One of the most common side effects of cancer is cancer-related fatigue. In fact, at least 80% of people with cancer report having this symptom. Cancer-related fatigue is different from the fatigue and general tired feeling of daily life and experienced by those without cancer. It can come on rapidly, is not a result of activity or exertion, and is not relieved by rest or sleep.

Fatigue is defined as a consistent lack of energy and a whole-body tiredness that is not relieved by rest. Feeling fatigued is more than feeling just tired. People often describe it as being exhausted, and someone can feel fatigue without knowing why. Fatigue becomes chronic if it lasts longer than a month, which can impose an extremely negative impact on someone’s quality of life.

Fatigue can present very differently amongst cancer patients. It may get better for a while, but then can return. Some may feel too tired to eat, walk around in their house, or even read a book. “Brain fog” from fatigue can make it hard to think and concentrate on daily tasks. Resting may help for short term relief, but the results are not lasting and very little activity can be completely exhausting. For some patients, this intense fatigue causes more distress than depression, nausea or pain.

Patients who have surgery for cancer with no other treatment, fatigue often decreases over time as they recover. Patients getting radiation therapy, fatigue usually gets worse as the treatment goes on and often lessens within a few months after treatment is complete. Patients getting chemotherapy, immunotherapy, or targeted therapy, fatigue often hits hard at first and then may get better, until the next treatment when the condition comes back. 

What causes CRF?

Cancer-related fatigue could come from the disease itself. Additionally, the treatments associated with having cancer such as surgery, chemotherapy, and radiation can be fatigue-provoking. Not everyone gets cancer related fatigue, but as mentioned earlier, it is a very common situation. 

Chemotherapy drugs, such as cisplatin, commonly cause fatigue in cancer patients. The level of fatigue may vary from patient to patient. While some patients only get fatigued during the time surrounding their infusions, some say they feel fatigued the entire course of their treatments. Chemotherapy can also cause anemia which can contribute to fatigue symptoms. 

Radiation treatments can cause fatigue over time (cumulative fatigue). While one may feel fine at the beginning, the treatments can be exhausting in the long run. The fatigue can persist after the treatments for weeks to months. 

Immunotherapy drugs have fatigue as one of the most commonly reported side effects. Fatigue is also often reported as a side effect in drug types such as checkpoint inhibitors, cytokines and oncolytic virus therapy.

Hormone therapy is another common treatment for cancer that causes changes in the body’s hormone levels, which can lead to significant fatigue. Hormonal changes may also occur as side effects of other cancer treatments.

There may be certain health changes related to cancer and it’s treatment.  Oncologists may take a blood sample or perform other tests. These results may show cancer-related causes of fatigue. Fatigue can be a symptom of the cancer itself or that the cancer is growing or spreading.

How is CRF managed?

A very common condition associated with cancer is pain. Living in chronic pain can be stressful and exhausting. Many of the drugs used for pain management can also cause drowsiness and fatigue. Natural ways to treat pain are becoming popular with people managing a cancer diagnosis. There are acupuncturists and massage therapists who specialize in managing pain and fatigue in cancer patients. 

Staying hydrated is an important aspect to cancer treatment. Dehydration is known to be a cause of fatigue in cancer patients. A common side effect of cancer treatment known as “brain fog” can be due to dehydration. While oral hydration should always be a priority, the addition of a hydrating type of IV formula can be extremely beneficial for people with cancer related fatigue. 

Managing stress and treating depression and anxiety can reduce fatigue. Stress and depression can be very fatiguing and some of the medications used to treat these symptoms can also have fatigue as a side effect. 

Poor sleep can also contribute to fatigue, but as we mentioned earlier, sleep and rest can also not help with cancer related fatigue. Normal fatigue is relieved by sleep but cancer related fatigue often is not. Still, it is important to get proper rest so as not to have poor sleep contribute to the condition. Inability to sleep 8 hours a night can contribute to feeling fatigued. 

A healthy diet and proper nutrition are important ways to manage fatigue levels. If the body is malnourished, fatigue can set in much easier and have more of an impact. Taste changes from certain chemotherapy agents or radiation treatments can affect the appetite and make proper nutrition a challenge. Health providers should be able to help manage these tough situations. Checking for nutritional deficiencies like iron, vitamin B12, or vitamin D are typical in cancer care. Having sufficient levels of the nutrients is essential to fighting fatigue.

Physical activity is important. Research shows that exercise and other types of physical activity can help relieve cancer related fatigue. Cancer care providers should be able to guide patients about what kind of physical activity is best for patients and what level of activity is appropriate. 

Physical therapy may benefit some patients. Certain patients may be at a higher risk for injury than others due to cancer or other health concerns, so working with a PT can help minimize the risks. A physical therapist will help patients safely improve strength and minimize pain. People may also benefit from working with a personal trainer who can also help formulate a personal exercise program to help keep people on their feet. 

Counseling can really help patients deal with the mental emotional consequences of being fatigued from cancer. Working through a cancer diagnosis can be challenging not  only for the patient but also for the caregivers. Cancer centers usually have mental health professionals that can help patients and their families with the special challenges that a cancer diagnosis brings. 

Working with an integrative medicine provider who specializes in cancer treatment can bring a lot of relief from the fatigue related to cancer treatments.  There are herbal formulations with ingredients that have been in use medicinally for centuries that have been shown to help people with cancer related fatigue.


Protectival, Tonix-R and CRF

Protectival has been through intense scrutiny and tested with many types of cancer and with many types of cancer treatments to evaluate its effect. It has been shown to be safe and not interfere in the process of cancer treatment and to also counteract some of the grave side effects that come with the drugs used in therapy. 

In a study published in the “Integrative Medicine Insight’s” journal, Protectival was shown to reduce fatigue in 70 percent of patients. There can be many symptomatic contributors to fatigue within the other side effects from chemotherapy. Protectival was shown to be effective in alleviating other symptoms, such as pain, nausea, and weakness. It also showed efficacy in helping to maintain or improve appetite and to improve bowel function.   

In another study, published in the journal “Oncologist,” Protectival was shown to help with issues which could contribute to fatigue, such as low red or white blood cell counts. This study focused on the rates of anemia and leukopenia, and showed that 82% of patients who took Protectival did not suffer from a decrease of white blood cell or red blood cell counts. Preventing blood based toxicities will not only help patients feel stronger but will also help avoid other complications, and can help patients complete their chemotherapy regimen without interruptions.

Tonix-R was tested for efficacy & safety by immunologists at the Sheba hospital and the results were published in the journal “Biomedical Reports.” Results showed significant enhancement on the immune system including an increase of Natural Killers cell (NK) activity and an increased vitality of neutrophils. For most patients undergoing cancer treatment, we recommend using both Tonix-R and Protectival together for enhanced protection from the toxicities of cancer drugs and to give patients extra shielding from CRF. 

Avoiding or correcting fatigue is hugely important in cancer treatment and is a goal throughout treatment. Providing the best botanicals to help patient’s thrive is our goal at LifeBiotic. When people feel good during treatment, they maintain a higher quality of life. Adding Protectival and Tonix-R into a treatment regimen can help achieve the best results for everyone involved: the patient, the family and the providers. 


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