Managing fatigue during cancer treatment

If you’re experiencing cancer-related fatigue, don’t be alarmed – fatigue is common in people with cancer, and there are strategies to help you cope.

The following information has been put together to help you understand some of the causes of fatigue, advice to help you manage symptoms of fatigue and answered some common questions we get from our patients.

What is cancer-related fatigue?

Cancer-related fatigue is the chronic, distressing, emotional and physical exhaustion that many people with cancer experience.

For some, fatigue can be quite severe and may interfere with everyday life. However, everyone’s experience of fatigue is different and often depends on the type of cancer and treatment approach.

Cancer-related fatigue can’t be measured, and there are no specific diagnostic tests. If you’re feeling fatigued, your specialist team will talk to you about your symptoms to determine your level of fatigue and develop a treatment plan.

What causes cancer-related fatigue?

Cancer-related fatigue can be caused by the cancer itself as well as cancer treatments such as chemotherapy, surgery, radiotherapy, bone marrow transplants or hormone therapy.

Changes in hormone levels and proteins that regulate inflammatory processes can lead to increased levels of fatigue4. Some cancer treatments and cancers that have spread to the bone marrow can reduce the amount of red blood cells in your body which can cause anaemia (or low iron), making you feel more tired.

Other cancer treatments may have side-effects, such as nausea or vomiting, which can reduce your appetite and impact on your sleep, contributing to your fatigue.

Certain tumours secret toxins which can prevent healthy cells from producing necessary nutrients such as calcium and potassium for optimal muscle function, resulting in weakness and tiredness.

How to cope with cancer-related fatigue

Exercise

Exercise throughout the week

Drink Fluids

Drink plenty of fluids

Sit down

Increase your opportunities to sit down

Accept help

Let your family and friends help

Limit your to-do

Don’t do too much each day

Sleep

Get at least 8 hours of sleep each night

Healthy eating

Eat healthy, balanced meals or snacks

Relax

Practice relaxation techniques

While fatigue may feel debilitating and overwhelming, there are many ways to manage your symptoms:

Get at least 8 hours of sleep each night – and, take short 30-minute naps during the day if possible
Drink plenty of fluids – dehydration can make you feel more tired
Eat healthy, balanced meals or snacks – eat at regular intervals throughout the day to help maintain your energy levels, and speaking with a specialist dietitian to assist you in healthy meal ideas may be helpful
Don’t do too much each day – prioritise the most important tasks
Increase your opportunities to sit down – take a chair into the shower, play with your children on the floor, and encourage cuddles in your lap (rather than lifting or carrying children or pets)
Let your family and friends help – accept help in the form of making freezer meals, cleaning, gardening, shopping and housework
Exercise throughout the week – regular exercise will help to boost your energy levels, and you can speak to your specialist team about a personalised exercise program
Practice relaxation techniques – yoga and breathing exercises can help restore balance and energy levels.

What role can exercise play in reducing cancer-related fatigue?

Exercise has many benefits for people with cancer. According to the Clinical Oncology Society of Australia (COSA), anyone with cancer should participate in physical activity before, during and after their treatments.

COSA exercise recommendations consist of both aerobic and resistance-based exercises, and include:

At least 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity exercise per week – examples include jogging, swimming or cycling.
Two to three sessions of moderate or high-intensity resistance exercise –such as lifting weights, and these sessions should target all of your major muscle groups.

It is important that you speak to a specialist, such as an accredited physiotherapist or physiologist so that your exercise programme can be tailored to your current level of fitness, whilst accommodating for your type of cancer, prognosis and any adverse effects you may be experiencing from current treatments. The goal of your exercise programme should be to progress towards the above exercise recommendations where possible, and once achieved, maintain this level of activity.

Cancer fatigue and emotional wellbeing

It is common to feel sadness and even despair with your cancer-related fatigue. Having a good network of friends, family and support groups that you can reach out to when your symptoms feel unmanageable is important.

If you are concerned, or wish to find a support group near you, speak with your specialist for information specific to your local area.

Your cancer care team at Icon can also help you with what options might suit you, your life and your type of cancer.

Next steps

If you have cancer-related fatigue, it’s important to speak to your specialist team and get a tailored treatment plan to help you feel more energised.

While fatigue can feel debilitating, it is possible to manage your symptoms with the right support.

Frequently asked questions

Speak with your specialist team before you take any dietary supplements or medications.
Certain supplements may increase the risk for drug interactions and skin reactions with treatments such as chemotherapy and radiation.
While it is common to experience fatigue during your diagnosis and treatment, it is important to talk with your doctor or specialist team if you experience any of the following symptoms:
- A feeling of breathlessness or trouble catching your breath
- Difficulty waking or getting out of bed during a 24 hour period
- Feeling of confusion, dizziness or loss of balance
- Fatigue that is worsening
These symptoms could be a sign of something more serious, so it’s best to seek medical advice if you’re ever unsure about anything.
People with cancer-related fatigue experience symptoms of severe and debilitating tiredness which impacts on their quality of life and daily functioning.
This type of fatigue is different from general tiredness, which most of the general healthy population will experience during some point in their lives.
tiredness is particularly common at the end of a busy day or after bouts of intense exercise, and it can typically be remedied with a good night’s sleep5
For some people, fatigue can last for many months after treatment has finished.
For people receiving chemotherapy, fatigue typically comes in waves, peaking during the days of treatment.
Those who are receiving radiotherapy may notice fatigue gradually increase as treatment progresses.

References

1. Bower, J.E. (2014). Cancer-related fatigue: Mechanisms, risk factors and treatments. Nature Review Clinical Oncology 11(10), 597 – 609. Retrieved on 6th December 2018.
2. COSA position statement on exercise in cancer care. (2018). Clinical Oncology Society of Australia. Retrieved on 6th December 2018.
3. Fatigue. (2012). Cancer Council Victoria, Australian Government. Retrieved on 6th December 2018.
4. What is Cancer related fatigue? (2018) American Cancer Society. Retrieved on 6th December 2018.
5. Cancer-related fatigue (2016) Cancer Society of New Zealand. Retrieved on 6th December 2018.
6. Risks and side-effects of dietary supplements (2015). American Cancer Society. Retrieved on 6th December 2018.

The content on the Icon Cancer Centre website is for informational purposes only and should not be considered medical advice. It is not a substitute for consultation with a qualified medical practitioner. For personalised medical guidance, please consult with your GP or another qualified healthcare provider.