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7 tips to help deal with #cancer-related fatigue #breastcancer #mastectomy #chemotherapy #radiationtherapy

Seven Tips to Help Deal with Cancer-Related Fatigue

What word comes to mind when you hear someone mention the “f” word? Okay, after that one. And on a side note, since cancer, do you find that your tongue has loosened just a bit? If you know what I mean, and I’m guessing you do. (Mine has anyway.)

Then there is that other “f” word many of us struggle with, and yes, I mean “fat”. I wrote about that one here.

And then, there is that third “f” word many cancer patients become all too acquainted with—fatigue.

This is the perfect time of year to talk about fatigue, but of course, any time is perfect when talking specifically about cancer fatigue.

With the holidays fast approaching, you undoubtedly have a long to-do list, and if you are also dealing with cancer treatment or collateral damage from cancer treatment, you understand about cancer fatigue all too well.

Cancer fatigue is very real. The specific medical term is cancer-related fatigue (CRF), and is defined by the National Comprehensive Cancer Network as follows:

Cancer-related fatigue (CRF) has been defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer and/or cancer treatment that is not proportional to recent activity and interferes with usual functioning.

Sometimes cancer fatigue lasts for months, even years after treatment ends. Obviously, patients who are metastatic likely deal with it for their rest of their lives because treatments do not end.

(From here on out, I’ll refer to it as cancer fatigue.)

It’s important for patients and caregivers to acknowledge and try to understand cancer fatigue.

Validation alone is helpful and almost makes you feel a little less tired, in and of itself. (Well, maybe not, but you get my point.)

It’s important to let your doctor know if you are really struggling with cancer fatigue. It could be a sign of depression, which is pretty common during cancer treatment (and after), or it might be a signal that something else is amiss and might need to be addressed.

As always, do not suffer in silence.

Cancer fatigue is different from just feeling tired as most people know it. Cancer fatigue is in a whole different ballpark.

(The American Cancer Society offers further information and specific symptoms here.)

Of course, the irony is that despite feeling so tired, often getting a good night’s sleep is nearly impossible due to lots of reasons.

When I was undergoing chemotherapy, fatigue was definitely a major side effect for me. Some days it was a struggle to do much of anything and I often found myself falling asleep, or wanting to, when I certainly wasn’t planning on a nap. Even now, I tire more easily and often struggle with sleep issues, probably partly due to the aromatase inhibitor I’m on. But that’s a different post.

What are the causes of cancer fatigue?

Like so many health-related issues, the causes can be complex and intertwined. Cancer treatments such as radiation and chemotherapy directly impact blood cell counts. Other contributing factors can include: pain, sleep issues, medications, lack of activity, poor nutrition, emotional stress, trying to keep up with work and other responsibilities, and of course, a wide variety of other non-cancer related health issues a person might have.

So, how do you cope with cancer fatigue?

Of course, everyone’s situation is different, and I certainly don’t claim to have the answers, but here are a few suggestions that might help. I hope you’ll share any you might have with a comment at the end of this post.

1.  First of all, ditch the guilt.

Cancer treatment of any kind is hard on a person’s body and psyche too. Do not feel badly about feeling tired.  Just do not.

2.  Listen to your body.

Your body is working super hard during treatment (and beyond). When your body is telling you to sleep, try to listen and, well, sleep.

Of course, many of us have kids, jobs, pets and homes to run, so this is easier said than done. Try to rest when you can, even if it means taking a nap an hour (or less) after you just got up.

3.  Along with the above, lower your expectations.

Who cares if your house isn’t as clean as it used to be? It’s likely no one does, other than you perhaps. It’s all about prioritizing. Do what needs to be done most and let the other stuff slide. Some stuff can slide for quite a while too.

4.  Ask for help.

This comes up time and time again when talking about cancer.

So why is it so hard to do?

We like to think we can handle anything and everything on our own I guess. But cancer is like having a full-time job and you can realistically only handle so many things in a 24-hour day. And if you’re metastatic, well, you really have to pace yourself and assemble a list of people to call on who are willing and able to help you out when you need it. And you will.

You might want to read, HELP! Seven Tips to Make Asking for It Easier.

5.  Eat as healthy as you can and try to squeeze in some movement too.

Obviously, proper nutrition is important during cancer treatment (and beyond) too. If this is an area you need help with, speak with a registered nutritionist or dietitian.

