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Managing Cancer Related Fatigue

For many patients cancer related fatigue can interfere with normal routines, and limit participation in activities that make life meaningful. Monitoring your fatigue levels, exercise, nutrition counseling, and lifestyle changes can help you cope.

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Despite fatigue, most people feel better when they exercise each day. Choose a sport or an exercise routine that you enjoy−stretching, yoga, or Tai Chi help some people.

Cancer-related fatigue is the most common side effect of cancer treatment and can be one of the most distressing for patients. It lowers self-esteem, stresses relationships, interferes with normal routines, and can limit participation in activities that make life meaningful. Fatigue usually decreases after cancer treatment ends, but some patients may still experience symptoms for months or years after treatment is completed.

It's not all in your head!

Research suggests that between 70 and 100 percent of cancer patients getting treatment have fatigue. Often vaguely defined as a persistent sense of physical or emotional exhaustion unrelated to recent activity, cancer related fatigue is often under reported to providers.  

In a recent presentation on ways to cope with cancer related fatigue, NCCC Oncology nurse Kate Wilcox  reported that  many patients perceive fatigue as more distressing than the pain, nausea, or vomiting they may experience during treatment " It is not all in your head," she said. Nearly every person in the room was relieved to hear her say this. "People say 'you just took a nap—you can't be that tired!'" One woman said. "I try not to be hard on myself, but asking for help is the hardest thing for me."

What are the causes of cancer related fatigue?

Usually a patient's cancer related fatigue has several different causes. Your body may be reacting to specific cancer therapies, or to changes in your immune system or hormones. Stress and anxiety can interfere with sleep cycles, which can impact mood and coping abilities. Sedating medications or other health problems like underlying heart or lung disease or infection may be contributing to fatigue. Several of these factors can negatively interact, leading to a vicious cycle of increased fatigue.

What does cancer related fatigue feel like?
  • Fatigue that does not get better with rest
  • Feeling weak, drained, or "washed out"
  • Sleep is not restful
  • Excessive need to rest
  • Muscle heaviness and weakness
  • Mental fogginess and diminished concentration
Talk with your provider about your level of fatigue

Wilcox recommends keeping a fatigue diary to regularly assess your level of fatigue (using a scale of 1 to 10) and describing your situation to your health care team. Treatment might include education and counseling, exercising or physical therapy, nutrition counseling, sleep therapy, supportive /expressive therapies, lifestyle changes, or medications or supplements.

Despite fatigue, be as active as you can

Most people feel better when they exercise each day. Some people even sleep and eat better when they exercise. Try to exercise every day. Even 15 to 30 minutes a day can help give you energy.

  • Walk for 15 to 30 minutes each day.
  • Take a short bike ride or ride an exercise bike.
  • Choose an exercise routine or a sport that you enjoy.
  • Ask your doctor or nurse about other exercises that can help−stretching, yoga, or Tai Chi help some people.
Do fewer things: ask for help when you feel tired
  • Save your energy: do the activities that are most important to you first.
  • Ask family and friends for help: they can make meals, drive you to the doctor, or help with groceries
  • Learn your limits. Don't fill your day with too many activities.
Plan time to rest
  • Listen to your body. Rest when you feel tired.
  • Sleep at least 8 hours each night.
  • Take short naps during the day. Nap for less than 1 hour at a time.
  • Read a book or listen to music to relax before going to bed at night.

To learn more about information sessions, classes, and other programs at the Norris Cotton Cancer Center visit Patient & Family Support Services

Sources:  National Cancer Institute, American Cancer Society

February 19, 2013