Managing Cancer-Related Fatigue

What is cancer-related fatigue?

Fatigue is a feeling of being physically, emotionally, or mentally tired, weak, or exhausted. It's a symptom of cancer and also the most common side effect of cancer treatment.

Some people with cancer have described fatigue as being tired to the bones or hitting a wall. Others say it is the most distressing side effect of cancer treatment. Fatigue may make you unable to work or do physical activity. It can make it hard to be involved with your family, socialize with friends, or complete daily activities. It can also make it hard for you to focus and pay attention. Sometimes it even causes people to miss cancer treatments.

Having fatigue doesn't mean the cancer is getting worse or treatment isn't working. Fatigue can come and go or it might stay for awhile. Fatigue from chemotherapy tends to be the worst a few days after treatment and then gets better before the next treatment. Fatigue from radiation can start slowly after a few weeks of treatment and get worse as treatment goes on. It may last many months after treatment is finished.

Fatigue is different for everyone. It's important to talk about it with your healthcare team and describe how you feel. Some of the problems linked to cancer-related fatigue can be treated.

What causes cancer-related fatigue?

Some of the causes of fatigue are understood, but not all of them. Fatigue may be related to physical changes caused by cancer or its treatment. Cancer-related fatigue tends to be more severe than the fatigue healthy people sometimes have. This fatigue lasts longer and is not relieved by sleep. Certain things can make the fatigue worse. For instance, if you have pain all the time, or pain that's not controlled, you may not be able to sleep well. If you feel short of breath much of the time, you may feel anxious or tired from working to breathe. Depression, nausea and vomiting, or diarrhea can worsen fatigue. If you're not eating well, don't drink enough fluid and are dehydrated, or are not able to move around much, you may tire more easily. The way a person handles stress, thinks, or behaves can impact fatigue, too. Most of these problems can be treated, and this can help lessen fatigue.

Other things that can worsen fatigue may be harder to treat, like financial worries and fears or concerns related to cancer or its treatment. It's important to talk about these things. There are healthcare providers who can help, like a social worker or counselor. Talking about fears or problems can help you feel more in control and might lead you to solutions to the problems. A support group can also be very helpful. A group can give you ongoing support and a place to share creative solutions to problems with fatigue. Talk with your healthcare provider for more information.

Anemia (low red blood cell levels) can cause fatigue. Chemotherapy can reduce the number of oxygen-carrying red blood cells, so the body does not get as much oxygen as it needs. A blood transfusion or medicines to boost your body's ability to make red blood cells might be needed. Talk with your healthcare provider about the risks and benefits of treating anemia.

What can I do to help ease fatigue?

Cancer- related fatigue can change from day to day. It's important to learn ways to conserve energy. It helps to think of energy like money. You have only a limited amount of it. How do you want to spend it? What activities are most important? What helps restore energy?

To manage cancer-related fatigue or help lessen it, try to:

• Eat a well-balanced diet and talk to your healthcare provider about taking a multivitamin daily.

• Drink plenty of fluids.

• Regularly do gentle exercise. Even a short walk can help. Talk with your healthcare provider about the type of exercise that's best for you right now.

• Talk about problems with friends and family or the healthcare team.

• Ask for help with chores or tasks.

• Take short naps or rest breaks.

• Try to go to bed at the same time every night and aim for 7 to 8 hours of sleep.

How do I talk with my healthcare provider about fatigue?

The most important thing you can do is talk with your healthcare team about fatigue and how it's affecting your daily life. Only you can describe your fatigue. It might help to talk about these things:

• When the fatigue started

• How long it lasts

• What makes it better or worse

• How well you're sleeping

• What things you can't do because of fatigue

• If you have pain, trouble breathing, nausea, or other problems that may be linked to sleep problems and fatigue

• If the medicines you're taking might cause fatigue

Be sure to talk with your healthcare provider about how you can manage or lessen fatigue.