- Radiotherapy and fatigue
- Learning to manage cancer fatigue
- Talking to your doctor about cancer fatigue
- Treatment for cancer fatigue
We all feel fatigue at times – maybe when we are working too hard, worrying about something or just doing too much partying! Cancer fatigue can be very different. The cancer or its treatment may make you feel very tired. It can go on for weeks, months or even years after you finish treatment. This is called chronic fatigue, which means long lasting. Most people get back to their normal energy levels from between 6 months to a year after the end of cancer treatment, but it can take longer.Fatigue is very common in people with cancer. It can be the most troubling symptom. It affects between 7 and 9 out of every 10 people (70 to 90%). Many people with cancer say that it is the most disruptive side effect of all. In the past, doctors and nurses haven’t always appreciated the long-term effects of fatigue on people with cancer. But there is now a lot of research into this area. Things are improving and there are ways of relieving fatigue.
You are not imagining your cancer fatigue. It is very real and can have a big impact on your life. If you have symptoms of fatigue, let your doctor or nurse know. There are ways of managing fatigue and your medical team will try to help you.
Radiotherapy and fatigue
Most people feel tired while they are having radiotherapy, particularly if they are having treatment over several weeks. This is because the body is repairing the damage to healthy cells, or tiredness can be due to low levels of red blood cells (anaemia).
You may also feel weak and as though you don’t have the energy to do your normal daily activities. This may last for a few weeks after the treatment ends. Rest if you need to and try to exercise a little when you can. This may help to reduce the tiredness.
Learning to manage cancer fatigue
You can do many things in your everyday life that will help to save your energy. Taking short cuts on some things or getting help from other people may help you feel less tired.
- Try not to rush – plan ahead where possible. Allow plenty of time for travel, and avoid the rush hour if possible.
- Put chairs around the house so that you can easily stop and rest if you need to.
- Sit down to dry off after your bath or shower, or simply put on a towelling dressing gown and let that do the work.
- Have some hand rails fitted in your bathroom to hold on to when you get in and out of the shower or bath (the hospital can help to arrange this for you).
- Prepare your clothes and lay them out in one place before you dress. Get dressed sitting down, as far as you can. Try not to bend too much – rest your foot on your knee to put socks and shoes on.
- Wear loose fitting clothes, and things with few buttons to do up.Fasten your bra at the front first and then turn it to the back.
- Where possible do household tasks sitting down – for example, peeling vegetables or washing up. You can also do ironing sitting down or buy clothes that don’t need ironing.
- Use a duster on a long stick and sit to do dusting.
- Write a shopping list and go when the shops are quiet; or do your grocery shopping online.
- If you have children, play games that you can do sitting or lying down – reading, puzzles, board games or drawing.
- Ask family and friends for help with shopping, housework or collecting the children from school.
- Have plenty of nutritious snacks and drinks in, so you can have something quickly and easily whenever you feel like eating.
- Don’t forget to do things that you enjoy – it will take your mind off your cancer and make you feel more relaxed.
Talking to your doctor about cancer fatigue
If you are very tired from your cancer or treatment, it is very important that you tell your doctor or nurse.
If you find it difficult to discuss these things, try taking along a family member or friend that you trust. Let them do some of the talking. They might also help you to remember what the doctor says, especially if you are feeling tired and having trouble concentrating.Some people find it easier to write down how they feel. Try keeping a diary of how you are feeling for a week or two and then give this to your doctor or nurse to read. Write down when you feel tired, how often you sleep, what makes you feel tired, your eating pattern, and whether you feel sad, depressed or anxious.Questions you might like to ask your doctor include
- What is causing my fatigue?
- Why do I feel so tired all the time?
- Why am I having trouble sleeping?
- Can any of my treatments cause fatigue?
- Is there anything that can help me control fatigue?
- Can I exercise, how much should I do?
- What is anaemia?
- Will I need a blood transfusion?
- Is there anything that I should not be doing?
- Is there anything I can eat to give me more energy?
- Is my tiredness normal?
- How long will this fatigue last?
Treatments for cancer fatigue
Your doctor can talk to you about what might be causing your fatigue and how best to treat it. Treatment options might include:
Many people with cancer get anaemia at some point during their illness. While it is not usually life threatening, fatigue caused by anaemia can have a big effect on your daily life. You might need a blood transfusion to bring your red cell count up again and make you feel more energetic.
Exercise may be the last thing you feel like doing when you are sick and fatigued but sometimes, the less you do, the less you feel like doing. Light to moderate exercise every day helps people with cancer to feel better and can give them more energy. A great deal of research shows that exercise can help reduce cancer related fatigue.
You can start with very light exercise. Try a short walk with a friend for support. Then try and increase the distance you go gradually. Try doing your exercise at different times in the day to find out when suits you best. Doing a bit of exercise every day will make you feel less tired and your appetite is likely to improve too.
Exercise can also help people in the advanced stages of cancer. You may not be able to go for a long walk but even gentle exercises in bed or standing up can help. Your hospital physiotherapist can help you plan an exercise programme that suits your needs and how much you can do.
If you have advanced cancer and are very tired, it is important to set yourself a few rest times throughout the day. It can be difficult to stick to this but it is important that you do not push your body too hard as you will become over-tired and less able to cope. It is not necessary to sleep during your rest periods but you should take time to simply just sit or lie quietly. If there are jobs that you can ask others to do- like shopping or picking up messages, think about asking friends or family to help so that you only have to do the most important things.
Cancer and cancer treatment can lead to sleepless nights. If you have cancer releated fatigue, think about some changes you can make to what doctors call sleep hygene so you can sleep as well as possible
- Go to bed and get up at the same time each day
- Make sure the room you sleep in is comfortable, calm, quiet and soothing and a nice temperature
- Spend time relaxing before you go to bed – have a bath, read or listen to music
- Don’t drink caffeine (coffee, tea, chocolate and cola drinks) after early afternoon
- Limit daytime naps to 45 minutes so they don’t stop you sleeping at night
- Don’t drink too much alcohol before bed
- Have a light snack before you go to bed to stop hunger waking you up
Researchers are looking into a number of different types of drug treatments for cancer fatigue. These include psychostimulants such as ritalin and modafinil which are drugs doctors use to treat attention and concentration disorders. Other drugs doctors are looking into include anti depressants. The results from the research into these drug treatments is mixed with some studies showing they can be helpful and others not.