Fighting Cancer Fatigue

[tips from 20 reliable sources]

Feeling exhausted? We’ve collected tips from reputable websites such as National Cancer Institute, Irish Cancer Society, MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, etc. to help you fight cancer fatigue and live 10X better.
Cancer fatigue (tiredness) is the most common side-effect of cancer treatment. Fatigue means feeling very tired and lacking in energy to do day-to-day things. Fatigue is very different from ‘normal’ tiredness a person usually feels at the end of the day. It doesn’t necessarily relate to activity and doesn’t always go away with rest and sleep.

Sleep and rest


Sleepless nights can make you feel tired, cranky and a bit dazed. It might help to change a few things about when and where you sleep if you often have trouble sleeping at night.
  • ‘Power nap’ Take short naps or rest breaks (30 minutes or less), rather than one long nap during the day. Too much rest can lower your energy level and make it harder to sleep at night. Balance rest and activity. Too much time in bed can make you weak.
  • Rest before you get too tired
  • Night time should be reserved for the longest sleep of the day. (Try to sleep 7 to 8 hours each night.)
  • Try to do some soothing or relaxing activities at bedtime. Spending time relaxing before you go to bed. For example, have a bath, read or listen to music.
  • Lie in bed for sleep only.
  • Try to keep the bedroom free from activities such as reading or watching T.V.
  • Avoid any ‘screen time’ (like computers, video games, electronic books) before bedtime as the light from the screens may interfere with your ability to fall asleep.
  • Do not eat before bed. This may cause indigestion (‘heartburn’). Try to eat light snacks in the evening
  • Avoid smoking, alcohol before bedtime.
  • Avoiding caffeine in fluids (like coffee, tea, energy drinks, or soda), medicines (like headache remedies), or even in foods (like chocolate) for at least 8 hours before bed.
  • Do not do strenuous activities before bedtime. Relax before bedtime. Sometimes drinking warm decaffeinated beverages, and/or relaxation techniques such as meditation, warm baths, or music can help.
  • Making sure the room you sleep in is comfortable, calm, quiet and soothing and a nice temperature.
  • Keep the bedroom cool, quiet and dark.
  • Use comfortable bedding and sleepwear.

Exercise


Friends and family may advise you to ‘take it easy’ and ‘get plenty of rest’. But staying in bed for a long time can cause you to feel even more tired. If you rest for a long time, your muscles will weaken, and you will find it harder to be active when you want to. Be as active as you can without making the fatigue worse. There is evidence that exercise helps reduce cancer fatigue. Regular moderate exercise can lessen feelings of tiredness and a lack of energy.
  • Good exercise activities include walking and cycling.
  • Do regular, mild to moderate exercise – not infrequent, intense workouts.
  • Start slowly and increase activity level over time as you are able to. For instance, start out walking for 5-10 minutes, 2-3 times a week and increase it slowly to 20-30 minutes, 3-4 times per week.
  • If you are feeling unwell or experience a change in heart rate, breathing or pain skip exercise and resume when feeling better. Don’t forget to talk to your nurse or doctor if this happens.
  • Talk to your doctor before beginning an exercise program.
  • Renewal through nature – Simple activities like sitting beside a lake, working in the garden, and bird watching have been found to restore attention and decrease fatigue in cancer patients.

Organize and daily living


  • Be flexible. Don’t measure your energy against how you felt before you were diagnosed. Set realistic goals.
  • Develop a routine and think about when your energy is highest and lowest. Then organize your day around those times. Set small, manageable goals – When you plan your day, include rest times.
  • Organize each day – Figure out what you have to do and when you need to do it. Pacing yourself helps to conserve your energy.
  • Set small manageable goals.
  • Plan ahead and give yourself plenty of time to get to places. Try not to rush allow plenty of time to get around or to appointments.
  • Each day, prioritize – decide which things are most important to you and focus on those tasks. Then plan ahead. Spread activities throughout the day. Do things slowly, so that you won’t use too much energy at once. And don’t forget to give yourself time to take short rest breaks between activities.
  • Modify the home environment to maximize efficient use of energy. For example: put chairs around the house so that you can easily stop and rest if you need to.
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Bathroom


  • After your shower or bath, sit down to dry off.
  • Have a chair in the bathroom so you can sit down when you wash up and brush your teeth.
  • Avoid hot showers and baths – could make you feel more tired.
  • Place a shower/bath organizer where you can easily reach it.
  • Install rails and handles where you need them, for example, in the shower, and near the toilet.
  • Use a sponge or brush (e.g., back brush) with a long handle to scrub your feet and other areas that may be hard to reach.
  • Install a raised seat on the toilet.

