Cancer fatigue: Why it occurs and how to cope

Fatigue affects most people during cancer treatment. Cancer fatigue can result from the side effects of treatment or the cancer itself. Here's a look at the causes and what you can do to cope when you're feeling fatigued.

People with cancer often describe the fatigue as making them feel tired, weak or exhausted. The fatigue can be physical or emotional. It often isn't helped by usual measures, such as resting or getting a good night of sleep. The level of cancer fatigue may vary from feeling tired to feeling completely drained of energy.

Fatigue may start even before your cancer diagnosis. Sometimes it's a symptom of cancer. For some people, the fatigue starts after a diagnosis. Others aren't hit with cancer fatigue until treatment starts. Some people have cancer fatigue that lasts long after treatment ends.

Cancer fatigue has many possible causes. The type of cancer you have, the kinds of treatments you're having, and your overall health can all play a part in cancer fatigue.

In general, causes of cancer fatigue may include:

• The cancer itself.
• Cancer treatment.
• Chronic pain.
• Emotions, such as feeling anxious, distressed, or depressed.
• Difficulty sleeping.
• Difficulty getting enough nutrition.
• Certain medicines, such as pain relievers.
• Changes in your activity level.
• Changes in the levels of hormones in your body.
• The stress of life.

Cancer fatigue is worrisome when it interferes with your ability to go about your everyday tasks. Tell your healthcare professional if you have fatigue that doesn't get better when you rest. Tell your healthcare professional if cancer fatigue keeps you from doing what you need to do.

Don't assume your fatigue is just part of the cancer experience. If it's frustrating you or affecting your ability to go about your day, it's time to talk with your healthcare professional.

If you're fatigued, your healthcare professional may examine you and ask questions to better understand your symptoms.

Treatment for cancer-related fatigue depends on its cause. If your cancer fatigue has a clear cause, your healthcare team can work to address it. This might be with medicines and other treatments. Medicines and treatments also can help with cancer-related fatigue that has no clear cause. Your healthcare team might also suggest things you can do on your own to fight cancer fatigue.

People with cancer fatigue might find they can boost their energy by taking some self-care measures. You might get some relief from cancer fatigue if you:

• Take it easy. Set aside time in your day to rest. You may notice you're most fatigued at certain times. Plan to rest at those times. Many people with cancer say the fatigue sets in during the midafternoon. Take short naps throughout the day rather than resting for one long period. Limit your naps to no longer than an hour at a time.
• Conserve your energy. Save your energy for your most important activities. Keep track of the times when you feel your best. Make a list of what needs to be done. Note what's most important. Plan to do those things when you have the most energy. Ask for help when needed.
• Maintain your energy. Keep your energy up by drinking enough water and eating healthy foods. If nausea and vomiting make it hard to eat, talk to your healthcare professional about these side effects.

• Get moving. Moderate exercise may provide some relief from cancer-related fatigue. Examples include walking, riding a bike and swimming. If you have cancer fatigue, exercise may help you build stamina. If you're starting cancer treatment soon, getting in the habit of regular exercise now may help prevent fatigue.

  If you haven't exercised much lately, check with your healthcare professional before you begin to make sure it's safe. If your healthcare professional says it's OK, start slowly. Consider adding strength training, such as lifting weights.

• Consider integrative medicine options. Some people with cancer find relief from fatigue through integrative medicine practices that encourage relaxation. Examples include cognitive behavioral therapy, yoga, tai chi and qigong. Massage and acupuncture may be helpful too. But check with your healthcare professional to make sure these are safe. Some may not be safe if you have low blood counts or if you take blood thinners.
• Ask your healthcare professional about supplements. Supplements that contain ginseng have been shown to relieve fatigue in small studies. If you're interested in trying supplements, discuss them with your healthcare professional. Your healthcare professional can make sure the supplements won't interfere with any medicines you take.