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 and find it difficult to do simple, everyday things. It is not unusual for this to last for months after treatment. In some people, tiredness continues for a year or more.

Possible causes of tiredness

Sometimes, tiredness is linked to pain. It can also be because of:

  • depression
  • sleep problems
  • an underactive thyroid gland
  • having a low number 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 also help. Your GP or specialist doctor can refer you. Some people find that complementary therapies also help to reduce stress and improve tiredness.

Sleep problems

If sleep problems are causing tiredness or making it worse, improving your sleeping pattern will help you feel better. We have more information about sleeping difficulties.

Some people find learning relaxation techniques can help. Relaxation CDs and tapes may be available from your local library. 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.

Underactive thyroid

Radiotherapy for head and neck cancers 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 and makes hormones. These hormones control all the cells in our body so that it is able to work normally. If we do not produce enough thyroid hormones, the cells and organs in our body slow down.

Symptoms of an underactive thyroid gland can include:

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

If you are at risk of developing an underactive thyroid, you will have yearly blood tests to check it is working normally. Your doctor will tell you if they think you may be at risk. If you do develop an underactive thyroid gland, it can be treated with tablets that you take every day.

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.
  • Try to go to bed and get up at the same time each day. Try not to stay in bed after you wake up.
  • Pace yourself. Balance activity with regular rest periods.
  • Let family, friends and neighbours know how they can help.

We have more information about coping with tiredness.

I set myself goals to deal with fatigue. I started off doing little things, like tasks around the house. Just bits at a time. Slowly, my fatigue started to improve.