Some days it feels really hard, okay, impossible to squeeze in exercise of any sort, but try to move a little bit each day even if it’s only walking to your mailbox. Exercise really does energize. Plus, it promotes a general feeling of well-being, cancer or no cancer.

Think about signing up for a class. The YMCA Livestrong program is excellent. There are places that offer classes specific to cancer patients, depending on where you live, of course.

6.  Figure out what time of day is most productive for you.

After you do this, you can plan activities and chores accordingly. This helps you see patterns and might help you feel more in control of your day.

This is another time when journaling (if you’re not too tired) can come in handy.

You might want to read, Twelve Tips for Journaling through Life’s Challenges.

7.  Always have a plan B (escape plan).

It’s always wise to have a back-up plan because you never know when or where cancer fatigue will kick in and become debilitating. In other words, have an escape plan. And do not feel badly if you need to use it.

Also, when asked to go out, attend an event or whatever, never hesitate to just say, no. And there’s no need to explain. Your polite “no thank you” needs no justification.

Remember, rest is never a luxury, it’s always essential to your well-being. But during cancer treatment (and beyond), it’s even more important.

So those are my tips for coping with cancer fatigue. 

Why not share one or two of yours?

Regardless of what point you’re at in your cancer experience, are you experiencing CRF?

What’s one of your tips for coping with fatigue?

Do you have a tip specific to the holidays?

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7 Tips for Coping with Cancer-Related Fatigue. #cancer #breastcancer #chemotherapy #radiation #MBC

21 thoughts to “Seven Tips to Help Deal with Cancer-Related Fatigue”

  1. I’m post treatment, but still have fatigue and depression and often times I just want to sit on the couch and read or surf the web. What I decided was to start going to the gym and riding a stationary bike.That way I can still do those things while moving. It helps to get out. The other thing I want to respond to is the part of this post about one’s tongue loosening up. I was at a bc fundraiser that a guy from “Real Men Wear Pink” was running and as we were leaving, I walked up to him to thank him for all he’s done ($$$)for the cause and he said to me “ anything to save 2nd base”. Normally I would have just let that go, but not this time. I told him that’s rude and women who’ve had breast cancer don’t care for that to be said. I’m thinking if he’s raising the money he should be mindful of what women think.

    1. Kim, Thank you for sharing what you decided to do. I agree that doing something that gets you moving can really help. It sounds counter intuitive when you’re feeling tired that getting active will make you feel less so. I don’t think going to the gym is necessary for everyone, of course, but figuring out something you can do to be more active is crucial for everyone, cancer or no cancer. And fresh air is hard to beat for re-energizing. Good for you for sharing your opinion with that man! What was his reaction? My tongue has definitely loosened. Glad to hear I’m not alone. 🙂

  2. I’m post-treatment, but I experienced my worst fatigue while taking the aromatase inhibitor anastrozole. It was worse than chemo fatigue. My chemo fatigue usually resolved in about three or four days; my fatigue under anastrozole had a sudden onslaught and lasted for more than a solid week before I saw my PCP. (I was going to wait until my quarterly checkup with my MO a few days later, but the fatigue was bad enough so that I saw my PCP as a walk-in.) No amount of sleep made me feel rested. Running errands felt like sleepwalking. My PCP gave me a B-12 shot and voila! Problem solved! Resolution occurred literally overnight. I received several more B-12 shots and then started taking sublingual B-12 supplements; the problem never returned. When I brought my experience up at my BC support group, I heard from three others who experienced anastrozole fatigue. Two others swore by B-12. The third said she would start taking B-12 right away. For anyone experiencing anastrozole fatigue, B-12 might be a literal quick and easy solution.

    1. Elissa, Thanks for sharing what helped you. Sounds like this is definitely something to discuss with your doctor if you’re experiencing fatigue that’s inhibiting normal day-to-day functioning.

    2. Hi Nancy,
      I am now 5 years post-cancer treatment (a year of: 8 cycles of neoadjuvant chemotherapy, mastectomy and immediate implant, and 28 sessions of radiation therapy and I still suffer from fatigue but it has definitely improved. I have borrowed from the fatigue management strategies of patients with MS and Chronic Fatigue Syndrome with benefit: pacing (the most important), prioritization, planning, preparation and patience – with others but especially with myself. Prior to cancer, at this time of year I would already have bought and wrapped 48 advent gifts for my two children. Now I have one gift wrapped for my little grandson and I am thrilled and at peace. Wishing you a very Happy Holiday.

