Cancer related fatigue

Fatigue is a feeling of tiredness or exhaustion. It can be caused by the cancer itself, or the side effects of treatments. As many as 9 out of 10 people with cancer (90%) get cancer-related fatigue (CRF).

It is possible to manage fatigue. Your healthcare team may be able to help prevent or relieve fatigue and improve your quality of life.

Cancer-related fatigue usually gets better after treatment finishes. But it may continue for months or even years. Everyone is different and there is no way to know how long fatigue may last for each person.

Please watch this short video about information you will find in this section of your Patient Education Programme.

The effects of fatigue

Some of the more common effects of fatigue may include:

• Difficulty doing simple things such as brushing your hair or getting dressed
• Feeling you have no energy or strength
• Difficulty concentrating and remembering things
• Difficulty thinking, speaking or making decisions
• Feeling breathless after light activity
• Feeling dizzy or lightheaded
• Difficulty sleeping (insomnia)
• Losing interest in sex
• Feeling low in mood and more emotional than usual

Having one or more of these symptoms can affect your daily activities or social life. For example, finding it hard to concentrate may affect your work or studies. Fatigue can also affect your relationships; you may need to rest more meaning you might spend less time with friends and family, or you may avoid going out because it makes you very tired.

Managing fatigue

How fatigue is managed depends on what is causing it. It is important to talk about fatigue with your healthcare team. There may be ways to help improve this. Your doctor will check for any causes of fatigue that can be treated, such as anaemia. They may examine you and you may have some blood tests. They may also look at the medications you are currently taking. This is to check whether they can make changes to them that might improve your fatigue. For example, they may reduce the dose of a tablet that may make you sleepy.

Things that you can do to combat fatigue

Physical activity

There is good evidence that physical activity can help reduce the symptoms of fatigue. It can:

• Boost your appetite
• Give you more energy
• Improve the quality of your sleep

Heathy diet and weight

Eating well and keeping to a healthy weight can help you maintain or regain your strength. It can also give you more energy. Try:

• Keeping a food diary
• Drinking plenty of fluids
• Trying different foods

Sleep

You may fee like sleeping all of the time, however:

• Stick to the same bed-time routine every day
• Limit naps
• Rest before big energy activities

Support online

RESTORE

RESTORE is a new online tool, developed by Macmillan and the University of Southampton, that provides information about things you can do to help you cope with fatigue. It is based on the most up-to-date evidence and can give you more confidence to manage your fatigue. RESTORE helps you to monitor your energy levels and set goals to help you manage your fatigue more effectively. It also links to the Macmillan fatigue diary, to help you keep track of your energy levels and work out what makes your fatigue better or worse.

The RESTORE tool is available for anyone experiencing cancer-related fatigue. Access the Restore Tool at Macmillan

Untire: Beating Cancer Fatigue

The NHS website mentions an app called Untire: Beating cancer fatigue. It has handy tips and advice, online support, it records your energy levels and you can see your progress. 

The Untire self-help app provides a step-by-step guide to help you and your family and friends beat cancer-related fatigue. Whether you’re a cancer patient or survivor, the programme can help you regain energy. Untire’s daily programme consists of positive tips and advice, stress reduction exercises, physical activities and education to help your cancer-related fatigue. 

The app lets you:

•      Find information to help you better understand fatigue
•      Access daily tips and reminders to improve your lifestyle
•      Learn mind and body exercises to increase your energy levels
•      Join private online support communities
•      Keep track of your progress and energy levels each week
•      Access audio and video guides about your condition
•      Involve buddies to help you beat cancer related fatigue 

Ruth’s story

Watch this short video of Ruth, and her experience of fatigue:

Watch this short video of Denton, and how he manages his fatigue:

Complementary and health and wellbeing therapies

There are many reasons why people use health and wellbeing therapies. Some people find they help them cope with the stress of cancer and its treatments. Many therapies are relaxing and may improve your mood and help with fatigue.

These therapies are used alongside conventional medical treatments to treat the whole person holistically.

The Sir Robert Ogden Macmillan Centre provides complementary therapies. Therapies that can help with fatigue include:

• Relaxation
• Massage
• Reflexology
• Yoga
• Hypnotherapy
• Acupuncture
• Reiki

Planning ahead

Writing down your energy levels will help you see the days and times when you have more energy. You may not be able to do everything that you used to do. Try to plan bigger tasks to fit in with the time of day that you feel less tired. Pace yourself and plan enough rest and sleep periods.

Macmillan Cancer Support have a Fatigue Diary that you may find helpful in working out what is causing your fatigue.

Other things that may help:

• Spreading tasks over the week – such as housework, gardening and supermarket trips
• Asking other people to do heavy work – such as gardening or taking the rubbish out
• Sitting down to do some tasks
• If possible, go shopping with a friend for extra support
• Ask for and accept help from family and friends – someone may be able to take your children to and from school or run errands for you

“My advice would be to make life easier for you wherever possible. Get to bed at a decent hour, eat well and when you have a bit more energy, think about how to make life easier for yourself in the next week”

Ruth

“At times it can be frustrating not to have the energy or the physical strength to do the things I love to do. It is important that I have a plan, and yet, also be realistic about what is possible. I try and concentrate on what I can do rather than what I can’t.”

John

“I wrote a diary and marked down what I could do and how long it would take me. I wrote down positive achievements and new things I had accomplished. I began to see that I was improving month by month and sometimes even week by week. I may be a long way off where I was before I had cancer, but I am a long way towards a new normal.”

Elizabeth