Can precancerous cells make you tired?

Feeling constantly tired or fatigued is a common complaint among many people. While there are numerous potential causes for chronic fatigue, one possibility that is not often considered is the presence of precancerous cells in the body. Precancerous cells are cells that have undergone some but not all of the changes required to become cancerous. Their presence raises the risk of eventually developing cancer.

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What are precancerous cells?

Precancerous cells, also known as pre-malignant cells, are cells that have acquired some but not all of the genetic mutations necessary to become cancerous. They exhibit some abnormal characteristics compared to healthy cells, but are not yet able to invade other tissues or spread to distant sites in the body (metastasize), which are hallmarks of cancerous cells.

Some common examples of precancerous conditions include:

Cervical dysplasia – abnormal cells on the cervix that can lead to cervical cancer
Actinic keratoses – rough, scaly patches on sun-exposed skin that can turn into skin cancer

Leukoplakia – white patches inside the mouth that can become oral cancer
Polyps in the colon or rectum – benign growths that can transform into colon cancer
Monoclonal gammopathy – abnormal plasma cells that can progress to multiple myeloma

These precancerous cells often do not cause any signs or symptoms initially. But over months to years, they can acquire further genetic mutations and transform into cancer. Therefore, detecting and removing precancerous cells when they are still harmless can prevent cancer from developing.

How do precancerous cells form?

The development of precancerous cells results from DNA damage. Our DNA continually gets damaged by factors like ultraviolet radiation, cigarette smoke, inflammation, and simply normal metabolic processes inside cells that generate free radicals. Cells have mechanisms to repair DNA damage and prevent mutations from being passed on. However, over time with excessive exposure to DNA-damaging agents, mistakes during DNA replication, or inheritied defects in DNA repair machinery, errors creep in.

This DNA damage can mutate important genes that regulate cell growth and division. Certain mutations confer a growth advantage to cells, allowing them to evade normal checks and balances on proliferation. They start to divide more rapidly than surrounding cells, continuing to accrue mutations. While not yet bonafide cancer cells, they form disorganized clusters of abnormal tissue called dysplasia or neoplasia.

Stages of precancerous growth

The progression from normal cells to precancerous cells to full-blown cancer typically follows several stages:

Initiation – This initial stage is irreversible DNA damage caused by carcinogenic factors like radiation, tobacco, or other chemicals. The DNA damage causes mutations in genes that control growth.
Promotion – Cells with mutations grow unchecked and thrive, as more growth-promoting mutations are acquired. Precancerous lesions start to take shape.

Progression – Precancerous cells evolve into a higher grade of dysplasia or neoplasia as their DNA damage continues to accumulate. They eventually become cancerous through a final mutation.

Progression through these stages can span 10-20 years for some cancers. Detecting precancerous changes early provides a window of opportunity to intervene and prevent further advancement toward cancer.

Risk factors

Anything that causes DNA damage or impairs the body’s DNA repair processes can lead to precancerous mutations. Major risk factors include:

Tobacco use – Cigarette smoking introduces dozens of cancer-causing chemicals into the lungs and other organs.
Chronic infections – Bacteria, viruses, and parasites increase inflammation and cell turnover.
Radiation – Ultraviolet light from the sun and tanning beds causes skin damage. Radon gas seeping into homes emits ionizing radiation.

Carcinogenic chemicals – Substances like asbestos, benzene, pesticides, and many others mutate DNA.
Inherited genetic mutations – Defects in genes like BRCA1/BRCA2 impair DNA repair and increase cancer risk.
Poor lifestyle habits – Smoking, excessive alcohol, obesity, and inactivity are implicated in multiple cancer types.

Advancing age – The longer we live, the more exposures our cells have to mutagens and the more chances for replication errors.

Link between precancerous cells and fatigue

There are a few reasons why the presence of precancerous cells could theoretically cause feelings of persistent exhaustion or lack of energy. However, the connection is complex and not well established in scientific research.

Some potential mechanisms by which precancerous cells might lead to fatigue include:

Chronic inflammation – Abnormal precancerous tissue triggers localized inflammation, which could spread beyond that site. Increased circulating inflammatory signals may generate symptoms like fatigue.
Nutrient deprivation – Rapidly dividing precancerous cells have high metabolic demands and may compete with normal cells for vital nutrients. Deficient nutrient levels may manifest as fatigue.
Impaired immunity – Immune cells may be consumed trying to eliminate precancerous cells, compromising their ability to fight other infections that could increase fatigue.

