If you feel tired and get some rest, most of the time you get your energy back. Cancer-related fatigue is different, though. The exhaustion you may have when you’re going through cancer treatment feels like it will never let up.
Rena Szabo, PsyD, director of the psycho-oncology program at Banner MD Anderson Cancer Center, said, “Cancer fatigue is different from the fatigue most people can identify with. For a healthy person, tiredness is caused by activity or lack of sleep and is relieved with rest, sleep and time. Cancer fatigue is not completely relieved by sleep or rest and may happen after no or minimal activity.”
With cancer-related fatigue, simple household or work tasks – like paying bills or answering emails – can feel overwhelming. You may even struggle to get dressed or make something to eat, and you may feel too exhausted to spend time with people you care about.
Cancer fatigue can come on suddenly or gradually and can last for months or years. It can make you feel frustrated, irritable and sad.
“It’s important to address this fatigue so you can maintain your overall well-being and quality of life. Fatigue can affect your physical, emotional and mental health. It can make it harder to cope with the demands of treatment and daily living. By understanding and managing fatigue, you can regain some control and improve your energy levels,” Dr. Szabo said.
She pointed out, though, that it may not be possible to eliminate cancer fatigue. “It’s about improving it. If you can improve your fatigue by 10%, it’s better than it was the day before. Accept that it’s part of the journey and look for the little wins, changes and improvements. It may take time, but improvements come faster when you are empowered, engaged and participating physically and emotionally,” she said.
Why is cancer treatment so exhausting?
Fatigue can interfere with every part of your life and it’s a common side effect before, during and after cancer treatment. These factors may play a role in why you feel so tired when you are being treated for cancer:
- Cancer symptoms: Fatigue may be caused by the way cancer affects your body and using the calories and nutrients you need for energy. Cancer also causes your body to release cytokines, which are substances that help you fight infections but can cause fatigue.
- Wasting syndrome: Some people with cancer develop cachexia, which causes muscle loss and weight loss.
- Treatment side effects: Chemotherapy, radiation therapy, surgery, immunotherapy, targeted therapies and hormonal therapies can disrupt the way your body functions. Fatigue affects more than 80% of people who have chemotherapy or radiation therapy.
- Emotional stress: Dealing with a cancer diagnosis, as well as possible anxiety or depression, can impact your energy levels.
- Anemia: Cancer treatment or the cancer itself can cause low red blood cell counts.
- Trouble sleeping: Pain, discomfort or medications may interrupt your sleep.
You may notice these symptoms
The main symptom of cancer-related fatigue is feeling extremely tired, drained or lethargic as if you have no energy. You may also:
- Feel heavy or slow.
- Have difficulty thinking, remembering or paying attention.
- Feel mentally or emotionally exhausted.
- Feel tired even after sleeping well.
You’re more likely to have higher levels of fatigue with blood, breast, prostate or digestive system cancers.
You can try these strategies to fight cancer-related fatigue.
1. Get the quality sleep your body needs
When you are coping with cancer and undergoing cancer treatment, it's important to get good sleep. Sleep helps your body heal and restores your energy levels. Try to:
- Go to bed and wake up at the same time every day, even on weekends.
- Make sure your bedroom is quiet, dark and cool. Use comfortable bedding and pillows.
- Don’t use stimulants like caffeine and nicotine close to bedtime, since they may make it harder for you to fall asleep.
- Relax before bed with a calm routine like reading, listening to music or taking a warm bath.
- Avoid using phones, tablets, computers or other electronic devices before bed, since the blue light from their screens can interrupt your sleep.
2. Fit in some physical activity
When you're exhausted, you may think exercising is the last thing you need. But that’s not the case. “Gentle exercise can reduce fatigue, improve mood, increase energy levels, help you sleep better and improve your quality of life,” Dr. Szabo said.
Of course, you don't want to overdo it. Good options include:
- Walking, which is an easy way to stay active.
- Yoga, which helps with relaxation, flexibility and stress management. Look for gentle or restorative yoga classes.
- Stretching, which can improve your circulation and reduce muscle tension.
Be sure to talk to your health care provider before you start physical activity. You'll also want to start slowly — a 5- to 10-minute walk might be a good place to begin. Listen to your body and if you feel overly tired or notice pain, take a break.
