Childhood Cancer

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Childhood Brain and Spinal Cord Tumors

Fatigue and weakness

Fatigue, a feeling of weariness, is an almost universal side effect of treatment for cancer. General weakness, although different from fatigue, is caused by many of the same things and is treated the same way. Fatigue and weakness may be constant throughout therapy or intermittent. They can be minor annoyances or totally debilitating. Fatigue and weakness are usually caused by one, or a combination, of the following things:

  • Cranial radiation
  • Your child’s body working overtime to heal tissues damaged by treatment and to rid itself of dead and dying tumor cells
  • Medications to treat nausea or pain
  • Mineral imbalances caused by chemotherapy, diarrhea, or vomiting
  • Malnutrition caused by nausea, vomiting, loss of appetite, or taste aversions
  • Anemia (low red blood cell count)
  • Infections
  • Emotional factors such as anxiety, fear, sadness, depression, or frustration
  • Disruption of normal sleep patterns (common when hospitalized or when taking some drugs)

Following are suggestions from parents:

  • Make sure your child gets plenty of rest. Naps or quiet times spaced throughout the day help.

Erica took a 2 ½ hour nap every afternoon throughout therapy. She’s 4 now and off treatment, but her endurance is low and she still tires easily.

  • Limit visitors if your child is weak or fatigued.

While in the hospital, my daughter was very weak. She had too many visitors, yet didn’t want to hurt anyone’s feelings. We worked out a signal that solved the problem. When she was too tired to continue a visit, she would place a damp washcloth on her forehead. I would then politely end the visit.

  • Serve your child well-balanced meals and snacks, but don’t get upset if he doesn’t eat them (see next point about stress).
  • Parents and children should try to avoid physical and emotional stress.
  • Encourage your child to pursue hobbies or interests, if able. For example, if your child is too weak to play on an athletic team, let her go to cheer the team on.

My eighth-grade daughter was a fabulous athlete prior to her diagnosis. When she went back to school after missing a year, she wasn’t very competitive, but she managed the softball team and dressed for basketball. So she was still part of the social scene and was able to do things with the teams.

  • Help your child make a prioritized list of activities. If he feels strongly that he wants to attend a certain event and you think he may run out of energy, throw a wheelchair or stroller into the car and go.
  • Encourage your child to attend a kid or teen support group, and go to the parent group yourself. Seeing that others have the same problems and talking about how you are feeling can lighten the load.

Some children go through treatment without fatigue or weakness, but other children are not so lucky. The following stories describe two common experiences.

Before Brent was diagnosed at age 6, he was exceptionally well coordinated and a very fast runner. During treatment, he slowed down to about average. He played soccer and T-ball throughout, and was very competitive.

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Jeremy has had some major, persistent problems with weakness and loss of coordination. When he was 9 years old, a year off therapy, he still could not catch a ball. When he ran, he was like a robot, and the trunk of his body stayed straight. Some kids made fun of him, and he got very frustrated with himself. He had lots of physical therapy, and now, 3 years off treatment, his skills have improved, but he still has to work harder than the other kids. We put him into martial arts in hopes of further increasing his motor skills and his confidence.

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