Fatigue is by far the most common symptom experienced by blood cancer patients prior to diagnosis. According to our 2018 patient survey, 56% of leukaemia patients experienced fatigue before being diagnosed. 67% of patients will suffer from fatigue as a symptom after diagnosis, either as a side effect of treatment or due to a progression of the leukaemia.
The fatigue that comes with cancer is known as cancer-related fatigue (CRF) and it is characterised by extreme or persistent exhaustion that disrupts your daily activities and function. People who have CRF have no energy and find it extremely difficult to complete even the simple, everyday tasks that others take for granted.
“I was a physical guy, and then all of a sudden, no explanation, I felt like I was in treacle. Very fatigued and very tired.”
Spotting the difference between everyday fatigue and CRF
CRF is different from the fatigue of daily life. Unlike the fatigue that healthy people will inevitably experience, CRF is more severe, often described as an overwhelming exhaustion that cannot be overcome with a good night’s rest. Some people may also describe it as feeling physically weak, drained or have difficulty concentrating (“brain fog”).
“I don’t feel my mind is what it used to be” “I used to be very good at multitasking, and now I can’t read a book and have someone say something at the same time, it takes me a few seconds to switch between tasks”
Spotting the signs CRF
Below are some signs of cancer-related fatigue that you should pay close attention to.
- Your tiredness remains even after rest or sleep, it keeps coming back, or it becomes debilitating.
- You find yourself more tired than usual during or after an activity.
- You’re too tired to do the things you usually do.
- You’re tired and it’s not related to an activity.
- You struggle to move your arms and legs as they feel too “heavy”.
- You feel weak.
- You have no energy.
- You’re spending extra time in bed and/or sleeping more. Or, you may have trouble sleeping.
- You stay in bed for more than 24 hours.
- Your tiredness disrupts your work, social life, or daily routine.
- You have difficulty concentrating and find yourself becoming confused more easily.
If these symptoms apply to you, we recommend you visit your GP.
So what causes CRF?
We often hear about cancer patients who are extremely fatigued, but a lot of cancer-related fatigue is caused by the side effects of cancer treatment or the stress/ anxiety that comes along with a diagnosis, not always cancer itself. In other words, for many people with cancer, fatigue begins after diagnosis. This can be extremely distressing for people who are already having to cope with a life-threatening illness.
In other words, in most cancers, fatigue isn’t a symptom that occurs until the cancer has progressed to a later stage and is almost never experienced alone without any other preceding symptoms. However, leukaemia and lymphoma are quite unique in the fact that they cause fatigue through a more direct mechanism and therefore fatigue may well be the first symptom to occur. For many people, anaemia is the main cause of CRF, and Leukaemia directly causes anaemia by preventing the bone marrow from producing blood cells efficiently.
Anaemia and fatigue in leukaemia
Bone marrow is a spongy tissue found in the centre of some of your bones. It contains stem cells which develop into all the various blood cells. Leukaemia occurs when cancerous blood cells form in the bone marrow and crowd out the healthy blood cells. One blood cell type that is crowded out by the rapidly dividing leukaemic blood cells are the red blood cells. A lack of red blood cells leads to anaemia.
Red blood cells contain haemoglobin that carries oxygen from the lungs to the body’s cells and tissues, and a deficiency of red blood cells, therefore, means there is less oxygen being carried around the body. The cells use the oxygen to fuel the combustion of sugar and fat, which then produces the body’s energy, and so, without oxygen, the body cannot function properly and this leads to the feelings of extreme tiredness. During anaemia, tissues and cells around the body lack sufficient oxygen and cannot work to their full potential, leaving you feeling tired, weak, dizzy and looking pale, all of which are also symptoms of leukaemia. Breathlessness is another key symptom that occurs in leukaemia, as your body is trying to replenish oxygen levels from the air by breathing more heavily.
It must be stressed that many different things can cause anaemia and fatigue, and more commonly it can be explained by things such as hormone imbalances, loss of blood or dietary deficiencies. However, for this reason, leukaemia can be hard to spot because the signs and symptoms are common to other unrelated illnesses. Knowing what other symptoms are typical of leukaemia is crucial for helping you make the decision to visit your GP sooner for a blood test. Connect the dots between the symptoms of leukaemia and spot leukaemia sooner.
For information on the other symptoms of leukaemia, click here.