Fatigue with Cancer

Fatigue is the most common and tormenting complaint of patients with cancer. It is described as feeling tired, weary, exhausted, or worn out, often unlike any feeling of fatigue ever experienced before. The National Comprehensive Cancer Network (NCCN) defines fatigue as “a distressing, persistent sense of tiredness or exhaustion that is not related to recent activity and interferes with the normal activities of daily living.” 

Feeling fatigued is not an indication that your cancer is worse. It is simply an undesirable but expected consequence of cancer treatment. Often, fatigue will end soon after treatment ends. Still, there are strategies that your doctor or nurse can discuss with you to help manage fatigue. 

What Can I Do to Avoid the Effects of Cancer Fatigue? 

Part of managing fatigue is discovering the causes and developing a plan of action to treat fatigue. Be sure to tell your health care team if you: 

  • Have difficulty sleeping 
  • Are anemic or at risk for anemia (low red blood cells) 
  • Are unable to exercise 
  • Experiencing pain 
  • Take other medications 
  • Are experiencing emotional distress, anxiety or depression 

When your doctor asks about medications, be sure to report all medicines that have been prescribed for you, as well as over-the-counter medicines like aspirin, cold remedies, vitamins, or herbal supplements. Some medicines and combinations of medications can contribute to fatigue. Adjusting medicines may improve fatigue. 

As you may expect, your diet can also contribute to fatigue. Aim to eat as healthy a diet as possible ; focusing on fruits, vegetables and protein for better energy. Water is also a key element in regaining energy.

Energy Conservation Can Help: 

  • Identify the time of day when you have the most energy and schedule activities during that time. 
  • Choose activities that are important to you. Prioritize to accomplish those tasks first. 
  • Plan your activities with realistic goals. 
  • Pace yourself and keep a regular daily routine that takes your energy level into account. 
  • Ask others to help you with household chores or driving you to appointments. Keep a list of tasks by the phone to share with friends who call to offer help. 
  • Asking for help should be viewed as a way to take control of your life and situation, not give up control. Family and friends are eager to support your efforts toward recovery. 

Energy Restoration Can Help: 

  • Aim to sleep at least eight hours each night.
  • Take a short nap during the day if needed (but not in the late afternoon.)
  • Avoid caffeine. 
  • Eat a nutritious diet and drink enough fluids. Quick, healthy snacks are helpful. 
  • Follow a comfortable exercise plan: walk, practice yoga, ride an exercise bicycle. 
  • Participate in activities that give you pleasure: read, listen to music, enjoy the sunset. 
  • Make the Mind-Body connection: try meditation, guided imagery, or other activities that help you decrease stress. 

Exercise Can Help with Fatigue from Cancer

There is a large body of research demonstrating the benefits of exercise on both the emotional and physical side effects of cancer and its treatment . Exercise reduces fatigue, distress and depression, helps with endurance, weight control and your ability to do the things that are meaningful and important to you. 

While many health care practitioners may encourage you to exercise, they may not tell you what to do. Be Patient Active and ask your physician for a referral to a physical therapist or cancer rehabilitation program. Exercise won’t make your cancer go away, but it is something you can do to feel better during treatment and stay healthy after your treatment ends. 

How Do I Start to Exercise When I’m Tired?

Start slowly and be patient. Developing an exercise strategy during cancer treatment is a process, and exhaustion is not your goal. Start with 15 minutes of exercise or less. Increase your activity slowly. If there is a Wellness Community in your area, exercise programs, like wellness workouts and yoga classes are often offered. 

Some cancer treatments and their side effects may make it more difficult for you to exercise. For example, if you have anemia that is not corrected with medication, you may experience shortness of breath. If you walk slowly and take rest breaks, you can still receive the benefits of exercise. Start by walking across the room a few times a day. You will get stronger if you are dedicated to being an active survivor. 

Long after treatment is behind you, exercise will be important for maintaining and improving your health. Exercise can help you manage a healthy body weight and reduce risks for heart disease, diabetes, and possibly even cancer recurrence. It is one of the most important things you can do for your health and well-being. 

How Much Fatigue Will I Experience and for How Long? 
It is difficult to predict how fatigued you will feel because every side effect is different for each individual. Also, some therapies cause more fatigue than others, such as bone marrow or stem cell transplants, antiangiogenesis medications, some biotherapies, and certain radiotherapies. In most cases, you will gradually begin to feel less fatigued when your treatment ends. 

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