Fatigue can be caused by cancer itself or the side effects of treatments. It is when you feel very tired or exhausted most, or all, of the time. Nine out of ten people with cancer (90%) experience fatigue and it affects everyone differently. For some people the effects will be very mild, for others it can be very disruptive. You may get tired very quickly, and not feel better after resting and sleeping. Fatigue can affect all areas of your life. Even reading or watching television can be very tiring. This can be frustrating and overwhelming.
Cancer-related fatigue (CRF) usually gets better after treatment finishes, but for some people, it continues for months or years. Tell your doctors and nurses about your fatigue and how it affects your life. You may find it helpful to keep a fatigue diary. Your doctor or nurse may be able to tell you about ways you can manage the symptoms or treat the causes. One of the best things you can do to manage your fatigue is to stay physically active.
What causes fatigue?
Cancer-related fatigue (CRF) can be caused by many things. These include:
- the cancer itself
- tests and investigations you may need to have
- treatments for cancer – including chemotherapy, radiotherapy, hormone therapy, targeted therapies and surgery. CRF usually improves when you have finished treatment but can sometimes be a long-term problem
- low levels of red blood cells in your blood (anaemia) due to your cancer or cancer treatments. You may have a blood transfusion to help increase the number of red blood cells
- the emotional effects of cancer, such as anxiety or depression. These are common emotions when you are first diagnosed with cancer, but generally get easier to manage with time
- poor appetite due to your cancer or side effects of treatment
- symptoms that cancer may cause such as pain, breathlessness or fluid retention
Managing symptoms of cancer-related fatigue
There are things you can do to help manage the symptoms of fatigue.
Eating well and drinking lots of fluids can help increase your energy levels. Your doctor or nurse can give you advice on your diet.
Being physically active can also improve your energy levels and increase your appetite. Start slowly and increase the amount of activity you do over time. Try setting yourself small goals that you can achieve, such as walking to the front door. Some exercise, even a small amount, is better than no exercise at all. It’s important to get advice from your doctor before you do any new physical activity. They may refer you to a physiotherapist for further advice.
You may find that you feel more stressed when you are having treatment. This can make you feel more tired. Try to make time to relax. There are relaxation techniques you can use to relieve tension and increase your energy. Complementary therapies may also help you cope with fatigue and help you to relax. Speak to your GP about using these therapies.
There aren’t any licensed drug treatments for fatigue, but they are being researched. Steroid drugs can be helpful for some people. Your cancer specialist can talk about this with you.
Managing everyday activities
It’s important to plan ahead if you have fatigue. Be realistic about what you can do and plan to do things when you usually feel less tired.
You may find some of these suggestions help you deal with everyday tasks:
- spread housekeeping tasks over the week and ask for help if you can
- try shopping online so it is delivered to your home – or ask a relative or friend to do your shopping for you
- cook simple meals and eat small meals and snacks throughout the day
- have a bath instead of a shower and try to wear clothes that are easy to take off
- listen to the radio or an audiobook instead of watching television
- if you have children, explain that you’re feeling tired. Plan activities where you can sit down while spending time with them
- avoid driving when you feel tired. Family or friends may be able to drive you instead
Remember to ask for help if you need it. Family, friends, neighbours, social workers and occupational therapists may be able to help you manage your tasks.
Managing work if you have fatigue
You may find that you can’t continue working due to fatigue, or that you have to reduce the amount of time you spend at work.
It can help to talk to your employer or personnel/human resources (HR) department and let them know that you may need some time off.
Don’t feel that you have to work if you’re too tired. If you do want to carry on working, you may be able to find ways of making your work less tiring for a while.
Anyone with cancer is protected by the Equality Act 2010, which prevents employers from victimising or discriminating against people with a disability. The act also states that employers are expected to make reasonable adjustments to support employees in the workplace. You may want to make suggestions for adjustments that could help to support you. Things that your employer can do to help include:
- changing your hours so that you can travel to and from work at less busy times (outside the rush hour)
- asking colleagues to be supportive and to help with some of your work
- finding you a parking place near to your place of work
- letting you take short breaks to lie down and rest
- allowing you to work from home (if this is possible)
- finding you lighter work if your job involves physical exertion or heavy lifting
If you’re self-employed, it can help to talk to the Department of Work and Pensions (DWP) about benefits that you may be entitled to claim.