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Managing fatigue
Fatigue is a common side effect of cancer and its treatment. In this section, we will provide information on how to manage fatigue both during and after treatment.
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Overview
The first step in managing fatigue is working out how it affects you. You can use a scale to describe your fatigue. You can rate the fatigue from 1–10; the higher the number, the worse the fatigue. Keep a record of your fatigue level at different times of the day, what you have tried and how it has worked. This information can help those caring for you understand how you are feeling day to day.
Talk to your general practitioner (GP); oncologist, haematologist or nurse; or an allied health professional such as an occupational therapist, physiotherapist or exercise physiologist. Let them know how you are feeling, including how long you have felt fatigued.
Your doctor will manage any health conditions, medicines or symptoms that may be causing the fatigue. For example, if your red blood cell count is low (anaemia), you may be prescribed medicines or have a blood transfusion. If pain is making fatigue worse, your pain medicine may need to be changed.
See below for tips on dealing with fatigue during and after treatment. How you manage fatigue will vary depending on the level of fatigue you have.
- Mild fatigue (0–3) – keep doing usual activities
- Moderate fatigue (4–6) – reduce symptoms and increase your energy levels gently
- Severe fatigue (7–10) – reduce symptoms and try to save your energy.
Ways to manage fatigue
These tips can help you manage cancer-related fatigue during and after treatment.
Exercise regularly
- Check with your doctor about what type of exercise is safe for you, especially if you are living with bone cancer or advanced cancer.
- See an accredited exercise physiologist or physiotherapist. They can develop a suitable program.
- Start slowly at first. Break up exercise into a couple of small sessions. As fatigue improves, gradually increase your exercise level.
- Try to be physically active with moderate exercise (e.g. walking, swimming) and some strength- training (e.g. weights or resistance bands).
- Try to work towards 150 minutes (2 ½ hours) of moderate exercise and 2 strength-training sessions a week.
- Watch our online exercise videos.
- See Exercise for people living with cancer.
Adjust your daily habits and sleep routine
- Pace your activities, take regular short breaks, and rest when you need to.
- Prioritise activities that you enjoy or give you a sense of achievement.
- Get a referral to an occupational therapist or physiotherapist for tips on how to save energy.
- If you’re not sleeping well, speak to your doctor.
- Aim for about 7–8 hours of sleep each night. Keep naps short during the day.
- Go to bed and get up at the same time every day.
- Have a bedtime routine that includes activities such as meditation.
- Avoid using computers, mobile phones or tablets in the evening.
- Get some natural light during the day to help you sleep at night.
- Avoid drinking alcohol and smoking as these can affect sleep.
- If you’re unable to fall asleep, get up and do something relaxing until you feel sleepy.
Look after yourself
- Eat as well as possible. A dietitian can provide suggestions, visit dietitiansaustralia.org.au to find a dietitian.
- Stay hydrated by drinking water when you feel thirsty.
- Try relaxation and meditation techniques to help reduce stress. Listen to our podcast Finding Calm During Cancer.
- Consider complementary therapies. Studies have found that yoga, tai chi, Qi gong, and the Chinese herb American ginseng can help with fatigue. Let your health care team know what you are using. They can tell you if it’s safe.
- Explore acupuncture. There is some evidence it can reduce cancer-related fatigue. Check your acupuncturist is registered at the Chinese Medicine Board of Australia. Some registered acupuncturists have special training in treating cancer-related conditions.
- See Nutrition and cancer and Complementary therapies.
Involve other people
- Tell family and friends how you are feeling – this can prevent misunderstandings.
- Accept offers of help or ask family, friends or neighbours to help with household chores, cooking or gardening.
- Your local council or social worker can put you in touch with services for help at home (such as house cleaning, meals or shopping). Some are free, while others have a cost.
- Talk to your health care team about how you are feeling. They can assess if you have depression. Counselling or medicine, even for a short time, may be helpful.
- Consider cognitive behaviour therapy (CBT) and mindfulness-based stress reduction (MBSR); they can help with mood. Ask your GP what’s available in your area.
- Connect with a support group, either in person, over the phone or online.
- Speak to your employer about changes they can make to support your return to work.
The costs for seeing an exercise physiologist, physiotherapist, dietitian or occupational therapist vary. If your doctor refers you as part of a General Practitioner Management Plan, you may be eligible for a Medicare rebate for up to 5 visits per calendar year. If you have private health insurance, your insurer may cover some of the cost.
Podcast: Managing Cancer Fatigue
Listen to more of our podcast for people affected by cancer
More resources
Prof Michael Jefford, Medical Oncologist and Director, Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, VIC; Kirsten Adlard, Exercise Physiologist, The University of Queensland, QLD; Anthea Carey, Consumer; Andrea Concannon, Consumer; Dr Briana Clifford, Exercise Physiologist, UNSW Fatigue Clinic and Research Program, NSW; Hazel Everett, Clinical Nurse Consultant – Cancer Services, St John of God Subiaco Hospital, WA; Dr Suzanne Grant, Senior Research Fellow, NICM Health Research Institute, Western Sydney University, and Chris O’Brien Lifehouse, NSW; Pippa Labuc, Senior Occupational Therapist, Peter MacCallum Cancer Centre, VIC; Prof Andrew Lloyd, Director, UNSW Fatigue Clinic and Research Program, NSW; Catherine Meredith, Consumer; Dr David Mizrahi, Exercise Physiologist and Research Fellow, The Daffodil Centre at Cancer Council NSW and The University of Sydney; Dr Elizabeth Pearson, Allied Health Researcher, Peter MacCallum Cancer Centre, VIC; Dr Astrid Przezdziecki, Clinical Psychologist, Mind My Health, NSW; Chris Sibthorpe, 13 11 20 Consultant, Cancer Council Queensland; Kate Woodhead, Physiotherapist, St Vincent’s Hospital Melbourne, VIC.
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