Being tired is very typical of the cancer survivor experience. Cancer-related fatigue is very common among survivors and among those undergoing cancer treatment; it can be caused by your treatment, or by other factors related to your physical health and/or emotional state, such as chemical imbalances, hormonal changes, stress and anxiety, or poor sleep.
Your treating oncology team should look for issues such as anemia; nutritional deficiencies; electrolyte disturbances; hypothyroidism; and lung, heart, or nervous system disease, as well as other potential causes.
If you are having trouble falling asleep, staying asleep, or waking up early, you may not be getting enough rest (especially during chemotherapy or radiation), and you should talk to your doctor.
Cancer-Related Fatigue
Cancer-related fatigue may be caused by chemotherapy or radiation during active cancer treatment, or after the treatment is completed.
Your symptoms may be strongly influenced by your mood and pain level, so be sure to talk to your primary care physician or oncologist if you are depressed or anxious, or are experiencing severe pain. Inactivity and lack of exercise can also add to your fatigue.
Because there are many types of cancer and many types of treatments, patients and survivors may experience cancer-related fatigue in different ways. As a result, your symptoms may be different from someone else’s symptoms.
When you talk with your oncology team about your symptoms, you may complete questionnaires to better understand your symptoms and the impact on your quality of life and overall daily functioning. Your responses help your doctors understand the full impact of your symptoms.
They may order blood tests to look for anemia, high calcium levels, low phosphorus, low thyroid hormone, and other medical problems. They may also order imaging studies, such as an MRI, CT scan, or lung or heart function test to see if your disease has spread, and to see if there are any effects on your body from the chemotherapy or radiation.
Treating Fatigue
Because fatigue in cancer survivors has many causes, the specific treatment can vary considerably. However, some general rules are important to remember. If you have a nutritional deficiency, hypothyroidism, or other physical abnormality, your oncology care team may recommend changes in your diet or your medications. If you are taking other medications, those may also be adjusted.
If your cancer has spread, your oncology team will adjust your treatment accordingly. If your pain is not controlled, your doctor may change your treatment and may encourage you to participate in specific activities, such as relaxation techniques, or cognitive behavioral therapy.
- If you are experiencing fatigue while undergoing chemotherapy or radiation, your oncology team may make adjustments to your cancer treatment
- Recognize the types and durations of activities that may make you more tired
- Get enough restful sleep: simple adjustments to your daily routine, such as limiting television and Internet use before bed, avoiding alcohol before bed, and sleeping in a dark, quiet room without noise
- Reducing stress, working on relaxation techniques will help
- If you are depressed or anxious, seeking assistance in the form of a therapist will help your mood as well as your fatigue
Exercise & Fatigue
Participating in a closely monitored exercise program, especially if you have lung or heart disease, will likely improve your cancer-related fatigue. These exercise programs should be strictly monitored by a physical therapist who is trained in a one-on-one setting to prevent any further injury.
Your exercise program will be based on the type of cancer treatment you are receiving, and on how you experience fatigue during and after exercise.
Your physical therapist can also help you design energy-conserving techniques for activities of daily living, so that your energy is used to its full potential.
Talking about your symptoms with your physician or navigator can help determine the causes and help you get stronger and more energetic.
