Cancer Related Fatigue

Author: Ohio State University Comprehensive Cancer Center-James Cancer Hospital & Solove Research Institute

Cancer Related Fatigue Cancer-related fatigue is one of the most common side effects of cancer and cancer treatment. This type of fatigue is very different than feeling tired from everyday life. Some people describe cancer-related fatigue as feeling weak, tired, drained, washed out or having a lack of energy. This type of fatigue can be physical, mental or emotional. Rest often does not make it go away.

As you finish cancer treatment your normal energy level may slowly begin to return. Some cancer patients however, may have fatigue that lasts months, or even longer, after treatment has ended. If you have cancer-related fatigue, it can affect many areas of your life. For some cancer patients the fatigue is just bothersome, but for others it can be much more of a challenge and make it hard to complete regular daily activities. For example, your fatigue may make it hard to spend time with loved ones, go to school or to attend social events. A lower energy level can make it difficult for you to work or go to all of your doctor appointments and treatments.

You may find it hard to think or make difficult decisions. Fatigue can affect your mood. You may feel more emotional or easily bothered by others. There are different reasons why people with cancer may have fatigue. Fatigue can be caused by the cancer itself or cancer treatments. There is often more than just one cause.

Causes of cancer-related fatigue may include: Cancer treatments: such as chemotherapy, surgery, radiation or immunotherapy Sleep changes or not sleeping well at night may make you feel tired. Stress and emotions such as anger, depression and anxiety may cause or worsen fatigue. Certain medicines that you take can also make you feel drowsy. These may include medicines prescribed by your doctor or some over the counter medicines. Not eating well when you have cancer may make your fatigue worse. A low red blood cell count (called anemia) may make you feel tired.

Cancer Related Fatigue

Other cancer side effects such as pain, nausea or diarrhea that are not controlled can increase your cancer fatigue, as can other health problems, other than your cancer. It is important to understand that if you feel more tired it does not necessarily mean that your cancer has gotten worse. Your fatigue may be from any of the causes we have just reviewed.

Relief from any side effects, including fatigue, is an important part of your cancer care. One way to manage fatigue is by doing regular exercise. Exercise can help fight fatigue, boost your energy level, relieve stress and tension, make your muscles stronger and help you sleep better. It is important to talk with your doctor before starting any exercise program to see if you need to follow any special precautions. The kind of exercise you do, and how often you should exercise, will depend on your health and treatment plan. Your doctor may ask you to see a physical therapist to help you develop an exercise plan to meet your needs. Space your activities throughout the day and plan for periods of rest in-between your activities.

Rest is important, but do not take naps longer than one hour so you are able to sleep at night. Do activities slowly. It may be helpful to keep a diary to write down the times of the day when you have the greatest amount of energy. Use those times for the things that are most important to you. Distractions may also lower fatigue. Games, music, reading or talking with others can be helpful. You may find yoga, acupuncture or massage helps relieve fatigue. Let family and friends help with work around the home, such as fixing meals or running errands.

Drink plenty of water or non-caffeinated fluids. Unless you are given other instructions by your doctor, try to drink 8 to 10, eight ounce glasses per day. Eat as well as you can to improve your energy level.

Try eating small meals or snacks throughout the day. Your dietitian can share information about how to fight fatigue with good nutrition. These tips may help to lessen nausea, deal with any changes in your appetite or taste, or offer ideas for times when you feel too tired to prepare a meal. You may find it helpful to meet with a counselor, or to join a support group, to talk about your cancer diagnosis and treatment. You may also find it useful to learn relaxation techniques to help manage your stress. It is important to tell your doctor about any other cancer related symptoms or side effects you may have such as pain, nausea or diarrhea, that may add to your fatigue. It is always important to tell your health care team how you are feeling. There may be times when you need to call your doctor if something changes.

Call your doctor right away if you feel confused or if your thoughts are not clear. You should also call the doctor if you are so tired that you are unable to get up and out of bed for 24 hours or more. Tell your doctor if your cancer-related fatigue becomes worse.

By letting your doctor know how you are feeling, the right treatment can be given to help manage your fatigue and any other side effects. We hope this information has helped you to better understand cancer-related fatigue. Write down any questions you might have for your health care team and bring them with you to each appointment. We are honored to care for you during your cancer treatment. Thank you for choosing The James.

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