How to Manage Cancer-Related Fatigue

Cancer-related fatigue is one of the most common side effects of both cancer and its treatments.

Affecting the vast majority of all cancer patients, cancer-related fatigue is defined by the National Comprehensive Cancer Network as “an experience of physical, emotional, and/or mental exhaustion related to cancer or its treatment. Cancer-related fatigue is not the typical tiredness that follows an active or long day. It is a lack of energy that is distressing, does not improve with normal amounts of rest or sleep, and disrupts daily life.”

We asked our cancer treatment team at Lipson Cancer Institute to explain what causes cancer-related fatigue and how they help patients to manage it effectively.

How cancer-related fatigue is different

General fatigue is associated with feeling tired and usually occurs after bouts of increased activity. This type of fatigue can be resolved with adequate rest. Cancer-related fatigue is different.

Many patients with cancer-related fatigue describe feeling tired, weak, not wanting to do things, not being able to concentrate, or feeling irritable.

“Fatigue related to cancer is a higher intensity lack of energy that cannot be resolved by a good night’s sleep and can negatively impact a person’s mental health and quality of life,” said Vatsala Kirtani, MD, a hematologist and medical oncologist at Lipson Cancer Institute.

Causes of cancer-related fatigue

Cancer-related fatigue most often affects patients who are undergoing chemotherapy, radiation therapy, bone marrow transplant, or immunotherapy (biologic therapy).

Fatigue is also an early symptom noted by many patients at the initial diagnosis of cancer. It may last for many months or even years after a patient completes cancer treatments.

Other factors that can contribute to cancer-related fatigue include:

• insomnia
• anemia
• depression
• stress
• medications
• pain
• hypothyroidism
• decreased nutrition

How to manage cancer-related fatigue

Physical therapy and exercise are noted as highly effective, evidence-based treatments for cancer-related fatigue.

“For years, cancer patients experiencing fatigue have been advised to rest and avoid any activity that may worsen their fatigues,” said Deanna Hayden, PT, a physical therapist who specializes in cancer-related fatigue therapy at Rochester Regional Health. “However, research shows physical activity actually can help improve their fatigue.”

Beyond reducing fatigue, studies show physical activity also helps to:

• increase endurance
• improve strength
• increase appetite
• improve sleeping pattern

The Rochester Regional Health Physical Therapy & Rehabilitation team and the Lipson Cancer Institute have collaboratively developed a treatment program for cancer-related fatigue. This approach brings skilled physical and occupational therapists together to use a holistic approach to help counteract some of the effects of this condition.

While cancer-related fatigue can’t be completely eliminated from every patient’s experience, it can be managed well. Taking some of these small steps can make a difference in providing relief.

• Plan ahead and prioritize tasks
• Delegate day-to-day tasks, if you can
• Schedule frequent rest breaks
• Keep a moderate pace for activities
• Breathe evenly
• Wear loose clothing
• Avoid extreme temperatures
• Eat a balanced diet
• Stay hydrated
• Take supplemental vitamins
• Manage stress
• Get a full night of sleep
• Implement a customized exercise plan