Feeling tired? fatigue and cancer

Friday 11 May 2018

You may be feeling a bit tired as you read this blog, but is it really tiredness?  And is there something you can do about it?

Fatigue is a common (and probably one of the most under - reported) side effects of cancer and cancer treatment.  Although it is often described as tiredness, fatigue goes deeper – it’s more a total lack of energy not linked with activity and not improved by sleep. Over the years I have heard it described as “bone tired” “like the worst jet lag” “just overwhelming” “I just don’t feel up to doing anything”................

Each person may experience fatigue in a different way and for varying lengths of time during or after treatment. It may come on suddenly or build up over a period of time. This lack of energy often interferes with daily plans and can delay a return to “normal” life following treatment for both the person with cancer and their carer.

What causes cancer related fatigue?
The exact cause of fatigue in people with cancer is difficult to pinpoint and probably different for each person who experiences it. However, it is likely to be a result of a combination of the disease itself and its treatments.

What can you do to help improve your energy levels and reduce feelings of fatigue?
This will depend to some extent be trial and error to see what works for you...... levels of fatigue vary enormously between individuals – from feeling a little less able to find the energy to do things than normal to feeling unable to complete even the simplest task.  

Fatigue can occur for short periods every now and then or for long periods of time - sometimes lasting for months after treatment has finished.

The following are strategies that others have found useful:

  • Tell someone If you are feeling fatigued it is important to let your healthcare team know, even if they have told you to expect to feel tired, so any physical causes such as anaemia can be identified and treated.
  • Know what is normal for you and plan round it Is there a pattern to when you feel fatigued? If so, plan your activity around those times allowing time to rest when you think you will need it.  If you are a night owl for example, then avoid planning early morning activity. If you know that you usually feel at your lowest energy levels the day after your treatment then it is probably not a good day to arrange for a trip out that day.  You could keep a diary of your energy levels – give yourself a score out of 10 for how energetic you feel – you can then use this to plan ahead.
  • Balance activity and rest One of the things that many people with fatigue experience is that if they do too little it can get worse. Exercise, in moderation, can actually help you to feel more energetic.  Strange but true................. I use the word “exercise” here with caution – I don’t mean you have to join a gym or do a marathon – tailor your exercise to what you can manage and start slowly – build up from what you have been doing.... maybe a short walk with a friend, a bit of gentle gardening , some armchair yoga  or maybe a walk across a room. Don’t overdo it.... a general rule of thumb is that exercise shouldn’t hurt.....or make you short of breath...Talk to your doctor or physiotherapist about starting the right level of exercise for you and plan short rests around your activity so you don’t get overtired.
    As “exercise” doesn’t mean marathon, so  “rest” doesn’t have to mean sleep – just less energetic time – reading, listening to music or doing whatever you find relaxing. Lack of sleep can make fatigue worse – if you are having trouble sleeping talk to your doctor or specialist nurse or cancer support specialist about possible ways to improve your sleep.
  • Get help It can be very difficult to accept offers of help when you are used to doing things for yourself or you may feel you are asking too much of other people.  However your friends and family are probably wondering how they can help you so let them!
    If you can, get some help at times when you know you are going to feel tired - routine tasks like housework, shopping, cooking. Ask someone else to move that heavy box or get something down from a high shelf, then you are more likely to be able to have the energy to do other things -  which you can enjoy more for not feeling so tired.
  • Eat well When you are feeling tired or unwell it can be easy not to bother with cooking that meal and many cancer treatments can affect your appetite or sense of taste.   Be aware of what you are eating - try to eat healthily and drink plenty of water. Nutritional therapists are on hand at Maggie’s centres to offer advice about healthy eating or you can contact your hospital dietitian.  You can find out more about diet and fatigue in our blog on fatigue by our Nutritional therapist 
  • Share A problem shared isn’t always a problem halved; however, speaking to someone about how you are feeling can help the way you can manage things and your ability to cope.  Anxiety and feeling low can contribute to fatigue and talking to a friend, counsellor or someone in a similar situation can often help with these feelings. Visit a Centre or join in the chat online
  • Manage stress Stress and anxiety can also make fatigue worse. As well as talking things through with others relaxation techniques can help you to cope with stress.   Ask about relaxation classes available at Maggie’s centres or in your local area.
  • Set realistic goals Don’t put too much pressure on yourself by  trying to do too much, even when you think you should be doing more – be patient and take it a step at a time..... Plan for what you think you can manage, if you can’t manage the plan don’t be too hard on yourself, review it and plan again for another day.

Interest into researching the causes and treatment of fatigue has been growing over the last few years. Areas of research include management of anaemia, use of stimulant drugs e.g. Ritalin, Modafinil, exercise, acupuncture  and additional support. You don’t have to face fatigue on your own – if you have a question, are just finding it all a bit overwhelming and need some help or a quiet chat you can always find your nearest Maggie's Centre


Blog originally written by Robyn 2013 - Updated April 2020

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