Mesothelioma Fatigue and Muscle Weakness

Those with mesothelioma, like most cancers, experience fatigue and muscle weakness. The cancer itself, symptoms, treatments, lack of activity, poor sleep, and other factors can cause fatigue and muscle loss. Addressing these can help increase energy.

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Does Mesothelioma Make You Tired?

Most patients with mesothelioma, and many other types of cancer, feel tired a lot of the time. This often goes well beyond usual tiredness. It is a fatigue that doesn’t improve much, even with rest and sleep.

Cancer-related fatigue and weakness cause significant symptoms and dysfunction:

• Feeling completely exhausted, to the point of struggling to get out of bed or do easy activities
• Having a hard time sleeping well or through the night
• Running out of breath when trying to do simple tasks
• Muscle pains when trying to be active
• Depression, anxiety, and lethargy
• Difficulty focusing, thinking, or making decisions

Fatigue and Muscle Weakness in Cancer Patients

Mesothelioma patients are not alone in feeling weak, tired, and lethargic; these are typical symptoms among cancer patients of all types. While similar and related, the symptoms are not the same:[1]

• Fatigue. Everyone knows what it feels like to be tired or to lack energy, but fatigue is the extreme version. Even with adequate sleep and rest, fatigue can be a problem, making it difficult to do anything. Between 80% and 100% of cancer patients experience fatigue.
• Muscle weakness. Weakness is specifically related to strength. When muscles weaken or decrease, it becomes difficult to be active or even mobile. Cancer-related muscle weakening can be one or a major cause of fatigue.

Are Fatigue and Weakness Late-Stage Mesothelioma Symptoms?

Because there are so many different underlying causes for cancer and mesothelioma fatigue, it can occur early and late in the disease. However, tiredness and weakness get worse as the cancer spreads and the disease progresses.

Patients in stage 4 mesothelioma are more likely to feel weaker and to have more extreme fatigue, in spite of efforts to manage these symptoms.

What Causes Muscle Weakness in Mesothelioma?

It is usually easy to pinpoint the underlying cause of muscle weakness in cancer patients. There are multiple factors of living with mesothelioma that contribute muscle weakness:[1][2][3]

• Malnutrition. Nutrition can be an issue for mesothelioma patients, leading to muscle loss. Loss of appetite is common, because of symptoms caused by the cancer or side effects of treatment, such as mouth sores from chemotherapy.
• Treatment. Many treatments for cancer cause fatigue for many reasons. During chemotherapy, for instance, the treatment kills healthy cells, which can make you tired and weaker. After surgery, your body needs to heal, which drains energy.
• Anemia. Chemotherapy can cause anemia, a decrease in red blood cells that leads to fatigue. You might also develop anemia if the tumors spread to bone marrow where red blood cells are made.
• Lack of activity. It can be difficult to be active at all when struggling with mesothelioma, which can subsequently lead to muscle wasting.
• Cachexia. This is severe muscle wasting caused by the underlying cancer. This is a sign of advanced disease and when this happens, can be closely associated with nearing the end of life. It occurs in all types of cancers, in later stages and results in loss of muscle and fat tissue.
• Bone metastasis. In many cases, advanced metastatic mesothelioma spreads to the bones. In bone tissue, the tumors stimulate bone cells and growth factors that ultimately lead to weakness. The weakness results from declining tissue and function in existing muscle tissue.[4]
• Other factors. There may be many other factors that contribute to weakness, including medications, radiation therapy, hormonal changes caused by tumors on glands, low blood count as a result of treatments, or infections.

What Causes Fatigue in Mesothelioma?

Fatigue is harder to quantify, and the causes are usually more complicated. Weakened muscles contribute to fatigue, but there may be many contributing factors:[1]

• Side effects of the cancer, like pain and poor appetite
• Treatments and their side effects, such as nausea and low energy
• Complications of treatments, such as changing protein and hormonal levels that lead to inflammation
• Toxic substances that accumulate in the body from the cancer cells
• Emotional responses to mesothelioma, such as depression, stress, and anxiety
• Lack of sleep
• Poor nutrition
• Lack of activity
• Chronic pain is exhausting to live with and contributes to fatigue

Treating Muscle Weakness

Management for muscle weakness or wasting depends on the cause. Treatment of the underlying cause can always be helpful, whether with systemic chemotherapy or radiation for bone metastasis. There are guidelines specific to physical activity and the benefit to overall energy and physical symptoms.

Cachexia is similarly challenging to manage, as it comes at the later stages of mesothelioma. However, some interventions will help, especially when caught early:[5]

• Managing any symptoms or complications that reduce appetite, such as nausea caused by chemotherapy or infections
• Using appetite stimulants
• Taking high-calorie and nutrient-dense nutritional supplement

Physical activity, using the muscles, can slow or reverse tissue loss. This may be difficult depending on the symptoms and cancer stage, but even limited exercise can help. Patients may work with a physical therapist to improve muscle mass.

Managing Fatigue

Fatigue can be more difficult to manage, especially if doctors cannot identify the main cause or if there are multiple factors. Addressing muscle weakness may be the first step, though. If contributing factors can be identified, such as pain or anemia, treating them may help.

Other strategies and therapies may help reduce fatigue and improve energy:[6]

• Light physical activity, such as walking or gentle yoga
• Massage therapy
• Dietary and nutritional counseling to improve diet
• Working with a sleep specialist
• Medications to boost energy
• Working with a therapist to manage stress or depression
• Getting plenty of rest and relying on family or friends to help with responsibilities

Muscle weakness and fatigue are difficult to deal with and limit the quality of life. Mesothelioma patients often struggle with these symptoms. Your medical team can put together an individualized plan to help you regain strength and combat fatigue.

Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP

Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.

Connect with Doctor of Nursing Practice Anne Courtney