Childhood Cancer

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Childhood Cancer Survivors

Screening and detection

A thorough physical and psychological evaluation is needed to identify possible causes of fatigue and determine what may be treatable. It helps to keep a record of your pattern of fatigue prior to going to your healthcare provider. For instance, you could note on your calendar how long you work each day, how many naps you take, how long they are, and how much you sleep each night. Many survivors force themselves to go to work but feel absolutely exhausted by the afternoon. This is an important piece of information to share with your healthcare provider.

Your evaluation should include the following: 2

  • Review of cancer history, treatment, and current status

  • Complete physical examination

  • Fatigue history

    • When it started, how long it has lasted, any changes

    • Actions or events that make the fatigue better or worse

    • Effect of fatigue on job, daily life, and relationships

  • Assessment of contributing factors, such as:

    • Pain

    • Hormone levels (i.e., thyroid, testosterone, estrogen, growth hormone)

    • Current medications, including over-the-counter medicines and supplements

    • Emotions (e.g., depression and anxiety)

    • Sleep and napping habits

    • Level of physical activity

    • Nutrition history, including weight gain or loss and changes in appetite

    • Other health conditions that could affect fatigue

I’ve never had debilitating fatigue, but in the 33 years since treatment, I’ve always struggled with having enough energy. When I worked a 40- or 50-hour week like everyone else, I had no energy to cook meals or clean house or do anything but collapse when I came home. I had to grieve when I finally realized it was from the treatment, because I could have managed it a whole lot differently. Now I do energy management. The things I really want to do, I make sure I do. I’m very up front with people. I tell them I have limits on my energy and will say, “This is a good time to do it,” or “Can we do this together, then I’ll sit and watch while you do that?” People are very understanding.

Signs and symptomsMedical management

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