Tiredness after treatment

Feeling extremely tired (fatigue) is one of the most common side effects of head and neck cancer treatment. You may feel like you have no energy so that it is difficult to do simple, everyday things. It is not unusual for this to last for months after treatment. In some people, tiredness may continue for a year or more.

Possible causes

Sometimes, tiredness is linked to pain. It can also be because of depression, sleep problems, an underactive thyroid gland or having a low amount of red blood cells (anaemia).

It is important to find out if there is a particular cause for your tiredness, so it can be treated. Tell your doctor or nurse how you are feeling. Be honest with them about how tired you are. They can take blood samples to find out if your thyroid gland is underactive or if you have anaemia. These conditions can be treated with medicines.


Tiredness can be a common symptom of depression. It is not unusual to feel depressed or anxious after cancer treatment. If you think you may be depressed, talk to your doctor or nurse. Your doctor may be able to prescribe anti-depressants.

Talking about your feelings with a professional counsellor can help. Some people find that complementary therapies also help to reduce stress and may improve tiredness.

We have more information about feelings after cancer treatment in our section on dealing with your emotions.

Sleep problems

If sleep problems are causing or contributing to tiredness, improving your sleeping pattWern will also help you feel better. We have more information in our section on difficulty sleeping.

You may want to learn some relaxation techniques. Relaxation CDs may be available from your local library or you can find relaxation videos online. Some hospitals, cancer centres and hospices offer breathing control and relaxation sessions. Ask your doctor or nurse whether any are suitable for you.


Coping with pain can be tiring. If you have effective treatment for your pain, this may improve your energy levels. You can read more information on managing pain in our section on pain or numbness after treatment.

An underactive thyroid

Radiotherapy for head and neck cancer can sometimes cause the thyroid gland to become underactive (hypothyroid). This can develop months or years after treatment. The thyroid gland is in the front of the neck. It makes hormones that control the rate that the body works at.

Symptoms of an underactive thyroid gland can include:

  • feeling tired and lethargic
  • constipation
  • slowed thinking
  • weight gain
  • dry skin and hair.

If your doctor thinks you may be at risk of developing an underactive thyroid, you will have yearly blood tests to check it is working normally. If you do develop an underactive thyroid gland, it can be treated with daily tablets.

Tips for managing tiredness

Here are some tips for managing tiredness:

  • Regular exercise, such as short walks, can help build up energy levels and reduce tiredness. It also helps to reduce stress.
  • Develop a routine so that you go to bed and get up at the same time each day. Try not to stay in bed after you wake up.
  • Balance activity with regular rest periods.
  • Let family, friends and neighbours know how they can help.

You can read more detailed information and practical advice for managing tiredness in our section on coping with fatigue.