A thorough physical and psychological evaluation is needed to identify possible causes of fatigue and determine what may be treatable. It helps to keep a record/log of your pattern of fatigue prior to going to your healthcare provider. For example, note on your calendar hours spent working each day, how many naps you take, how long naps are, and how many hours sleep each night. Many survivors force themselves to go to work but feel absolutely exhausted by the afternoon. This is an important piece of information to share with your healthcare provider. This evaluation should be extensive to determine what is causing your fatigue, how long it has lasted, what makes it better or worse, medications you take, and how it is affecting your daily life.

Your chronic fatigue evaluation should include the following:

• Review of cancer history, treatment, and current health status

• Complete physical examination

• Fatigue history

• When it started, how long it has lasted, any changes

• Actions or events that make the fatigue better or worse

• Effect of fatigue on job, daily life, and relationships

• Assessment of contributing factors, such as:

  • Pain

  • Hormone levels (i.e., thyroid, testosterone, estrogen, growth hormone)

  • Current medications, including over-the-counter medicines and supplements

  • Emotions (e.g., depression and anxiety)

  • Sleep and napping habits

  • Level of physical activity

  • Nutrition history, including weight gain or loss and changes in appetite

  • Other health conditions that could affect fatigue