Fatigue may be caused by the pancreatic cancer or the symptoms of the cancer, or it may be a side effect of treatment. Fatigue is a very common symptom of cancer and is often called cancer-related fatigue. This page has information about these causes of fatigue, which include:
We give some tips for dealing with these here. There is also more information on other ways to deal with fatigue in the next section.
The cancer itself can cause fatigue, although we don’t fully understand how or why this happens. People may have fatigue when they are diagnosed, even before they start treatment. Other symptoms caused by pancreatic cancer, such as problems digesting food, can also cause fatigue.
The pancreas makes enzymes which help to break down your food. This is part of digestion. Your body then gets nutrients and energy from your food. Pancreatic cancer can affect digestion, which means that you don’t get the energy you need from your food. This can cause fatigue.
Problems with digestion can also cause loss of appetite, tummy discomfort, diarrhoea and sickness. These can all mean that you may eat less, and so get less energy from your food. Fatigue may also mean that you feel less like eating.
Pancreatic enzyme replacement therapy (PERT) helps to manage these problems with digestion. It replaces the enzymes that your pancreas would normally make. Common brands include Creon®, Nutrizym® and Pancrex®.
“The cancer affects your eating, making you weak. It affects your toilet habits, which makes you feel uncomfortable so you don’t want to eat anyway. It all has a knock-on effect – all these little things add to fatigue. It’s all connected.”
Pancreatic cancer can cause pain for some people. Pain may be linked to fatigue, although we need more research into this.
Having pain can be exhausting, and it may cause problems sleeping. Your fatigue may be worse when you have more pain and you may feel less tired when you have less pain.
Sometimes, pancreatic cancer can cause diabetes. This is a condition where the amount of glucose (which is a type of sugar) in your blood is too high. Diabetes may make you feel tired, lethargic and confused.
If you are diagnosed with diabetes, you will need advice that is specific to you because of the cancer. There are different types of diabetes, and information on the internet may not be right for you because of the pancreatic cancer. It’s important that you eat well to maintain your weight, and that your diabetes is managed around this. Don’t try to reduce how much you eat to manage your diabetes.
If you have diabetes and haven’t seen a dietitian or diabetes nurse to help you manage it, ask your doctor or nurse to refer you.
Pancreatic cancer can make you feel and be sick (nausea and vomiting). This can be caused by the cancer or it can be a side effect of treatment.
Being sick can be exhausting. It may also mean that you don’t absorb all the nutrients you need from your food, making you tired. But there are ways to manage sickness.
"She couldn’t do the everyday things she used to like getting out the house as much, the sickness made her constantly exhausted. Only rest and being able to eat what she could helped."
Advanced pancreatic cancer is cancer that has spread to other parts of the body, such as the liver and lungs. If you have advanced cancer, you may find that the fatigue gets worse over time, and that it has more of an effect on your daily life. This is normal, but it can be upsetting for you and your family.
Your medical team may be able to change the way they manage your symptoms to help with the fatigue.
“Seek medical advice, don’t just hope that it’ll pass. Confide in family members.”
Speak to your doctor or nurse about any symptoms or side effects that might cause fatigue, such as problems with diet and digestion, pain or feeling sick.
You can also speak to our specialist nurses with any questions about your fatigue.
Chemotherapy uses drugs to kill the cancer cells. It is one of the main treatments for pancreatic cancer. Fatigue is a common side effect of chemotherapy.
Some people find that the fatigue starts a few hours to a few days after having chemotherapy, and improves after a few days. It can take several months for the fatigue to fully improve.
“I was sleeping 17 hours a day. When I mentioned it to the oncology team, my chemotherapy dose was adjusted, resulting in improved wakefulness.”
"My dad has chemo on Fridays. Come Tuesday and Wednesday, he can't get out of bed. The two days are an absolute write off. After these two days though, he regains some energy and has 5 good days!"
Surgery to remove pancreatic cancer, such as the Whipple’s operation, is major surgery. If surgery to remove the cancer isn’t possible, some people may have bypass surgery to treat a blocked duodenum or a blocked bile duct. This is also a big operation.
It is normal to feel tired and weak after surgery, and it can take several months to recover. Some people still get fatigue a year or more after surgery.
"It was hard to find the energy to do anything after surgery. I’m slowly improving but still regularly get times when I need to stop and sleep for an hour or so in the day."
Some people with pancreatic cancer may have radiotherapy, which is sometimes combined with chemotherapy (chemoradiotherapy). Fatigue is a common side effect of radiotherapy. You may need to travel to hospital every day for treatment and this can make fatigue worse. Fatigue can last for several weeks or months after treatment finishes.
Some medicines can make you feel sleepy, especially when you first start taking them or when the dose is changed. These include opioid painkillers, like morphine, and some anti-sickness medicines such as metoclopramide and lorazepam.
"It took several weeks to realise that it was the metoclopramide that made me so fatigued after chemotherapy, not the chemotherapy itself."
“You don’t realise how much the medication can make somebody really tired. Once he started taking the tablets he became very lethargic and sleepy, and couldn’t do as much.”
Anaemia is a low level of red blood cells or haemoglobin. Haemoglobin is the part of the red blood cell that carries oxygen around the body. Anaemia can make you feel tired, dizzy, short of breath and have problems concentrating. It may have many causes, including chemotherapy. You will have regular blood tests to check your blood cell levels during chemotherapy. There are things your doctors can do to treat anaemia.
When you have cancer it’s natural to feel worried, anxious, down or stressed. But sometimes these feelings can become overwhelming. Anxiety and depression can be common in people with pancreatic cancer. And depression can be linked to fatigue in people with cancer.
Your medical team may be able to help with things that might be worrying you. For example, how to get advice about financial issues, or managing at home. Dealing with problems like these may reduce stress and anxiety.
Problems sleeping can be common in people with cancer and can make fatigue worse.
You may find that napping during the day gives you a bit more energy. If having a short nap helps, then it is fine. Try to limit how long you nap to about 30 minutes, as sleeping too long can make it harder to sleep at night. You could set an alarm so that you don’t keep sleeping. An occupational therapist can give you advice about napping.
“Sleep helped slightly but it was difficult to switch off and sleep.”
"It helped to have quiet times during the day, sometimes in a different room to others."
Updated October 2022
To be reviewed October 2025