Side Effect Management - Fatigue

Fatigue is a common side effect of many cancer treatments, including chemotherapy, immunotherapy, radiation therapy, bone marrow transplant, and surgery. It can also be caused by the cancer itself. Patients often describe cancer-related fatigue as feeling extremely tired, weak, heavy, run down, and having no energy, making it a very difficult side effect to cope with.

Cancer-related fatigue is different than fatigue experienced by healthy people. When a healthy person is tired from day-to-day activities, their fatigue can be relieved by sleep and being less active in the hours or days that follow. On the other hand, if you are a cancer patient, you may get tired more easily than people who do not have cancer. Cancer-related fatigue is not completely relieved by sleep, and more rest may be required for relief. Fatigue usually decreases after cancer treatment ends, but patients may still feel some fatigue for months or years after treatment.

Causes of cancer-related fatigue

Mental stress, physical problems, or difficulties faced in your daily life can cause fatigue. Some of the most common causes of cancer-related fatigue include:

  • Pain
  • Anemia (low red blood cell count)
  • Cancer treatments (chemo, radiation therapy, surgery, hormone therapy)
  • Medications, other than the primary cancer treatments
  • Emotional distress (anxiety, depression)
  • Nausea or vomiting
  • Sleep problems
  • Infections
  • The cancer itself
  • Poor nutrition
  • Lack of exercise

How to tell if you’re fatigued

Fatigue can affect cancer patients in different ways. There are, however, some common signs that could mean you are fatigued. The most common symptom is weariness, which can be described as feeling extremely tired, weak, heavy, run down, and unenergetic. Other signs of cancer-related fatigue to look for are:

  • Sleeping more often than normal
  • Inability, difficulty, or lack of desire to do normal daily activities
  • Trouble thinking or concentrating (also known as “chemo brain”)
  • Shortness of breath after light activity
  • Difficulty finding words or speaking
  • Feeling more emotional than usual, especially feelings of sadness and depression
  • Paleness
  • Shakiness
  • Arms and legs that feel heavy and hard to move

How to manage cancer-related fatigue

Managing fatigue is an important part of your cancer treatment plan. Fortunately, there are some simple things you can do that can help minimize the effects of fatigue so you can feel in greater control of your life. Here are some recommendations:

Plan time to rest

While it’s important to rest, too much sleep during the day can make it difficult to sleep at night. It is best to take short naps about an hour in length, or less, throughout the day, rather than one long nap. Other tips for getting enough rest can include:

  • Avoiding caffeine after lunchtime
  • Getting to bed earlier and sleeping in a little later, aiming for seven to eight hours each night
  • Exercising earlier in the day rather than too late in the evening

Eat nutritious foods

  • Eating the right foods can give you energy and help your body heal.
  • Stay well hydrated with water or other fluids, such as tea or milk. Limit your intake of caffeine and alcohol 
  • Eat foods high in protein and calories to help keep up your strength
  • Focus on eating small, frequent meals, rather than three large meals
  • Cook a large batch of food and freeze it in single-serving containers so you have easy meals on days you’re too fatigued to prepare lunch or dinner
  • Ask your doctor or nurse to refer a dietician, who can also give you helpful ideas

Stay active

It may sound like the opposite would be true, but regular, light exercise is a good way to ease the effects of fatigue.

  • Set aside time each day to exercise
  • Exercise by doing something you enjoy, such as walking, swimming, dancing, bicycling, or yoga
  • Talk to your oncologist about the amount and duration of exercise that is appropriate for you

Prioritize your day-to-day activities

  • Don’t feel as though you must keep up with your normal activities. Instead, pick what is most important to you and focus on those areas. Consider opting out of some things you may have done before your cancer diagnosis, even if only for a short time.
  • Conserve your energy by doing things slowly and spreading activities throughout the day.
  • Accept help from others if they offer and try to ask for help when you need it. 

Lower your stress level

Managing stress is an important part of your cancer care. To help ease the burden of fatigue, do your best to eliminate unhealthy or unnecessary stress in your life. Sharing your feelings with others can also help you cope with fatigue. Consider talking with a counselor or joining a support group.

Focus on things you enjoy

It can be easy to let cancer occupy all your thoughts. To keep that from happening, distract yourself with things you enjoy. This could include things such as listening to music, reading a book, or spending time with family or friends. Activities such as these can give you an escape from your fatigue without requiring too much energy.