Tiredness or Fatigue

Fatigue (feeling tired all or most of the time, or not able to carry out some of your normal everyday activities) is common in patients undergoing cancer treatment. There are many causes of fatigue – most anti-cancer treatments will make you feel fatigued but there may also be other causes (for example anaemia, low thyroid function or some painkillers amongst others). You will probably find that you are more fatigued at some points during your cycle than in others.

It is important to change your activities accordingly and rest when you need to. Although fatigue can be frustrating and can sometimes impact on your quality of life, it is important to remember it is not necessarily a sign that treatment is not working, or that the disease is getting worse.

Some symptoms of fatigue (such as a loss of interest in doing your usual activities, changes to your concentration and difficulty sleeping amongst others) can also be a sign of depression so it is important to seek advice from your oncology doctor, clinical nurse specialist (if you have one) or your GP so they can identify the best way to manage/treat your symptoms.

Although there is no medication available that has been proven to help relieve fatigue, there are some things you can do to help yourself.

Tips for Coping with Fatigue

There are lots of things that you can do by yourself or with the help of a friend or relative that may help you to cope with fatigue.

Managing Daily Living

When you have fatigue you may find you have very little energy to do anything, so it is important to save energy to allow yourself to do the tasks/activities that you want to do. It is important to balance activity with rest, so you should aim for periods of rest between tasks/activities.

A traditional approach to saving energy and managing fatigue is the three ‘P’s’ – Prioritise, Plan and Pace. This involves:

1. Prioritising which activities/tasks are important to do.
Think about your day or week ahead and decide which activities/tasks are most important to you, and which activities/tasks can wait. Sometimes your priorities may be everyday tasks such as shopping or cleaning, and other times they may be social activities such as seeing your friends or family. Everybody has different priorities so your priorities will be entirely individual to you.

If there is something you want to do that you know will make you feel tired, perhaps make that task your priority for the day and put off other things to conserve your energy. Prioritising activities/tasks will then allow you to plan how to use your energy in the most efficient way.

2. Planning which activities/tasks you need to carry out and how you will do them.
Think about which activities/tasks you made a priority and plan how you will carry them out. Planning ahead can help you to use your energy in the most efficient way. When planning, be realistic about what you are able to accomplish and decide whether you need the help of a friend or relative. It is also important to plan the days around your treatment so you avoid doing anything tiring during the 24 hours before and after treatment. Remember to plan frequent periods of rest into your day too.

3. Pacing yourself whilst carrying out your activities/tasks.
Take your time when carrying out activities/tasks. Remember you don’t have to do everything, only the things that are important to you right now. If you are going out or have appointments to make, try not to rush and give yourself plenty of time to get to places.

Physical Activity and Exercise

It may seem different to what you would expect but studies have shown that physical activity is actually beneficial when you have fatigue as it can give you more energy. It is important to only do what you are able to do. Even doing just a little bit of mild activity everyday will help. You could start out by doing 2-5 minutes daily, then build up to 20 minutes twice a week, and then increase this to 30 minutes 3-4 times a week.

A common sense approach to physical activity is vital. Only do physical activity that you feel safe and comfortable doing. Do not over exert yourself or make yourself extremely short of breath. If you suddenly experience any pain, become breathless or dizzy/light-headed, have nausea or an irregular pulse stop exercising immediately.

Rest and Sleep

If you are very tired it is important to set yourself a few rest times throughout the day. You don’t have to sleep during these rest times. Just sitting or lying down somewhere quiet will help. Make your surroundings comfortable so that you can totally relax.

Getting a good quality night’s sleep is also very important to help with fatigue. Sometimes when you have fatigue you may find you need to nap during the day, which can disturb your sleep at night. To help you get back into a more regular sleeping pattern it may help to change a few things about when and where you sleep. It is important to establish a routine in the evenings to help you relax for bedtime. Be patient with any changes you do make as it may take a couple of weeks to get back into a good sleep routine.