Dressing


  • Get dressed sitting down. Plan what you will wear and have your clothes in one place before you dress.
  • Minimize leaning over to put on clothes and shoes.
  • Bring your foot to your knee to apply socks and shoes.
  • Wear comfortable clothes and low-heeled shoes – Wear loose fitting clothes to allow for free and easy breathing and things with few buttons to do up.

Household and gardening


Conserving (or saving) energy is one way to make sure you have enough energy to do what needs to be done each day. You may need to accept the fact that you can’t do everything you want to do.
  • Schedule household tasks throughout the week
  • Let family and friends help with tasks where possible. Schedule household tasks over the week (e.g. washing one day, vacuuming the next) so you don’t do too much on one day. Lower your standards for a while.
  • Be specific – Help others understand and support you. Talk to family and friends about how they can help. Be specific, for example: “I need someone to do the vacuuming every week”.
  • Where possible, do household tasks sitting down; for example, peeling vegetables or ironing.
  • Drag or slide objects rather than lifting. Use proper body mechanics. Use your leg muscles not your back when working.
  • Stop working before becoming tired
  • If you don’t have a dishwasher, soak dishes instead of scrubbing and let dishes air dry. Wash up after each meal so the dishes don’t build up.
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Shopping


  • Use a shopping trolley rather than a basket.
  • Have your groceries delivered. Consider doing your supermarket shopping online.
  • Ask for help. Use shops where the staff are considerate and will carry your bags and boxes to the car.
  • Shop at less busy times (evenings or early in the morning).
  • Write a shopping list and go when the shops are quiet.  

Children and childcare


  • Use a shopping trolley rather than a basket.
  •  Play games that you can do sitting or lying down; for example reading, puzzles, board games or drawing.
  • Get help with collecting the children from school.
  • Talk to your healthcare team if you need a break and don’t have anyone to help with your children
  • Accept offers of babysitting, play-dates or driving from people you trust
  • Avoid lifting smaller children (teach children to climb up on the lap or chair)
  • Explain to your child(ren) that you are feeling tired and are not able to do as much as in the past. Their response and suggestions may also help you.

Eat


Cancer-related fatigue is often made worse if you are not eating enough or not eating the right foods. Eat as well as you can.
  • Have plenty of nutritious snacks and drinks in the house so you can have something quickly and easily whenever you feel like eating.
  • Try to eat a wide variety of healthy foods, including protein.
  • Some people find that a diet with lots of fruit and vegetables and grain-based foods (like pasta and rice) gives them a feeling of energy. Others might get the same feeling from having more meat in their diet. A dietitian will be able to help if you want to change your eating habits.
  • Meet your basic calorie needs. The estimated calorie needs for someone with cancer is 15 calories per pound of weight if your weight has been stable. Add 500 calories per day if you have lost weight. Example: A person who weighs 150 lbs. needs about 2250 calories per day to maintain his or her weight; active people need 20 calories per pound of weight to maintain their body weight.
  • Make sure you are getting enough vitamins. Take a vitamin supplement if you are not sure you are getting enough nutrients.

Meal Preparation


  • Make simple meals – Use convenience foods/ easy-to-prepare foods (tinned sardines, tuna, and salmon; salad; omelets and scrambled eggs; baked potatoes; steamed vegetables; grilled lean chops; vegetable stir-fries.)
  • Accept offers of meals from friends and family.
  • Use small appliances (they take less effort to use)
  • Prepare meals sitting down
  • Use frozen foods – If you’re making a soup or pasta sauce, prepare double portions and freeze half.
  • Rearrange things so you don’t have to bend or reach.
  • Order takeaway food sometimes if you can afford it.

Drink


  • Make sure you drink plenty if you can. Aim to drink 8 cups of fluid every day. Fluids could include water, juice, milk, soup, and milkshakes.

Emotional


Cancer is stressful and your mood, beliefs, attitudes, and reactions to stress can also affect the amount of fatigue you feel.
  • Remember that feeling emotional is “normal” and it is OK to be upset or angry about what is going on for you.
  • If your cancer treatment is finished, do not expect yourself to get “back to normal” right away. Give yourself some time to get back on your feet.
  • Remember that fatigue caused by treatment is short-term and that energy often returns slowly after treatment has ended.
  • Avoid stress where possible: relaxation techniques and exercise can help to reduce unavoidable stresses.
  • Talk to someone you trust about your feelings can help ease the burden of fatigue.
  • Join a support group – Sharing your feelings with someone in the same situation may make you feel less anxious about your fatigue. And you can often get tips on how to cope better from talking about your own situation.
  • Learn ways to deal with your stress – Learn about meditation, deep breathing, or relaxation techniques
  • Keep a diary or journal about your feelings and experiences
  • Counseling – Talking with a counselor may help reduce fatigue. For example, cognitive behavioral therapy may help you do the following: (Reframe your thoughts about fatigue, Improve coping skills and Overcome sleep problems that contribute to fatigue.)
  • Try an activity such as reading, seeing friends and listening to music. This may help take your mind off worrying thoughts.
  • Mental exercises help to relax your mind. These include imagery exercises.
  • Have realistic expectations – As soon as treatment finishes, don’t expect to be able to instantly do all the things you used to do before cancer. Your body is still recovering and it will take time for your energy levels to return.

