What Is the Connection between Fatigue and Chemotherapy?

A. Reed

Contained within shafts of long bones and the pelvis, bone marrow is the soft substance from which blood cells are made. When someone receives chemotherapeutic drugs, he or she develops a condition referred to as bone marrow suppression causing the body to decrease blood cell and platelet production. The rate at which this happens depends upon the type of cancer, its progression, and the specific cytotoxic drug being used. Through destruction of blood stem cells within bone marrow, fatigue and chemotherapy are interrelated manifesting certain disease processes including aplastic anemia and thrombocytopenia.

Chemotherapy destroys normal cells as well as cancer cells, which often leads to increased fatigue.
Chemotherapy destroys normal cells as well as cancer cells, which often leads to increased fatigue.

Introduced during the 1950s as a standard treatment for cancer, chemotherapy involves the use of cytotoxic agents to destroy cancerous cells in the body. Even though it has been used as an effective cancer treatment, the downside of taking these drugs is that they also destroy normal cells. While cancer does cause fatigue in patients, it is not just the condition that is responsible. Due to the connection between fatigue and chemotherapy, people with cancer sometimes develop a condition called aplastic anemia, causing an abnormally low amount of all types of blood cells. including white, red, and even platelets, structures necessary for clotting of the blood also referred to as thrombocytes. Possibly a life-threatening illness, aplastic anemia increases infection susceptibility which oftentimes leads to death.

Some patients who undergo chemotherapy develop aplastic anemia, a potentially dangerous side effect.
Some patients who undergo chemotherapy develop aplastic anemia, a potentially dangerous side effect.

Further demonstrating the relationship between fatigue and chemotherapy, thrombocytopenia is a blood disorder occurring as a result of an unusually low number of thrombocytes present in the plasma. As a patient receives chemotherapy, it may lessen blood platelet production specifically, characterized by increased bruising and hemorrhaging in the urine, stool, and out of the nose. Blood transfusions are part of the treatment for thrombocytopenia, and sometimes chemotherapy is stopped if the condition is serious which could affect the prognosis of the cancer.

After chemotherapy,  doctors may prescribe a patient blood transfusions to increase red blood cell levels.
After chemotherapy, doctors may prescribe a patient blood transfusions to increase red blood cell levels.

Stem cell transplantation refers to the delivery of immature blood cells in order to stimulate new blood cell production in patients previously affected by fatigue and chemotherapy. Bone marrow is obtained from a matched donor, who could be a relative or someone who is not related, during a surgical procedure referred to as harvesting. The harvested cells are administered intravenously to the stem cell recipient and can take five hours to complete the process, even though it could take up to four weeks to generate new bone marrow. Lymphomas and leukemias are typical cancers indicated for stem cell transplantation.

Emotional support may also help a patient to manage chemotherapy fatigue.
Emotional support may also help a patient to manage chemotherapy fatigue.

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