Battling Fatigue Decades Later

Childhood leukemia and lymphoma survivors often have chronic fatigue years later

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Being tired after any type of cancer therapy is to be expected. Some survivors of childhood cancer, though, can still be battling fatigue many years later.

A new study has found individuals who beat blood cancers as children were four times more likely to have chronic fatigue than the general population.

This fatigue can linger for years – even decades – after treatment.

"Get help if you’re frequently overly tired."

The study, led by Hanne Hamre, MD, of the Department of Oncology at Oslo University Hospital in Oslo, Norway, evaluated levels of fatigue in survivors of childhood acute lymphoblastic leukemia (ALL), Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL).

The researchers explored whether or not chronic fatigue was associated with the original blood cancer and its treatment, inflammation and mental and physical late effects. 

Late effects are problems that occur months or years after diagnosis or treatment.

Fatigue is often a late effect of cancer therapy. Fatigued survivors feel tired or even exhausted, and lack overall energy. Fatigue that comes and goes or lasts for six months or longer is considered chronic fatigue.

Fatigue has a negative affect on a person’s quality of life, daily activities and work life.

For this study, 143 male and 147 female childhood blood cancer survivors were examined, had blood tests and completed a detailed questionnaire regarding fatigue. The median age of survivors was about 30 years.

The control group – healthy individuals who had not had cancer as children – included 1,405 people in their early 20s from the general Norwegian population.

Chronic fatigue was seen in 27 percent of the childhood blood cancer survivors compared to 8 percent of the control group.  Specifically, the researchers found chronic fatigue was experienced by:

  • 22 percent of ALL survivors
  • 30 percent of NHL survivors
  • 34 percent of HL survivors

In lymphoma survivors, B-symptoms (fever, night sweats, weight loss) at the time of diagnosis were predictors of chronic fatigue. Patients who reported higher levels of anxiety and depression were also more likely to suffer from chronic fatigue.

The characteristics of the cancer that was treated did not influence chronic fatigue. The scientists did find markers of low-grade inflammation among those with chronic fatigue.

“At a median of 20 years after diagnosis, the prevalence of chronic fatigue in CLSs (childhood leukemia/lymphoma survivors) is more than three times that of the general population. A persistent low-grade inflammatory response may be involved in the pathogenesis (development) of chronic fatigue,” the study authors concluded.

This study was published in the March issue of the Journal of Adolescent and Young Adult Oncology. The research was supported by ‘‘Helse Sørøst HF.’’ No conflicts of interest were disclosed.

Reviewed by: 
Review Date: 
March 21, 2013
Last Updated:
August 16, 2013