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Q: My husband has oral cancer and went through seven weeks of radiation, which ended December 14. He is very tired all the time and finds it hard to function on a daily basis. Is there any medication that can help him wake up and stay awake during the day?
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Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

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July 14, 2008
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A:

Fatigue after cancer treatment is extremely common. It may be due to a number of potentially treatable problems such as anemia (low levels of red blood cells), hormonal alterations, poor sleep, physical deconditioning and anxiety or depression.

Of course, there is also cancer-related fatigue that many survivors experience after their treatment. This phenomenon is not well understood, but seems to be due to the treatment itself.

Sometimes doctors will use medications to help improve fatigue. For example, your husband's doctor may prescribe iron supplements if he has an iron-deficiency anemia. Or, if your husband has insomnia, his doctor may prescribe a drug to help him fall asleep more easily. If he's depressed, perhaps he needs an anti-depressant medication.

Occasionally doctors will also use medications that stimulate the brain (called psychostimulants) such as Ritalin (methylphenidate).

Two things I usually encourage my patients to do are:

  1. Try to eat regularly — usually three meals with two nutritious snacks in between — to help promote healing and energy.
  2. Get a pedometer and count how many steps a day you take. The goal for active, healthy people is 10,000 steps per day. Most cancer survivors who suffer from fatigue aren't even close to that level.

However, increasing the number of daily steps can help to improve stamina and energy levels.

Your husband is several months out from his treatment, so I'd recommend making a specific appointment to talk to his oncologist about his fatigue and how that is affecting his ability to function day-to-day.

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