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Fatigue is by far the most common symptom experienced by blood cancer patients prior to a diagnosis. According to our 2018 patient survey, 56% of leukaemia patients will experience fatigue in the lead up to their diagnosis.
The fatigue that comes with leukaemia or any 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. Spotting the difference between harmless and harmful fatigue may be key in diagnosing leukaemia early.
“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
Fatigue is defined as extreme tiredness that results from mental or physical exertion, or illness. Everyone will experience fatigue at some point as it is simply the body’s natural way of showing that rest is needed. However, exhaustion that lasts for prolonged periods of time is not normal.
Cancer-related fatigue (CRF) is different from the fatigue of daily life. It is more severe and is often described as an overwhelming exhaustion that cannot be overcome with a good night’s rest. Some people may also describe it as constantly feeling physically weak, drained or have difficulty concentrating (“brain fog”).
Below are some signs of cancer-related fatigue that you should pay close attention to. If more than one of the following symptoms apply to you, we recommend visiting your GP.
- Weakness or tiredness that lasts for longer than 2 weeks
“I noticed myself getting more and more tired, but I just put it down to getting older and working so hard.”
- Weakness or tiredness accompanied by a loss of weight
“I started losing weight, but had tried to lose a few kilograms, so didn’t relate this to anything untoward. I was becoming increasingly tired as well. One afternoon I fell asleep at my desk!”
- Tiredness that remains even after rest or sleep, it keeps coming back, or is getting worse.
“I went to bed, slept normally, and woke up feeling fine… but still tired.”
- You are continually finding yourself more tired than usual or breathless during or after an activity.
“I started to feel very tired, and although I was exercising a lot and running at least once a week, I felt that my fitness levels were not improving; in fact, I was getting worse.”
“I remember struggling to climb the stairs in my house.”
- You’re spending extra time in bed and/or sleeping for unusual amounts of time.
“Looking back now I had been tired for about a month but put it down to my lifestyle.”
- You are finding it significant difficulty to concentrate and becoming confused more easily.
“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”
- You have also noticed other symptoms of leukaemia or anaemia
Other symptoms of leukaemia can include bruising, night sweats, bone pain, abdominal pain or frequent infections.
“I found out during the appointment that some of the symptoms I was having, and just shrugged off, were actually signs of leukaemia. These were: excessive sweating, tiredness (I thought it was just because I was doing more exercise), breathlessness (I had pinned this down to being out of shape), a rash (I thought it was a food allergy) and unintended weight loss.”
- Since fatigue in leukaemia is nearly always caused by anaemia, keep a look out for symptoms such as breathlessness, dizziness, poor concentration or pale skin. Anaemia is usually diagnosed using a full blood count, and so leukaemia can also be picked up at this stage.
“Looking back at photos in the six months leading up to my diagnosis, I looked pale and tired but not unwell.”
Anaemia and CRF
For many people, anaemia is the main cause of CRF. In comparison to most other cancers, leukaemia and lymphoma are unique in the fact that they can directly cause anaemia by preventing the bone marrow from producing blood cells efficiently. For this reason, fatigue may well be the first symptom to occur.
An overcrowding of cancerous, leukaemic cells in the bone marrow causes anaemia by preventing the bone marrow from efficiently producing red blood cells. Since red blood cells contain ‘haemoglobin’, which carries oxygen from the lungs to the body’s cells, a deficiency of red blood cells means there is less oxygen being carried around the body. Your body’s 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.
When should I be concerned?
It is important to remember that many different things can cause fatigue and/or anaemia, and more commonly it can be explained by lack of sleep, long hours at work, hormone imbalances, anxiety, depression or dietary deficiencies. However, for this reason, leukaemia can be hard to spot because the signs and symptoms are common to other unrelated problems. As a general rule, if your level of tiredness is affecting your ability to function properly and is persisting for an unusual length of time, visit your GP to gain professional opinion and rule out any underlying problem.
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.