The bone aching tiredness or fatigue (extreme tiredness) that follows cancer and its treatment is common (up to 8 out 10 people). Cancer fatigue goes beyond feeling a bit tired. You may feel exhausted having carried out the smallest of tasks. This is like nothing you have ever felt before. Even when you rest you may not feel much better.
Does this all sound familiar? It is not only you or I that think that this is one of the most frustrating symptoms of cancer, there are many other people who agree. Even after rest you may find that the fatigue continues and you do not wake up feeling very refreshed. For some people the fatigue can continue for weeks, months or sometimes years after the treatment has finished.
This all sounds a bit depressing – enough to make you want to go and lie down!
So what can you do?
There may be another underlying cause for your fatigue so if you are concerned that you are not improving it is worth speaking to your doctor. Examples of underlying causes are Anaemia (which may be caused by low iron or B12 in your body and is easily tested for), Underactive thyroid, other disturbances in blood levels or depression.
Once other potential causes have been thought of and excluded if necessary there are some things you can do that may help:
- Healthy eating
- Rest and Relaxation
- Getting good sleep
- Delegate (ask for help!)
- Take short cuts
Exercising to help Cancer Fatigue
This may sound a bit crazy – if you feel tired you should go out and make yourself more tired – but guess what? It really works! You may not notice the benefit the first time you give it a try but the effect will build up and the more exercise you do the better you will feel!
The type and amount of exercise you start with will depend on your pretreatment level of fitness. You may have been pretty fit before the cancer diagnosis and have lost an awful lot of fitness over the course of it. It is important that you are kind to yourself and build up slowly. Rushing in and overdoing things will result in injury and may well set you back both mentally and physically.
Start slowly by doing a little exercise each day. Walking is probably the best in most cases and certainly the easiest and cheapest! Set yourself a small goal that you can gradually build up. I know they are not everyones’ cup of tea but a wrist worn device that measures steps can be a good way of doing this. I didn’t wear mine for a few months at the beginning as I didn’t want the added pressure but it has been great while I have been getting back in to exercise and does make me park that little bit further away at supermarkets.
As you build up your exercise this may be a good time to try something different – for me yoga has been a new discovery and I have met some lovely people through it.
If at first you don’t notice any difference to your fatigue and you have checked out other possible causes keep going! In most of the literature I have looked at on this subject the message is Keep Active!
Healthy Eating and Cancer Fatigue
If you search for the key words cancer and eating you will see hundreds of diets and nutrition tips. A lot of these make sense but a lot don’t have any basis in science.
You probably won’t go far wrong if you follow the same basic healthy eating plan that everybody should be following anyway ie thinking about the amount of salt, fat, sugar and alcohol you consume. It is important that you don’t overeat, which can be tempting when you feel so tired and drained, as an increase in weight can make your fatigue worse.
You may be one of the people who is struggling to maintain their weight after cancer and its treatment. In this case it is suggested that you eat little and often and make sensible food choices.
There are many foods that are calorific but contain very little that is good for you or that can provide more energy – things like cake and fizzy drinks (I have found that cake is always there when friends pop in to cheer me up and support me and avoiding it when I feel tired has been really hard!). Some sugary foods will give you a burst of energy immediately after you’ve eaten them but you will then feel even more drained.
Choose foods that are high in protein, healthy fats and fibre. These will not only give you more energy but also contain plenty of vitamins and minerals that your body is going to need for a healthy recovery.
Protein Rich foods
- Meat and Fish
- Milk and Cheese
- Olive oil
- Fatty fish
High fibre Foods
- Wholemeal pasta
- Beans and Lentils
- Fruit and Vegetables
- Wholemeal bread
- Some cereals – but check the sugar content
Don’t Forget to Drink to help Cancer Fatigue
One of the symptoms of not drinking enough and getting dehydrated can be tiredness and fatigue so be aware how much you are drinking every 24 hours. This can be any fluid (we’re not talking alcohol here though!) but be aware of the potentially hidden calories in fruit juice and milk based drinks.
