Immunotherapy, a treatment designed to boost or restore the body’s natural defenses to fight diseases like cancer, can indeed cause fatigue. This fatigue is often more intense and persistent than ordinary tiredness, affecting patients physically, mentally, and emotionally.
Fatigue related to immunotherapy is a common side effect experienced by many patients undergoing this treatment. Unlike normal tiredness that improves with rest, immunotherapy-related fatigue can linger for weeks or months and may not fully resolve even after sleep. It can significantly interfere with daily activities, concentration, and overall quality of life.
The reasons immunotherapy causes fatigue are multifaceted. First, the treatment activates the immune system to attack cancer cells, which requires a substantial amount of energy from the body. This heightened immune activity can lead to systemic inflammation and the release of various immune signaling molecules, which contribute to feelings of exhaustion.
Second, immunotherapy can trigger side effects that indirectly cause fatigue. For example, it may cause anemia (a reduction in red blood cells), which reduces oxygen delivery to tissues, leading to weakness and tiredness. It can also cause other symptoms such as nausea, pain, or decreased appetite, all of which can sap energy and worsen fatigue.
Additionally, immunotherapy can affect the endocrine system, leading to hormonal imbalances such as hypothyroidism or adrenal insufficiency. These conditions disrupt the body’s normal metabolism and energy regulation, often resulting in profound fatigue.
Neurological side effects are another factor. Some patients experience muscle weakness, cognitive changes, or neurological inflammation as a result of immune checkpoint inhibitors or CAR T-cell therapies. These neurological complications can contribute to unusual fatigue and muscle tiredness.
Fatigue from immunotherapy is reported across various types of cancers and immunotherapy drugs. For instance, patients treated with immune checkpoint inhibitors like pembrolizumab (Keytruda) or nivolumab (Opdivo) frequently report fatigue as one of the most common side effects. The incidence of fatigue can range widely, with some studies showing it affects roughly a quarter to over half of patients receiving these treatments.
The severity of fatigue can vary from mild tiredness to debilitating exhaustion that limits physical activity and mental focus. It may come on gradually or suddenly and can fluctuate during the course of treatment.
Managing immunotherapy-related fatigue involves a combination of approaches:
– Monitoring and treating underlying causes such as anemia or thyroid dysfunction.
– Encouraging balanced nutrition and hydration to support energy levels.
– Promoting gentle physical activity as tolerated, which can help reduce fatigue.
– Addressing emotional and psychological factors like stress, anxiety, or depression that often accompany cancer treatment.
– Ensuring good sleep hygiene to improve rest quality.
– Close communication with healthcare providers to adjust treatment if fatigue becomes severe or is accompanied by other concerning symptoms.
Because immunotherapy fatigue can be complex and persistent, patients are encouraged to report their symptoms openly and seek supportive care tailored to their needs.
In summary, fatigue is a very common and significant side effect of immunotherapy. It arises from the body’s immune activation, treatment-related side effects, hormonal changes, and neurological impacts. While it can be challenging, understanding its causes and working with healthcare teams can help patients manage fatigue and maintain quality of life during immunotherapy.