Coping with Cancer Related Fatigue

Everyone has experienced feeling tired.  Tiredness can be felt physically, mentally and emotionally, but for most people after a little relaxation or a good night’s sleep, we find that we are ready to go out and take on the world.  Cancer survivors, on the other hand, report that getting relaxation or a good night’s sleep just doesn’t do it for them.  

Cancer causes fatigue and its treatments also cause fatigue.  The physical strain caused by the disease and its treatments, along with our emotional responses to having cancer can permeate our being and sap our stamina.   Being diagnosed with cancer is highly stressful, and stress negatively affects our state of mind, our sleep, and our energy level. All of this leads to significant fatigue.

If you are a victim of cancer stress, even if you get adequate sleep or rest, you might feel this severe fatigue, or be too tired to perform your normal, everyday activities. We experience cancer stress and fatigue as a persistent, whole-body exhaustion. Concentrating, reading and many other of your regular activities just become too overwhelming to complete. 

 What is cancer-related fatigue (CRF)?

Doctors are finally beginning to understand that Cancer-Related Fatigue (CRF) is one of the most common, universal and distressing side effects experienced by cancer survivors. It can negatively impact all of our daily activities including our ability to work, our social relationships, and our mood.   It significantly affects our quality of life. 

CRF is so common that research has shown that at least one-quarter to nearly all cancer survivors will experience it. CRF might improve after treatment has ended, but many survivors report that some level of fatigue persists for months or even years following the completion of treatment. 

The American Cancer Society describes CRF as:

•    A constant feeling of tiredness that doesn’t ever go away or get better

•    Being more tired than usual before, during, or after activities

•    Feeling too tired to perform routine tasks

•    Feeling general weakness or lethargy

•    Lacking energy

•    Being tired even after a good night’s sleep

•    Inability to concentrate or focus

•    Inability to remember

•    Being sad, irritable or depressed

•    Easily frustrated or angered

•    Trouble sleeping/insomnia

•    Difficulty moving arms or legs

There is medical help available for cancer-related fatigue.

Unfortunately, many of us never report our CRF because we don’t believe that anything can be done to resolve it.

Some things can be done to alleviate the debilitating effects of CRF.  Do not leave your CRF untreated, CRF may lead to your becoming more depressed and more fatigued which will profoundly diminish your quality of life.   It is important that you speak to your doctor if fatigue is an issue for you.

In addressing your CRF, your doctor should first confirm that there are not any underlying additional medical issues which may be contributing to your fatigue.  For example, a common side effect of chemotherapy drugs is anemia and resolving the anemia might mitigate your fatigue.  Fatigue is often confused with depression. A good evaluation can distinguish between the two, indicating the proper treatment. 

In addition to medical interventions, there are some strategies you can utilize to help cope with your CRF.

1. Balance your expectations of yourself.

Be realistic with what you expect from yourself.  Don’t expect that you will be able to function at the same levels you did before cancer.  Learn about and then accept your new limits; over expecting from yourself doesn’t help you to get more done, but it does add to your personal feelings of depression and anger at yourself.   Balance your activities and don’t over-task or drain yourself. Many of us refer to this as establishing and accepting our 'new normal.'

2. Plan your day.

Prioritize your daily activities.  Learn to plan your day so that you are sure that you will accomplish what is most important to you.   Creating a ‘To Do’ list each evening for the next day can help prioritize the things you need to do.  Become a scheduling maven, plan what you want to do and spread the activities out over the day.  A full day's activities do not have to be completed in just a morning, take the entire day, pace yourself based on your ability.  Don’t forget to take breaks between activities and fill those breaks with things you enjoy.

3. Learn about your fatigue and use this information in scheduling your day.

Try to keep a fatigue diary by recording your activities and noting how much fatigue you feel when you do this activity.  You can do this by using a simple fatigue scale, like a 1 to 10 scale.  Creating this diary will help you to understand if there are specific types of activities that cause you to have more or less fatigue.  Use this information when you plan your day.

4. Make sure that you include daily and regular light exercise in your schedule.

When you feel fatigued one of the last things you probably want to do is exercise.  In reality, if you don’t find a way to exercise, you’re more likely to experience more fatigue. A study has verified that exercise and psychological interventions are powerful tools in combating cancer-related fatigue. Exercise reduces the symptoms of fatigue and encourages your body to release endorphins which will make you feel better.

5. Healthy eating is not only good for you; it will help you reduce your CRF.

Frequently, when we are fatigued, we seek out junk food to eat.   Highly processed and highly sugared foods do provide us with a quick pick-up, but the pick-up is short lived and will quickly leave you feeling even more fatigued. Awell-balanced diet that is high in protein and carbohydrates, but low in sugar will go a long way in helping to control your fatigue.  

6. Try to adjust your work schedule.

If you have shared with your employer that you have cancer and are undergoing treatment, make sure that you directly and explicitly solicit their support.  Discuss with them about making adjustments, as you need, to your work schedule and workload.

Depending upon your job consider asking about flexible working hours, reduced working hours or working from home.  U.S. Federal law requires that an employer must accommodate special medical and health issues.  If you need, you could also ask sympathetic work colleagues to help you with some of your workload. 

Use these and other coping techniques you develop to deal with any cancer-related fatigue you might experience.  Don’t allow the fatigue to run your life; you can accommodate it, work around it and develop ways to maintain the quality of your life.  There is no one, best way to deal with CRF.  Find out what does work for you and then do it.