Fatigue and cancer

Friday 1 February, 2019

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This information has been prepared to help you understand more about fatigue, a common side effect of cancer and cancer treatments. We hope this information will help you, your family and friends understand what fatigue is and how it can be managed.

What is fatigue?

Fatigue is when you feel very tired, weak, drained and worn out. Cancer-related fatigue is different to normal tiredness because it doesn't always go away with rest or sleep. Some people describe it as mental and physical exhaustion.

Research shows that most people experience fatigue after a cancer diagnosis.

Even though it is common, managing fatigue is an important part of cancer care. Talk to your health care team about support and treatment.

What are the symptoms?

Fatigue affects people with cancer in different ways. The way you feel can change over time and fatigue may be different before, during and after treatment.

Some symptoms may be:

  • having little or no energy
  • muscle aches and pains
  • weakness or slowness
  • trouble thinking clearly or concentrating
  • not being able to do daily tasks

Feeling fatigued does not usually mean the cancer has advanced. If you are concerned, speak to your doctor or call Cancer Council 13 11 20.

What causes fatigue

Fatigue can be caused by:

  • the cancer itself and cancer treatments
  • medicine, such as pain relief
  • side effects of treatment, like low red blood cells (anaemia) or pain
  • changes to what you eat
  • stress and mood changes, including depression
  • sleeping difficulties
  • a lack of physical activity
  • other health problems, such as infection.

How long does it last?

Fatigue can last throughout cancer treatment and for some time after it is finished. Energy levels usually improve over time. Most people find they feel better 6-12 months after treatment ends. For some people, fatigue can continue for a longer period of time.

If you have advanced cancer, see Living with Advanced Cancer for more information.

The impact of fatigue

Fatigue can be severe and distressing. Some people say fatigue is the most difficult side effect of cancer. Some people might look well but still be experiencing severe fatigue. Fatigue can make it hard to do everyday things, creating feelings of frustration and isolation. If you have continued feelings of sadness or frustration, talk to your doctor. You may have low mood or depression, and treatment may help.

"After radiation therapy, I was so fatigued that initially all I could do was sit on the couch. I didn't realise the impact the treatment would have on my body, but little by little I could do more."  Susan

Managing fatigue

The first step in managing fatigue is working out how it affects you. Start by talking to your GP, nurse or specialist doctor about how you are feeling, including how long you have felt fatigued.

It may help to write down how you are feeling from day to day. This can help you to learn when you have the most and least energy.

You may have tests to see what could be causing the fatigue. If possible, the health care team will treat conditions like pain or anaemia that might be contributing to the fatigue. You may need a referral to a specialist or a fatigue clinic (if available in your area).

Exercise to manage fatigue

It is important to be as physically active as is safe before, during and after cancer treatment. Research shows that exercise can help manage ongoing effects of cancer and its treatment, including fatigue. Talk to your doctor about what is right for you, especially if you are living with bone cancer or advanced cancer.

Exercise physiologists and physiotherapists can help with safe, appropriate exercise plans. You may also be able to join a local community-based exercise class or group for people with cancer.

Cancer Council has free online exercise videos for people affected by cancer. See Exercise for People Living with Cancer for more information.

"At first I used a wheelchair, then a walker. I loved the trolley at the supermarket because it was like a walker in disguise. Later, I could use an exercise bike and start yoga therapy. I also did a guided meditation every day. It helped physically and mentally to reconnect with things that were important to me before treatment."  Susan

Sleep and cancer

Research shows that people experiencing cancer fatigue often have difficulty sleeping or sleep too much. This can make fatigue worse, so it is important to speak with your health care team.

It may help to set up a bedtime routine including relaxing activities, such as meditation. Avoid using computers, mobile phones or tablets in the evening, and keep naps during the day short.

You might like to consider counselling or cognitive behavioural therapy (CBT) as these may help with fatigue and sleep problems. Speak with your GP about options in your area.

Tips for managing fatigue

The best way to manage fatigue will depend on your individual situation, but the following general tips may help you to manage day to day:

  • Plan a loose daily schedule or routine based on how you are feeling.
  • Save your energy for what you want or need to do most.
  • Pace yourself. Try to attend to one thing at a time and include regular short breaks throughout the day. Rest when you need to.
  • Eat as well as possible, drink lots of water, and avoid smoking and alcohol.
  • Be physically active – ask your health care team how to exercise safely for your situation.
  • Try relaxation and meditation techniques.
  • If you can, ask family, friends or neighbours to help you.
  • Listen to the podcast The Thing About Cancer for tips on how to manage fatigue, sleep and cancer.
  • Your local council or social worker can put you in touch with organisations for help at home (such as house cleaning, meals or shopping). Sometimes these services are free.
  • Remember fatigue usually gets better over time.

Your health care team is trained to assess your situation and help you manage fatigue. You can also call Cancer Council 13 11 20.

"I had to accept that I was dealing with fatigue and celebrate small improvements. I had to be careful not to overdo it and whatever help people offered, I took. That was very challenging for me but it helped."  Susan

Question checklist

When you talk to your doctor about fatigue, you may want to ask some questions.

  • What is causing the fatigue?
  • Do I need a blood test to investigate the causes of the fatigue?
  • Is there anything that I should avoid doing?
  • What can help me to sleep better?
  • When will I have more energy?
  • Can a social worker or occupational therapist talk to me about help at home?
  • What exercise or activity do you recommend?
  • Can you refer me to a physiotherapist or exercise physiologist who works with cancer patients
    experiencing fatigue?
  • Are there fatigue clinics or local group programs that I can access?

Where to get help and information

Call Cancer Council 13 11 20 for more information. Trained health professionals can listen to your concerns and put you in touch with local services. Ask for free copies of booklets that may be relevant to you, or download digital versions from your local Cancer Council website:

Expert content reviewers:

Dr Dani Bullen, Clinical Psychologist, Peter MacCallum Cancer Centre, VIC; Dr Keely Gordon-King, Psychologist, Cancer Council Queensland, QLD; Sharyn McGowan, Occupational Therapist, Bendigo Health, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia, WA; Susan, Consumer; Dr Carolina Sandler, Lecturer and Accredited Exercise Physiologist, Queensland University of Technology, Adjunct, University of New South Wales Fatigue Clinic, and Honorary Fellow, School of Public Health, University of Queensland, QLD; Professor Janette Vardy, Medical Oncologist, Concord Cancer Centre, Principal Research Fellow, University of Sydney, NSW; Juliet, Consumer.

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