Battling Cancer Fatigue

On your end, getting enough nutritious foods and enough physical activity is important in getting back your strength.

According to the American Cancer Society, everyday activities such as talking on the phone, shopping for groceries, and even lifting a fork to eat can become overwhelming. Most people who receive cancer treatment develop fatigue, and cancer-related fatigue is worse than regular fatigue. It lasts longer, it’s unpredictable, and sleep doesn’t necessarily make it better.

Why So Tired?

The main causes of cancer-related fatigue are:

  • cancer itself
  • cancer treatment
  • anemia
  • pain
  • emotional/psychological factors
  • lack of sleep
  • poor nutrition
  • medication
  • lack of exercise
  • infections
  • hormonal changes

From the above list, it is clear that there is no one-size-fits-all solution. For one person, a blood transfusion may be what is needed; for another, there may be an infection that requires treatment with antibiotic therapy. For some, better control of pain can help the lack of sleep; for others, dialing back on a pain medication -- while still controlling the pain -- may be what is needed to lift the fog. Weight loss during cancer, with muscle weakening, has been proposed as another potential source of clinical fatigue, and physical activity can by an ally for many people with cancer.

Exercise to Feel Less Wiped Out

Research has shown that physical exercise and the treatment of underlying problems, such as anemia or clinical depression, are effective at building your energy levels.

Evidence also hints that complementary approaches may help, including stress management/relaxation, energy conservation, anticipatory guidance/preparation, and attention-restoring activities. Exploring the mind-body connection is huge.

Better physical functioning and a greater sense of emotional wellbeing are benefits of exercise, and you can get started after therapy as soon as it's tolerated by taking baby steps.

If you your treatment is still on the horizon, training your body -- as tolerated -- can even be helpful even in advance of the start of treatment or before a surgery. In either case, discuss your exercise plan with your doctor before getting started, and don’t overdo it. If you are already being treated for blood cancer, many times exercise is still practical and beneficial, but there are also special concerns to be aware of.

Supplements

Vitamin C is one such example, but unfortunately, most studies did not have controls, so it’s hard to discern what is due to the placebo effect. Several recent studies have indicated that intravenous vitamin C may alleviate a number of cancer- and chemotherapy-related symptoms, such as fatigue, insomnia, lack of desire to eat, nausea, and pain.

Ginseng has been studied for its potential role in cancer patients. Barton and colleagues used ginseng in a large trial of 364 patients from 40 different institutions. Results were encouraging for combating fatigue, but investigators highlighted the need for further research, including the need to examine possible drug interactions.

It is important to not "go it alone" when supplementing to boost your energy. At the very least, let your doctor know so that he or she can take note.

Nutrition, Self Care and Living Through It

Work with your doctor so that any treatable underlying causes of fatigue can be identified--and treated. Whether it's treatment of anemia, a slightly different approach to pain management, or treatment of depression, stress and anxiety, your doctor can be a strong ally in battling fatigue.

Although some fatigue may be unavoidable, self-care is also extremely important, and there are many things you can do at home to try to feel better, including healthy living, eating healthy foods and staying well hydrated, and gentle exercise (as tolerated in accordance with medical advice). If you have access to a nutritional counselor, this can help you eat a well balanced diet and deal with issues such as lack of taste or nausea.

After treatment, you need the nutrition and physical activity plan to help rebuild your muscle strength, and correct any ongoing problems such as anemia. Getting enough nutritious foods and enough physical activity are key to recovery.

Protecting your sleep with good sleep hygiene may also be helpful when some of the fatigue is due to sleep disruption.

Sources

Fatigue. http://www.cancer.net/navigating-cancer-care/side-effects/fatigue Accessed November 2014.

Carr AC, Vissers MC, Cook JS. The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life. Frontiers in Oncology. 2014;4:283.

Maughan D, Toth M. Discerning primary and secondary factors responsible for clinical fatigue in multisystem diseases. Biology. 2014;3(3):606-622.

Viale PH. Can ginseng alleviate cancer-related fatigue? Journal of the advanced practitioner in oncology. 2013;4(6):392-393.

Updated November 2015. TI

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