Cancer Fatigue

Fatigue is something we all feel from time to time. Fatigue can be our bodies way to tell us we need more water, sleep or that we may be anaemic (low levels of red blood cells). We often become fatigued when overstressed or overworked. The feeling of fatigue can vary from person to person, but it is usually described as a lack of energy for starting or completing tasks or the inability to do, or want to do activities due to the feeling of tiredness. 

Cancer fatigue is a very common side effect of a cancer diagnosis and its treatments; up to 80% of people diagnosed with cancer will experience cancer fatigue during some stage of their diagnosis.

Fatigue can be caused by a number of reasons and is usually resolved once the underlying cause is treated. For example, if stressed or overworked, people find yoga, meditation, or relaxing alleviates their fatigue. Underlying causes for cancer fatigue can be numerous, and complex in nature, so a level of fatigue could remain for the duration of a cancer diagnosis and its treatment.

Ongoing fatigue can affect a person a number of ways. Prolonged periods of fatigue have been linked with decreased mood, poor appetite and lack of energy leading to decreased activity. People may struggle to understand why you’re not keen to take part in activities, socialise, or resume your normal routine. Luckily there are ways to manage fatigue. The best way to manage fatigue is to first understand what is causing it.

Cancer is a complex disease which can cause fatigue both directly and indirectly.

Directly, cancer cells have the ability to affect your hormones and blood cells. Chemicals produced by cancer cells can change the levels of hormones, or hinder the production of red or white blood cells. Too much of a shift in some hormones or blood cells can lead to fatigue and exhaustion. For some people, this ongoing exhaustion is the symptom that triggers them to go see a doctor.

Indirectly there are countless ways cancer cause fatigue. Stress from new symptoms, a cancer diagnosis, scans and tests can cause enough stress to leave you feeling lacklustre. Medications, treatments, and side effects of treatment additionally can all result in fatigue. It’s exhausting just thinking about it!

Cancer fatigue differs from everyday fatigue. It can be challenging for some people to comprehend that at times you are just tired and don’t have the energy to undertake your usual activities. Friends and family may try and provide you with advice and tips on how to manage your fatigue. As they know you, and your capabilities, some pieces of advice can be helpful and beneficial, and therefore good to try out. 

Keeping a sleep diary is an excellent way to articulate to your friends and family of how you feel after different activities and at different times of the day. It allows you to illustrate how your energy levels flow, which will help others understand and provide appropriate support.

Treating the underlying cause of fatigue will usually result in increased energy levels. But if the cancer itself is causing you to feel tired, or there are many different factors that are causing you to feel tired, you probably won’t start seeing improvements until treatment commences or after treatment finishes. Luckily, there are simple and gentle ways to manage your fatigue and improve your energy levels and mood.
Keep a diary
Writing down how you are feeling before and after activities, as well as keeping account of what you’re eating, how long you are sleeping and how many naps you are taking may help you identify what helps improve your energy levels. Keeping a diary can also alleviate fatigue related anxiety as it is an outlet to share your thoughts and feelings. 

Identify what you think you are capable of doing and set yourself small goals

This could be a small walk around the block, or meeting a friend for a cup of tea for 30 minutes. Once you know what you feel up to doing, find a person you would like to do it with as you’re more likely to commit to something if you do it with someone else. Additionally, if you set yourself small challenges, these will be more realistic to achieve, in comparison to goals that are above and beyond how you’re feeling at the moment (these could become long-term goals).

Keep your brain stimulated

It is very easy to turn your brain off during cancer treatment. People often note how their cognition decreases partly due to fatigue. But keeping your brain stimulated through colouring in books, brain training or crossword puzzles can give invigorate your mind and gentle give you a bit more energy for the day. 

Speak to a specialist

Two very important facets of fatigue are stress and diet. Not managing either of these can result in feel dull. If you are finding it difficult to manage your stress or diet, speaking to a specialist such as a counsellor or a nutritionist can improve energy levels. Your treating doctor and nurse should be able to refer or suggest a suitable person for you to speak to.

A sleep diary is a book that tracks your sleeping patterns and the way you feel. Sleep diaries are great for keeping track of:

• how much sleep you're getting 
• how you feel after naps
• how exercise and diet help to improve your sleep
• the optimal time and length for you to sleep 

Sleep diaries can improve your sleep and therefore help reduce cancer fatigue. They can also be used as helpful reminders about how you've been feeling between hospital visits or doctor check ups.

Cancer itself can make you tired. Cancer cells can play around with your hormones and blood cells leading you to feel exhausting and needing extra sleep. Surgery, radiotherapy, immunotherapy, chemotherapy and medications can also you feel sleepy and wanting to take naps during the day.

Naps let you fall asleep but aren’t long enough for you to go into a deep sleep. The stage of deep sleep is very important for healing and restoring blood and hormone levels. 

Napping with cancer fatigue is a double-edged sword. A quick nap can restore or boost your energy levels and keep you on track for what you need to accomplish that day. But naps can also leave you feeling groggy and restless. Excessive napping, especially late in the afternoon or before bed, can impact your sleeping pattern by making it difficult to fall asleep and get proper R.E.M sleep, which in turn can leave you feeling like you need to nap.