Coping with cancer fatigue is one of the most frustrating concerns during cancer treatment. Unlike ordinary “tiredness” that occurs after a busy day, or can be remedied by a caffeinated beverage, cancer fatigue is felt through your entire body as a tiredness you can’t seem to push through. A tiredness that can come on fast, may occur with the simplest activity, and persists despite a good night's sleep. The most important thing you can do is simply recognize that cancer fatigue is real and unique. You are not being lazy, nor does anyone expect you to accomplish what you may have prior to your diagnosis of cancer.
The first step in coping with cancer fatigue is to share your symptoms with your doctor. He or she will want to rule out any treatable causes of fatigue such as anemia, a low oxygen level in your blood (hypoxemia), sleep apnea, or medications that may need to be adjusted. Your doctor will also want to know if your treatment is interfering with your ability to eat a nutritious diet and get adequate rest at night. If he or she doesn’t find any cause of fatigue that can be easily treated, there are still many things you can do to make living with fatigue a little more tolerable.
1. Ask for HelpLearn to ask for help, and graciously accept help that is offered. Don’t try to be a hero. People want to help, and allowing them to help can ease their own anxiety and sense of helplessness at this time. That said, don’t assume that people will jump in and do the things you would find most helpful. None of us can read minds, and sometimes we need direction. Keep a running list of specific items you could use help with, and have your friends and loved ones “sign up” for those tasks they are willing to do.
2. Exercise ModeratelyStudies have shown that moderate exercise can improve cancer fatigue. Research hasn’t evaluated which activities or duration of exercise are most effective, so choose an activity that you enjoy and an amount of time that feels comfortable to you.
3. Get Enough SleepTry to get at least 8 hours of sleep each night, and nap during the day if needed. On the other hand, too much rest can actually make you feel more tired. It might be helpful to keep a journal noting how much you sleep and how you feel the next day, to understand what amount of rest works best for you.
4. Eat RegularlyEating regular meals is very helpful when it comes to maintaining your baseline energy level. Avoid becoming overly hungry or eating in excess. In addition, emphasizing complex carbohydrates and protein-rich foods over sugary treats and fats can prevent some of the highs and lows in your energy level.
5. Keep Your Environment ComfortableSetting the thermostat at a comfortable temperature – not too hot, not too cold – can help your energy level as well. Avoid hot showers, long hot baths, or activities where you might become chilled.
6. PrioritizePlan ahead and try to complete your most important activities when you are feeling fresh. In one study, researchers found that patients said fatigue was most upsetting when it interfered with an activity they particularly enjoyed. Identify those activities that make you happiest, and fit them in at times when you are feeling your best.
7. Pace YourselfWith cancer fatigue, slow and steady wins the race. Rushing tends to tire you out more quickly, and can add to your anxiety level as well. Listen to your body. Many cancer survivors find that taking short, frequent rest periods during the day instead of one long period of rest is helpful.
8. Avoid Alcohol and CaffeineBoth alcohol and caffeine can contribute to tiredness during cancer treatment. A cup of coffee in the morning probably won’t hurt, but using caffeine to stay awake can backfire and leave you feeling more tired. Likewise, alcohol may help you fall asleep, but your sleep will not be as restful as if you abstain.
9. Keep a JournalKeeping a journal can help you identify times of the day when you have the most energy, so you can plan accordingly. It can also help identify those things that seem to drain your energy level, and activities that improve it.
10. Manage StressWe all know how stress can drain our energy, even when we aren’t going through cancer treatment. Find ways to relieve stress that you find enjoyable. Meditation, yoga, or prayer are helpful for some people; others find reading, listening to music, or a walk in a park to be calming. Visualization is being taught in many cancer centers, both as a way to cope with the symptoms of cancer, and as a method of moving past the inevitable stress of cancer treatment.
11. Consider Complementary/Alternative Therapies to Fight FatigueMany alternative therapies are being used to help with the fatigue that accompanies cancer. Both therapeutic touch and acupuncture have been linked with a decrease in fatigue in clinical studies on cancer patients. Check with your cancer team, and support group, to see what services are offered in your community.
12. Join a Cancer Support GroupOften, just knowing that you are not alone can help you cope with the fatigue of cancer treatment. On top of that, a support group allows you to hear from others that have experienced similar symptoms and what they have done that has helped them cope.
Aghabati, N. et al. The Effect of Therapeutic Touch on Pain and Fatigue of Cancer Patients Undergoing Chemotherapy. Evidence Based Complementary and Alternative Medicine. 2008. Feb. 2. Epub ahead of time.
Cramp, F. and J. Daniel. Exercise for management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews. 2008. 16(2):CD006145.
Fitch, M. et al. Exploring patient experiences and self-initiated strategies for living with cancer-related fatigue. Canadian Oncology Nursing Journal. 2008. 18(3):124-40.
Kangas, M. et al. Cancer-related fatigue: a systematic and meta-analytic review of non-pharmacological therapies for cancer patients. Psychological Bulletin. 2008. 134(5):700-41.
Lee, Y. et al. Fatigue experience and coping strategies in Taiwanese lung cancer patients receiving chemotherapy. Journal of Clinical Nursing. 2008. 17(7):876-83.