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The tiredness that follows lymphoma treatment is not ordinary tiredness and does not reliably improve with rest. Several of its causes, including anaemia, an underactive thyroid, poor sleep and low mood, are separate and separately treatable, which is the reason to report it rather than to absorb it.
**What it is.** Lymphoma Action describes cancer-related fatigue as extreme tiredness that can be physical, mental and emotional, that is not relieved by sleep in the way ordinary tiredness is, and that can start during treatment and continue for months or years afterwards. It is listed both as a side effect, starting during or soon after treatment, and as something that can also appear as a late effect months or years later.
**Why it is worth taking apart.** Several contributors to it have their own treatment. Anaemia is one, and is found on a full blood count. An underactive thyroid is another, and after radiotherapy to the neck Lymphoma Action says a blood test is done once a year to check for it; the charity notes that the risk of an underactive thyroid is highest in the first five years after treatment and stays higher than it would otherwise have been after that. Lung scarring after chest radiotherapy, bleomycin or rituximab can present as breathlessness on exertion rather than as tiredness. Low mood and poor sleep are treatable in their own right. Pursuing the list is more useful than being told to pace yourself.
**What helps.** Lymphoma Action's exercise material and the general cancer literature both put graded physical activity ahead of rest; the charity publishes practical material on planning activities around energy levels and on coping with fatigue. Macmillan's tiredness page describes the same approach for any cancer.
**The honest part.** For some people the fatigue lasts a long time, and a person can be in complete remission and still unable to work a full week. Lymphoma Action's recovery material treats this as a recognised part of recovery rather than as a failure to bounce back, and its support meetings include ones about fatigue specifically.
Showing the technology this term belongs to: Cognitive behavioural therapy for fatigue and distress.
Shares Early-stage classical Hodgkin lymphoma (stage I to II), Relapsed and refractory classical Hodgkin lymphoma, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome).
Shares Early-stage classical Hodgkin lymphoma (stage I to II), Relapsed and refractory classical Hodgkin lymphoma, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome).
Shares Waldenström macroglobulinaemia, Marginal zone lymphoma, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma), Follicular lymphoma.
Shares Early-stage classical Hodgkin lymphoma (stage I to II), Late effects and survivorship toxicity, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma).
Shares Going back to work after lymphoma, and the money in the meantime, Early-stage classical Hodgkin lymphoma (stage I to II), Relapsed and refractory classical Hodgkin lymphoma, Survivorship care and late-effects surveillance.
Shares Survivorship care and late-effects surveillance, Waldenström macroglobulinaemia, Marginal zone lymphoma, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma).
Shares Early-stage classical Hodgkin lymphoma (stage I to II), Advanced-stage classical Hodgkin lymphoma (stage III to IV), Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma), Follicular lymphoma.
Shares Early-stage classical Hodgkin lymphoma (stage I to II), Relapsed and refractory classical Hodgkin lymphoma, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Waldenström macroglobulinaemia.