Altered hormone levels – Precancers arising in hormonally-active tissues like the thyroid, ovaries, and testes could disrupt hormone balances and multi-system homeostasis.
Cancer symptoms – If precancerous cells progress to actual cancers, symptoms like fatigue appear as the cancer grows and impacts body functions.

Unfortunately, research specifically examining whether precancerous cells directly instigate feelings of tiredness is limited. But theoretically, they could be contributing in subtle ways already to the fatigue people experience as a “warning sign” that should prompt further cancer screening.

Evaluating fatigue symptoms

Since fatigue has an extensive differential diagnosis, precancerous cells are just one of many possibilities doctors consider. Other medical causes like anemia, hypothyroidism, heart disease, and sleep apnea need to be excluded first. Fatigue related to lifestyle factors such as lack of exercise, poor sleep habits, excess weight, and stress are also evaluated.

If no other cause is found, then precancerous cells may be investigated as a source of otherwise unexplained fatigue, especially if someone has risk factors for cancer. Screening tests like Pap smears, colonoscopies, PSA tests, and skin checks can detect abnormal precancerous growths.

Some steps doctors take to assess precancerous cells as a potential reason for fatigue include:

Asking about personal and family history of cancer
Reviewing any related symptoms – weight loss, fever, pain, lumps, digestive issues
Examining the patient thoroughly from head to toe

Ordering blood tests to check for anemia and markers of inflammation
Performing age-appropriate cancer screening tests based on the patient’s gender, age, and risk factors

Treating precancerous lesions

If screening tests do uncover precancerous cells, the recommended treatment is typically removal of the abnormal tissue. This eliminates the source of potential problems before it can progress to cancer. Precancerous lesions can be removed by:

Surgery – Cutting out abnormal growths or entire organs where precancerous changes are occurring.
Cryosurgery – Freezing precancers to destroy them.
Laser therapy – Using a highly focused laser beam to target and eliminate precancerous lesions.

Photodynamic therapy – Applying a light-sensitizing medication, then activating it with light to destroy precancerous cells.
LEEP – Using an electrically heated loop to remove precancerous cervical lesions.

If fatigue or other symptoms are arising due to inflammation or other effects of precancerous growths, successfully removing them can provide relief in some individuals. But more clinical research is needed to firmly establish whether their removal reverses fatigue specifically.

Can fatigue persist after precancer treatment?

In some circumstances, feelings of fatigue may continue even after precancerous lesions have been successfully treated:

If the abnormal cells had already initiated a chronic inflammatory response, inflammation may linger.
There may be emotional fatigue from the stress of receiving a precancer diagnosis and undergoing treatment.

Root causes like poor sleep, lack of exercise, medications, or other medical conditions still need to be addressed.
Extensive treatment may have caused physiological fatigue – for example, anemia after significant blood loss during surgery.

Discussing any persisting fatigue with your doctor is wise to sort through these possibilities. Cancer screening should continue as well, since even after precancer treatment, the risk of new abnormal cells developing remains elevated.

The bottom line

While preliminary links between precancerous cells and fatigue have been proposed, this relationship is poorly understood. There is no high-quality evidence demonstrating that precancerous lesions directly trigger or cause feelings of tiredness and low energy. Fatigue is extremely common in people with full-blown cancer, but whether early-stage precancerous changes can contribute to fatigue is questionable.

Nonetheless, unexplained chronic fatigue warrants medical investigation to identify any possible cause, including screening for precancerous cell growths. Finding and removing them when they are still in their harmless precancer stage provides the best opportunity to avoid cancer progression. But precancerous cells are likely just one piece of a complex fatigue puzzle. Treating them alone may not resolve fatigue. An integrated approach addressing all lifestyle factors is essential.

Conclusion

In summary, precancerous cell growth is a theoretically plausible but unproven culprit in some cases of otherwise unexplained fatigue. While research attention has heavily focused on fatigue in patients with diagnosed cancers, studying fatigue in the precancer stage could provide valuable insights. If fatigue or related symptoms do turn out to be an early subtle clue signaling precancerous changes, it could allow for screening and intervention at the ideal time to prevent cancer. However, conclusively establishing whether precancerous cells directly trigger feelings of tiredness requires more rigorous longitudinal studies tracking people over long periods. For now, fatigue is just one piece of the cancer prevention puzzle, not a definitive red flag on its own. Anyone experiencing persistent exhaustion should still discuss screening options with their doctor rather than prematurely assuming precancerous cell issues are to blame.