Fatigue, or feeling very tired and lacking energy for daily activities, is a common physical side effect of cancer and its treatment. Fatigue is different from tiredness, as it doesn’t always go away with rest or sleep.
Now that treatment is over, you may think you should be full of energy, but often this isn’t the case. If you were unable to be active during treatment, you may have experienced a loss of muscle strength and fitness. This could contribute to your fatigue.
Many people say that fatigue has a big impact on their quality of life in the first year after treatment. Most people find that their energy returns 6–12 months after finishing treatment. However, some people lack energy for years after treatment and their energy levels may never fully recover.
Many survivors worry fatigue is a sign that the cancer has come back or that it never really went away. This is usually not true.
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Signs of fatigue include:
- lack of energy – you may want to stay in bed all day
- difficulty sleeping – see Sleep disturbance
- finding it hard to get up in the morning
- difficulty completing tasks, especially in the afternoon, when energy levels can be unexpectedly low
- feeling anxious or depressed, particularly if fatigue persists
- muscle weakness – you may find it hard to walk or climb stairs
- reduced mobility and loss of muscle strength (weakness)
- breathlessness after light activity, such as making the bed
- difficulty concentrating
- finding it hard to think clearly or make decisions
- having little or no interest in sex (low libido).
Many cancer survivors don’t tell their doctor about fatigue because they think that nothing can be done about it. However, your treatment team may be able to help. For example, your fatigue may be caused by a low red blood cell count (anaemia), an under active thyroid gland, depression or the side effects of drugs, which your doctor may be able to address. You may also find the following tips helpful.
- Set small, manageable goals – Focus on doing a little bit each day rather than a lot all at once.
- Ask for, and accept, offers of help – Family and friends can help with school pick-ups, shopping or mowing the lawn.
- Plan your day – Make a task list and do the most important activities when you have the most energy.
- Take it slow – Work at your own pace and take regular breaks. Leave plenty of time to get to appointments.
- Exercise regularly – Light to moderate exercise can boost energy levels and reduce fatigue.
- Make time to relax – Try activities like walking on the beach, spending time in the garden or listening to music.
- Adapt your play – If you have children, sit down to Try activities like reading, board games, puzzles and drawing.
- Be realistic – Don’t expect to be able to instantly do everything you used to do. Your body is still recovering and it will take time for your energy levels to return.
- Say no – Don’t feel pressured to do things that you don’t feel like doing. If you have trouble saying no, ask someone to do it for you.
- Stop smoking – Smoking reduces your energy. If you smoke, consider quitting.
- Take it easy – Sit down to talk on the phone or do light chores. Do your shopping online. Talk to an occupational therapist for more tips on reducing fatigue in specific daily activities.
- Eat nutritious foods – Aim to eat a healthy, well-balanced diet.
- Seek help – Talk to your GP if your fatigue is caused by depression
Dr Haryana Dhillon, Senior Research Fellow, Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, University of Sydney, NSW; Polly Baldwin, 13 11 20 Consultant, Cancer Council SA; Jessica Barbon, Dietitian, Southern Adelaide Health Network, SA; Dr Anna Burger, Liaison Psychiatrist and Senior Staff Specialist, Psycho-oncology Clinic, Canberra Region Cancer Centre, ACT; Elizabeth Dillon, Social Worker, Peter MacCallum Cancer Centre, VIC; Prof Paul Glare, Chair in Pain Medicineand Director, Pain Management Research Institute, University of Sydney, NSW; Nico le Kinnane, Nurse Coordinator, Gynaecology Services, Peter MacCallum Cancer Centre, VIC; Amanda Piper, Manager, Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, VIC; Kyle Smith, Exercise Medicine Research Institute, Edith Cowan University, WA; Aaron Tan, Consumer; Dr Kate Webber, Medical Oncologist and Research Director, National Centre for Cancer Survivorship, NSW. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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