Slowly add longer and more frequent exercise sessions as your energy levels improve. And try to be consistent. Even just a few minutes a day can make a difference.
3. Pay attention to what you eat and drink
Cancer treatments may affect your appetite and make it harder for you to get the nutrients you need. However, a well-balanced diet is important for your energy levels and your overall health. “Proper nutrition can help combat fatigue, support the immune system and promote healing,” Dr. Szabo said.
Good food choices are:
- Fruits, including bananas, berries and citrus fruits, which have vitamins, minerals and natural sugars.
- Vegetables such as leafy greens, carrots and peppers contain essential nutrients and fiber.
- Protein from sources including chicken, fish, beans and tofu. Protein can help with your energy levels and with muscle repair.
- Whole grains in bread, brown rice, quinoa and oatmeal.
- Healthy fats from avocados, nuts, seeds and olive oil.
It's important to stay hydrated, too. Try to drink at least eight cups of water a day and to eat foods with high water content, such as cucumbers, watermelon and oranges. Limit caffeine and alcohol, since they can be dehydrating.
4. Take steps to manage stress
Reducing stress can help you manage cancer-related fatigue and improve your overall well-being. “Lower stress levels can lead to better sleep, increased energy and a more positive outlook,” Dr. Szabo said.
You may want to try these techniques:
- Deep breathing: Slow, deep breaths can help calm your mind and relax your body. Inhale through your nose, hold your breath for two seconds then exhale slowly through your mouth.
- Meditation: A daily meditation practice can help lower your stress levels. Even a few minutes can make a difference. Focus on your breath, a word or phrase or a peaceful image to help clear your mind.
- Progressive muscle relaxation: Starting from your toes and working your way toward your head, gradually tense and then relax every muscle group in your body. You should notice a sensation of relaxation.
5. Connect with support
Emotional support is an important part of coping with cancer-related fatigue and stress. “Connecting with others can provide comfort, encouragement and a sense of belonging,” Dr. Szabo said.
Here are some options to try:
- Support groups: Join a cancer support group, either in-person or online. Sharing experiences and advice with others who understand can be helpful.
- Family and friends: Lean on your loved ones. Share your feelings and let them know how they can help.
- Professional care: Consider speaking with a counselor or therapist who specializes in helping people with cancer. They can give you strategies for managing emotional challenges.
- Community resources: Local organizations may offer support services for people with cancer, such as transportation, meal delivery or home care.
6. Practical tips
Learning to pace yourself and manage your energy levels can help you work through cancer-related fatigue. Here are a few techniques that may help:
- Pay attention to your body's signals and schedule activities for times when you have the most energy.
- Take short, frequent breaks and rest before you feel completely exhausted.
- Switch between physically and mentally demanding tasks so you don't feel overloaded.
- Focus on your most important tasks first. Make a list of your tasks, identify the essential ones and postpone or delegate the others.
- Break larger tasks into smaller, more manageable steps.
- Focus on one task at a time, so interruptions don't waste your energy.
- Use assistive devices like shower chairs, reachers or electric can openers to make tasks easier.
- Ask for help with tasks that are too difficult or tiring.
- Plan your day with times for meals, activities and rest. Staying consistent helps your body conserve energy.
- Listen to your body and adjust as needed based on how you feel. Some days, you may find that you need more rest.
7. Get professional help
Talk to your treatment team about your fatigue and the steps you are taking to try to manage it. They may recommend:
- Pain management
- Cognitive behavioral therapy, a form of psychotherapy
- Antidepressant or anti-anxiety medication
- Psychostimulants
- Steroids
- Respiratory therapy to help with oxidative stress
- Physical therapy
- Nutritional therapies and support of a registered dietitian who specializes in oncology
- Supplements, if approved by the oncology team
The bottom line
If you’re facing cancer and undergoing treatment, you may have a lot more fatigue than you’re used to. Getting enough sleep, adding in some light physical activity, choosing nutritious foods, managing stress, connecting with support and listening to your body can help.
For more advice on how to cope with the exhaustion you may feel with cancer, reach out to your care team or an expert at Banner Health.
