Fatigue is the most common symptom experienced by cancer patients.  A study by the Fatigue Coalition found that while the majority of patients experience fatigue, it is one of the most overlooked and under-treated side effects of cancer.

There are many factors, both physical and emotional, which can cause fatigue.  These include the lymphoma itself, treatments, medications, pain, nutritional deficits, anxiety and depression.

In addition, lymphoma and its treatments can cause anemia, a decrease in the red blood cells, which leads to fatigue.  An important part of red blood cells is hemoglobin.  This is the portion of the red blood cells that actually binds and carries the oxygen molecule throughout the body.  When hemoglobin is low, oxygen levels decrease and it becomes more difficult for your body to sustain its normal activity level.  Chemotherapy-related anemia may be easily treated with medication to stimulate red blood cell production.

It is important to let your doctor know about your fatigue; so it can be evaluated.  Be as specific as possible about your level of fatigue and when it occurs (e.g., in the morning, after treatment, etc.), as well as those activities you have difficulty doing.

Fatigue, as with other aspects of cancer and its treatment, varies from person to person.  The severity of your fatigue and how long it lasts depends on many factors including the type and length of cancer treatment and your health other than the cancer.  While you might not be able to prevent it altogether, the following tips may help you deal with the effects of fatigue.


  • Extreme weariness, lack of energy
  • Leg pain, difficulty climbing stairs or walking short distances
  • Shortness of breath
  • Difficulty performing simple tasks, such as cooking, cleaning, making a bed or taking a shower
  • Difficulty concentrating or making decisions


  • Medications and treatments including chemotherapy and radiation
  • Body's need for extra energy to repair healthy tissue after treatment
    Toxic substances released by dying cancer cells
    Treatment-related changes to the nervous system
  • Side effects or symptoms including anemia (decreased red blood cells), fever, nausea, vomiting, diarrhea, pain, breathing difficulties, lack of sleep, poor quality of sleep
    Changes in nutrition or nutritional needs
    Lack of exercise
    Emotional factors including depression, anxiety and fear
  • Diseases not related to cancer (e.g., heart, lung, musculoskeletal, etc.)
  • Post cancer fatigue


  • Take an active role in your treatment, ask questions.
  • Keep a diary to help you identify when you have the most energy and what activities make you feel fatigued or energized.  This information can help you plan your activities for the times you have the most energy.  This information will also help you to communicate with your physician.

  • Delegate.  Ask family or friends for assistance with chores, cooking and childcare.  Often, family members or friends are happy to help because it is something concrete they can do for you.

  • Exercise if your doctor says it is okay for you to do so.  Simple stretching and range of motion exercises or a short walk may give you more energy, not decrease the energy you have.  Begin slowly and build up to the level that is right for you.  Your doctor, nurse, or physical therapist can help you devise a personal exercise plan.

  • Rest as often as needed and take short naps.  Try not to rest more than necessary as this may decrease your energy level.  Many people find that an afternoon nap helps them feel less fatigued for the rest of the day.  If you are having trouble sleeping, talk to your health care team to determine why and what you can do about it.

  • Control other side effects or symptoms as best as you can.  Work with your doctor or other health care team member to manage things like nausea, vomiting and fever.

  • Speak with a professional counselor to help you cope with the stress of your illness.  Learning some relaxation or stress relieving techniques may help.

  • Review your diet with your doctor or a nutrition counselor.  Treatment and recovery often puts extra demands on your body for calories, nutrition, and fluids.

  • Join a support group or participate in a one-on-one buddy program, such as LRF's Lymphoma Support Network, to speak with other lymphoma survivors.