Rest and Relaxation to help Cancer Fatigue
If, like most of us, you are usually dashing around getting everything done it can be quite difficult to make yourself rest and relax. It has taken sometime but I think I am there now.
One of my tips is to manage your diary effectively to make sure you don’t get overbooked. At the beginning I found, as you may have, that I had a lot of visitors and even if I felt shattered I wasn’t very good at cancelling or rearranging. What I have come to realise is people don’t mind if you cancel even fairly last minute, they understand.
Sometimes you may feel that you have had a few busy days on the trot and then feel incapable of doing anything. Listen to your body and don’t do anything. These days we are spoilt by the number of box sets available at the click of a button and while these don’t appeal to everybody it is no bad thing to spend an hour a day sitting down and vegging out in front of the TV. Sit and read, catch up on those books you haven’t had time to open, let alone read!
You may be continuing to work during your diagnosis and treatment so your time may be even more squeezed. Don’t forget to try and make time to rest and relax. Plan your activities carefully to make sure you can get to bed at a reasonable time. If you are struggling to cope with work and cancer fatigue then speak to your doctor who may be able to help or liaise with your employers suggesting an alternative working pattern or a change of hours.
Ironically, if you are working from home you may also struggle to get enough rest or relaxation time as the tendency is to continue to plough through. This may suit you but if you find yourself too exhausted to do anything else then try and plan the amount of work you do each day, within reason.
Getting good sleep
You are probably thinking, if only…..
Sleep problems go hand in hand with cancer and chemotherapy, have a look at the hints and tips which may help you. Try to avoid the temptation to have very long naps during the day as this could affect your sleep at night. You may find a quick ‘power nap’ in the early afternoon when most people feel at their lowest energy will give you a boost.
At this stage I should imagine that, like me, you are totally fed up with drugs, however there may be instances where they can be helpful to treat fatigue, for example in specific causes of fatigue such as anaemia or depression.
It has been very difficult to find any recent evidence about drug treatments for cancer fatigue. Over the years various groups of drugs have been looked at without much success.
Delegation can be harder than you’d think. It doesn’t come naturally in the home setting for those of us who adopt the ‘I may as well just do it my self’ attitude. Now is the time to change that! This may mean redistributing roles at home – getting the kids to put the hoover round and load the washing machine. Hopefully they will feel they have got involved in helping you out and be keen to continue (fingers crossed).
Friends are an invaluable resource but they may not have realised you need a hand, especially if you have been very ‘can do’ generally. Ask them for help with the school run, for a lift to that appointment. From my experience people want to help. (Just say yes!)
It is hard to let go sometimes and appreciate that at this particular moment in time you can’t do everything – but does it really matter? are some of the things you are stressing about relatively unimportant compared to your health?
Take Short Cuts
On a more light hearted note this is a time in your life when you can take short cuts without beating yourself up. Once you are back up and running again there will be time enough to worry about life’s small problems so try not to get too bogged down with what may not really matter.
Other non drug treatments
In some trials which were looked at in the USA several years ago support groups and psychotherapy were found to be beneficial too. If you want to read the science (albeit slightly older now) look at the paper by Ann Berger Treating fatigue in cancer patients.
Psychotherapy (a form of talking therapy) may be available through your cancer centre or oncology team. Support groups again may be available through your cancer centre but what is available will vary with your location.
Tell Someone about your Cancer Fatigue
Above all else tell your medical professionals about your cancer fatigue – it is recognised as a condition. Some of the questions you may be asked when attending a chemotherapy unit will ask specifically about fatigue and grade it each visit. If people don’t ask and you are struggling do mention it. Cancer fatigue can be so debilitating and as discussed there may be other conditions that need excluding in your case.
Cancer Research UK has some really good information about cancer fatigue.