise and healthy eating to help you manage chronic fatigue and improve your quality of life.
Physical activity during and after treatment for lymphoma can help improve your energy levels. One MyLymphomaTeam member shared, “Working through the pain and moving around seems to actually make me feel better than sitting.” It’s important to consult your health care team before starting a new exercise program, especially if your lymphoma has spread to your bones.
Consulting a nutritionist or dietitian can help you ensure you’re taking in enough nutrients, especially if cancer treatments are causing nausea or vomiting. “Eat a lot of fruits and vegetables and drink plenty of fluids,” one member recommended to another battling fatigue.
Read Diet and Lymphoma: Nutrition Tips for Feeling Your Best, which includes tips from registered dietitian Kimberly Mugler for fighting anemia and dehydration.
Getting adequate rest at night and taking short naps during the day — a half hour or less — can help manage fatigue. Long naps during the day can sometimes make you feel more tired and interfere with nighttime sleep. Establishing a consistent bedtime routine can also help reduce fatigue.
The best way to manage severe fatigue will vary from person to person. Finding ways to take care of yourself and prioritize your most important tasks can help you balance rest and activity.
MyLymphomaTeam members have different approaches to finding balance. “I do what I can, when I can. I am not pushing myself,” a member posted. Another member commented, “I rest when I need to, but I refuse to change my social activities.”
By joining MyLymphomaTeam, you gain the support of more than 5,400 people living with lymphoma. Members talk about a range of personal experiences and struggles. Fatigue is one of the most discussed topics.
Can you relate? How do you cope with fatigue? Share your tips in the comments below or start a conversation on MyLymphomaTeam.