Tips Coping With Cancer Fatigue

'I'm So Tired From Cancer - What Can I Do?'

woman in bed tired with alarm clock
What are some tips for coping with that awful symptom of cancer fatigue?. istockphoto.com

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 leading to hypoxia), 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 Help

Learn 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 Moderately

Studies have shown that moderate exercise can improve cancer fatigue. Research hasn’t evaluated which activities or what duration of exercise is most effective, so choose an activity that you enjoy and an amount of time that feels comfortable to you.

3. Get Enough Sleep

Try 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.  Keep in mind that in a recent study of cancer-related causes of fatigue, insomnia ranked 3rd only secondary to shortness of breath and cough.  In addition, we've been learning that insomnia may even play a role in cancer survival.  So if insomnia is contributing to your fatigue, talk to your oncologist.

4. Eat Regularly

Eating 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.  Though sometimes you simply won't want to eat, keep in mind that cancer cachexia - a syndrome which includes unintentional weight loss - is a leading cause of death for people with cancer.

5. Keep Your Environment Comfortable

Setting 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. Prioritize

Plan 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 Yourself

With 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 Caffeine

Both 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 Journal

Keeping 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.  If you decide to try journaling, check out some of the other ways that journaling has been found to benefit people with cancer, as well as ways to get started.

10. Manage Stress

We 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 Alternative Therapies to Fight Fatigue

Many alternative therapies (integrative 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, and a 2016 study found qigong especially helpful. Check with your cancer team, and support group, to see what services are offered in your community.

12. Join a Cancer Support Group

Often, just knowing that you are not alone can help you cope with the fatigue of cancer treatment. On top of that, a support group or cancer support community allows you to hear from others that have experienced similar symptoms and what they have done that has helped them cope.

Coping for Those Who Have a Loved One With Cancer

It's not just those with cancer who find it difficult coping with cancer fatigue. When it's your loved one it can make you feel helpless on top of frustrated. If this describes you, check out these thoughts on when your loved one has cancer.

Sources:

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.

Klein, P., Schneider, R., and C. Rhoads. Qigong in cancer care: a systematic review and construct of effective Qigong therapy. Supportive Care in Cancer. 2016 Apr 5. (Epub ahead of print).

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.

Long, N., Thanasilp, S., and R. Thato. A causal model for fatigue in lung cancer patients receiving chemotherapy. European Journal of Oncology Nursing. 2015 Nov 7. (Epub ahead of print).

Roscoe, J. et al. Cancer-related fatigue and sleep disorders. Oncologist. 2007. 12 Suppl 1:35-42.

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