Visitors


  • Limit the number of visitors you have. Use Facebook and emails to update friends and family on how you are rather than seeing lots of visitors if you don’t have the energy to meet them in person.

Caregivers


  • Make sure you are educated about your loved one’s illness -knowledge is empowering.
  • Help the patient set up a routine for activities during the day.
  • Use resources in your community that can help you and your loved ones. Take advantage of transportation agencies, home care services, support groups and educational programs.
  • Try not to push the patient to do more than they are able to.

Treatment day


Tell your medical team how much fatigue you have and how much it is affecting you. Don’t just assume there is nothing that could help and that you just have to put up with it.
  • Be aware of your own warning signs of fatigue; Fatigue warning signs may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.
  • Keep a diary or notes about how you are feeling, and you may see a pattern in your levels of energy and fatigue. For example, if you notice that you are very tired in the morning, plan to rest at this time.
  • Treating the causes to reduce fatigue – it is important to address medical conditions that contribute to your fatigue. These include the following: Pain, depression, anxiety, insomnia, and anemia.
  • Ask your doctor which types of physical activity are best for you. And ask about recommended levels of physical activity. These recommendations may change during and after cancer treatment.
  • Medications – Sometimes antidepressants for depression and/or anxiety or erythropoietin for anemia may be helpful in combating fatigue.
  • Plan your treatment schedule. Schedule treatment for times when it will have the least impact on your job or other activities. For example, many patients find that scheduling treatment in the afternoon or at the end of the week allows them to be more productive at work.
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References


1. Fatigue – Cancer Council Victoria. Cancervicorgau. 2018. Available at: cancervic.org.au. Accessed May 10, 2018.

2. Managing Cancer-Related Fatigue. Cancerorg. 2018. Available at: cancer.org. Accessed May 10, 2018.

3. Managing Cancer-related Fatigue at Home. Cancerorg. 2018. Available at: cancer.org. Accessed May 10, 2018.

4. Fatigue. CancerNet. 2018. Available at: cancer.net. Accessed May 10, 2018.

5. Treating cancer fatigue | Cancer in general | Cancer Research UK. Cancerresearchukorg. 2018. Available at: cancerresearchuk.org. Accessed May 10, 2018.

6. Cold F, Health E, Disease H et al. An Overview of Cancer-Related Fatigue. WebMD. 2018. Available at: webmd.com. Accessed May 10, 2018.

7. Cancer fatigue: Why it occurs and how to cope. Mayo Clinic. 2018. Available at: mayoclinic.org. Accessed May 10, 2018.

8. Fighting Cancer Fatigue. Nccnorg. 2018. Available at: nccn.org. Accessed May 10, 2018.

9. Fatigue. National Cancer Institute. 2018. Available at: cancer.gov. Accessed May 10, 2018.

10. Fatigue: A Side Effect of Treatment. Breastcancerorg. 2018. Available at: breastcancer.org. Accessed May 10, 2018.

11. Managing your fatigue – Information and support – Macmillan Cancer Support. Macmillanorguk. 2018. Available at: macmillan.org.uk. Accessed May 10, 2018.

12. Fatigue – Canadian Cancer Society. wwwcancerca. 2018. Available at: cancer.ca. Accessed May 10, 2018.

13. Fatigue. MD Anderson Cancer Center. 2018. Available at: mdanderson.org. Accessed May 10, 2018.

14. Fatigue after cancer treatment. Cancerie. 2018. Available at: cancer.ie. Accessed May 10, 2018.

15. Managing Cancer-Related Fatigue | Memorial Sloan Kettering Cancer Center. Mskccorg. 2018. Available at: mskcc.org. Accessed May 10, 2018.

16. Cancer C. Fatigue and Cancer Fatigue – Managing Side Effects – Chemocare. Chemocarecom. 2018. Available at: chemocare.com. Accessed May 10, 2018.

17. Secondary breast cancer and fatigue. Breast Cancer Care. 2018. Available at: breastcancercare.org.uk. Accessed May 10, 2018.

18. Cancer-Related Fatigue. University of Michigan Comprehensive Cancer Center. 2018. Available at: mcancer.org. Accessed May 10, 2018.

19. Cancer-Related Fatigue | Leukemia and Lymphoma Society. Llsorg. 2018. Available at: lls.org. Accessed May 10, 2018.

20. Fatigue | Side effects | Cancer Council NSW. Cancer Council NSW. 2018. Available at: cancercouncil.com.au. Accessed May 10, 2018.