Many cancer treatments are followed by side effects that affect an individual’s daily life, energy levels and mood. Several options, including chemotherapy and radiotherapy, list fatigue as a common side effect. While this can make treatments more challenging to recover from, knowing how to manage fatigue is essential for maintaining a high quality of life.
Most people living with cancer will experience fatigue at some point during their journey. Today, we’ll explore what fatigue is, offer tips on how to manage it effectively, and discuss getting support when you need it.
What Is Fatigue?
Fatigue is an overwhelming feeling of tiredness or exhaustion. It’s a common symptom of many types of cancer, but also their treatments. This may be because fighting the disease takes much more out of the body, leaving less energy for it to complete other tasks as easily as it used to.
You may feel fatigued more quickly after less activity, or feel exhausted even after a good night’s sleep. Cancer-related fatigue (CRF) affects everyone differently and can vary throughout the day. Many people notice that their fatigue improves once treatment ends, but others may experience chronic fatigue for months or even years afterwards.
How Does Cancer-Related Fatigue Affect the Body?
For some, cancer-related fatigue can be a debilitating condition that affects every aspect of life. Others may experience a milder form of fatigue, which affects them less. Everyone is different, and each day can bring varied levels of fatigue for those undergoing chemotherapy and radiotherapy.
Some of the most common effects of fatigue are:
- Feeling weak, like you have no energy or strength left
- Difficulty completing simple tasks, such as getting dressed
- Breathlessness after light activity
- Difficulty concentrating and remembering things
- Sleep troubles or excessive sleeping
- Difficulty thinking, speaking or making decisions
- Low mood or feeling more emotional than usual
Some cancer treatments cause anaemia, which often causes fatigue. Others affect the body’s immune system, which requires extra energy to repair and heal. Sometimes, fatigue may be caused by a build-up of chemicals as cancer cells are destroyed within the body. Many cases of cancer-related fatigue are still unexplained.
How to Manage Fatigue After Cancer Treatments
Cancer-related fatigue affects everyone differently, so it might take time to discover which management techniques work best for you. Your healthcare team, including your GP, cancer doctor, specialist nurse or cancer carer, can provide advice on coping strategies.
Some of the most common and effective ways to manage cancer-related fatigue are:
Keep a Fatigue Diary
There aren’t any clinical tests to measure levels or degrees of fatigue, so you might be recommended to keep a diary of your symptoms and feelings. Specialist nurses often recommend using a numeric rating scale, ranging from 0 to 10, where 0 indicates no fatigue and 10 represents the worst possible fatigue.
You can track your fatigue between appointments with your specialist and use it to demonstrate how fatigue impacts your daily life.
They might find it useful if you record your:
- Fluctuating energy levels throughout the day
- Patterns of fatigue
- Anything you’ve found that makes the fatigue better or worse
A fatigue diary can also be beneficial for you to record when you’re most active, helping you plan your days accordingly. For example, many people undergoing cancer treatment find that planning their important tasks in the morning ensures they have the most energy possible to complete them well.
Remain Physically and Mentally Active
While the idea of exercising your body and mind may feel less than appealing when you’re already battling fatigue, it can actually reduce symptoms and help you feel better. When we don’t use our muscles as regularly as we used to, which is common during cancer treatments, they become weaker through deconditioning.
Activity doesn’t have to be strenuous. Simply engaging in brisk walking, yoga or Tai Chi, or training your brain through activities like crossword puzzles and Sudoku, can help reduce symptoms. Increased activity may also improve your appetite, giving you more energy through food.
Eat Well to Maintain Weight
Another common side effect of cancer treatments is loss of appetite, which can lead to reduced weight and strength. While it may be challenging, maintaining a healthy diet is essential to prevent weight loss, as this can impact treatment and energy levels.
We recommend keeping a food diary that reminds you of what you’ve eaten each day, and when. You can even keep this with your fatigue diary to show your doctors and avoid paperwork from overwhelming you.
Energy comes from all foods, but focus on high-nutrient foods such as:
- Nuts and seeds are full of healthy fats, protein and fibre
- Healthy fats and oils, such as avocados, olive oil and sunflower oil, can be added to salads or used in cooking
- Fatty fish like salmon and sardines are excellent sources of protein and omega-3 fatty acids
- Cheese and full-fat yoghurt are energy-dense dairy options that aren’t too filling
- Beans, lentils and peas are great sources of protein, complex carbohydrates and fibre
- Oatmeal, brown rice and whole-wheat bread provide sustained energy
- Sweet potatoes are a good source of complex carbohydrates and other nutrients
Between meals, be sure to drink plenty of water and try new foods to help maintain a healthy appetite. If you think you’re struggling to maintain a healthy weight, ask your doctor to refer you to a dietitian for personalised advice.
Prioritise Your Night time Sleep
Even if your fatigue makes you feel like you’re sleeping all the time, it’s still important to prioritise night time sleep. A good sleep routine will help your circadian rhythm remain as it should, hopefully reducing daytime sleepiness and extreme fatigue. Wherever possible, refrain from napping during the day to protect your nightly routine.
To prioritise night time sleep, we recommend setting a suitable bedtime and wake time, and creating a quick 10-20 minute bedtime routine to wind down for the night. This includes no screens or excessive light, gentle sounds and relaxing music.
If you’re having difficulty sleeping, talk to your GP or cancer nurse. They may be able to recommend medication or calming routines to continue alongside your chemotherapy or radiotherapy appointments.
Complementary Therapies to Manage Fatigue
Complementary therapies are often recommended by cancer patients and doctors to encourage relaxation, mindfulness and stress relief. These can be used alongside cancer treatments without impacting their effectiveness, helping manage fatigue safely.
Some therapies might be available on the NHS, or local cancer support groups in your area can usually provide assistance.
Popular complementary therapies to manage cancer-related fatigue include:
- Acupuncture: Some studies suggest that acupuncture may be an effective treatment for reducing fatigue.
- Mindfulness: Practising mindfulness can promote better sleep and relaxation, helping to alleviate fatigue.
- Massage: Massage is a popular technique for promoting relaxation, reducing pain associated with cancer treatments, and inducing deep sleep.
- Reflexology: This involves applying pressure to specific points on the feet and hands, which may help increase relaxation levels.
- Aromatherapy: Certain essential oils can provide comfort, such as rosemary, lemongrass, basil, peppermint and eucalyptus.
- Hypnotherapy: Some people find that hypnosis can help with cancer-related symptoms, including fatigue.
- Tai Chi: This gentle exercise combines movement and breathing to improve circulation, boost energy levels and enhance mental stimulation.
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