How is cancer fatigue assessed?

To help your healthcare team assess your level of fatigue they will ask you many questions. How tired you feel can change throughout your treatment and can continue afterward. They go through these questions before you start treatment and at times during your treatment. They often check how you are coping at your follow up appointments.

Describing how you feel

There are no medical tests to measure fatigue. A good way to describe fatigue is on a scale of 1 to 10. Where 1 means you don’t feel tired at all and 10 means the worst tiredness you can imagine.

The person doing the assessment might use a questionnaire to help them work out how your fatigue or tiredness is affecting you.

These questions are about:

• how you feel
• what you can manage to do each day
• any treatment you're having

They will also want to know about other illnesses and conditions that affect how you feel, such as pain or lack of sleep.

Going through this may seem like too much to deal with if you're feeling tired and weak. You probably just want them to sort it out as quickly as possible. But it is very important that your fatigue is properly assessed.

This helps your healthcare team to make the right decisions about treating you. Your family and friends may be able to help if you are feeling so tired that you can't answer questions.

Questions to help assess cancer fatigue

Some of the questions your doctor or nurse might ask you include:

• When did it start?
• How long has it lasted?
• Is it something that comes and goes?
• Has it got worse over time?
• Does anything make it feel better or worse? For example, exercise, eating or pain?
• Does it affect your daily living activities such as washing, cooking or walking?
• Do you have any problems sleeping?
• Are you sleeping in the day and for how long?
• How long roughly do you sleep at night?
• Is your sleep interrupted, meaning do you get up or wake up during the night?
• Do you have any other major problems in your life such as relationship, money or work worries?
• Do you have any other symptoms with your fatigue such as feeling or being sick, breathlessness or pain?
• Are you eating well?
• Do you prepare your meals or does someone usually help?
• Is the fatigue made worse or better when you have treatment such as chemotherapy or radiotherapy?
• Do you have any other medical conditions or symptoms?
• Did you feel fatigued before your cancer was diagnosed?
• How long since you have had your bowels open?
• Are you having any problems with passing urine?
• What medicines are you currently taking and when do you take them?

Being examined

Once you have gone through the questions your doctor, nurse or healthcare professional might examine you. They may:

• feel your tummy (abdomen)
• feel for swollen glands (lymph nodes) under your arms, in your groin and around your neck
• listen to your chest

You might have blood tests and a sample of urine (wee) tested. Your doctor might also suggest you have a chest x-ray or scans.  

Treatment for cancer can cause side effects that make you very tired, for example, anaemia . Some treatments can affect your hormone levels which can also make you extremely tired. So, the tests you have depends on your treatment and your symptoms. 

In some situations, these tests may help explain what is causing your fatigue and why you are feeling so tired and worn out. Your healthcare team will tell you more about these tests.

Don't be afraid to ask any questions you have.