  3. I’m in the middle of taking oral chemotherapy and have radiation coming up in January. I find it very hard to deal with the fatigue because it comes with severe mental fog and everything I use to entertain and distract myself requires some level of concentration. My husband set up our Roku with audio books so I can lie on the couch and just listen for when the fatigue really knocks me down.

    When I do have a few spoons to spend I find that laundry and filling the dishwasher are fatigue-friendly chores. For 5 minutes of effort I get to rest for 40 minutes while the washer or dryer completes its cycle. For 10 minutes of effort I can rest for 90 minutes while the dishwasher runs. For some reason, it’s easier to rest during these times because I’m “doing” something!

    1. mamamorgaine, I’m sorry you are finding it hard to deal with the fatigue. You’re certainly not alone. It’s understandable that the oral chemo is taking a toll on your energy. And with upcoming radiation too, it likely won’t be subsiding. It’s nice your husband set that up for you and your idea of combining tasks with rest periods sounds like a good strategy. Remember that resting IS doing something. Are you able to go outdoors and walk around your neighborhood for a short time? There’s something about a walk in the fresh air that reinvigorates. Hopefully your care team is aware of your fatigue and offering some guidance as to what to do about it. Thank you for sharing so candidly.

      1. I would love to get outside and walk around! Unfortunately, I’ve got a horrible case of hand and foot syndrome with this medication and my feet are blistering and peeling badly. (I’ve already had my dosage reduced twice.) I’m very upset that I can’t use exercise to help with the fatigue and my care team doesn’t have anything else to offer.

        I have a treadmill at home that I hope to be able to use as soon as the peeling stops. Walking the neighborhood now that it’s winter in Vermont relies upon how well the roads have been plowed!

        Thank you for providing a space to vent about the challenges of treatment! Just this morning I had to deal with a “the most important thing is to stay positive!” person. I hate having to lock down my rage, fear and despair around others…it just puts it all under pressure and makes it so much harder to bear.

        1. Mamamorgaine, I’m so sorry that you were subjected to “the tyranny of positivity”. Being admonished to be positive was the most difficult thing to hear when I was undergoing treatment and I so agree with you that it makes everything so much more difficult to bear. You have every right to feel fear, rage and despair -and to be able to authentically express those emotions. All the best.

        2. mamamorgaine, I am sorry to hear about the hand and foot issues you have due to your medication. That sounds awful and yes, that certainly makes walking around your neighborhood pretty undoable. I use a treadmill, too, when the roads I generally walk on are not what I want to tackle and when it’s just too darn cold. Can you manage some simple stretching and bending exercises while sitting? Seems like your team could provide some guidance and maybe a specialist to help with coming up with some. But hopefully things will improve so more options are open to you. And jeez, what’s with the positivity police people anyway? Feel free to not give that free pass. I think I wrote a post about that, but can’t remember which one it is offhand. lol. Thank you for sharing. Feel free to vent anytime. 🙂

  4. Hi Nancy,

    Thank you for such a great blog. I’m still struggling with fatigue even though it’s now over two years since my treatment ended. I have a draft blog about it which I may publish soon. It’s hard to explain to others how it feels. I completely agree with and love all your tips, particularly about not needing to justify yourself. One of my tips is to devise an escape plan with someone else. For example, if I give you that look or say that word I need to leave.


    1. Julia, Cancer or no cancer, a person doesn’t really need to justify when saying no or leaving early. And I like your escape plan trick of giving the person who’s with you a certain look. Great idea. I look forward to reading your blog post. Thank you for reading and commenting on mine.

  5. I have to admit that I am tired of being tired. Sometimes I’m so tired, I can’t even say fatigue.
    And it comes out sounding like taaad.
    I am not always tired, sometimes I am full of energy.
    But I cannot predict either state of being, since I can start out full of piss and vinegar
    and then suddenly, whoosh, like a waterfall, the fatigue will wash over me and I melt.
    And then comes the “why bothers” and the “what the hell fors”…………………and then the “WTF’s”

    My biopsies, surgeries and radiation treatments ended 3 years ago,
    You would think I would be “over it” by now…….
    but I have been suffering the bleeping side effects of the demon pill they insist you take for 5 years,
    these past 3 years. And never mind the other meds to counteract certain other side effects
    They all definitely make me tired………..and full of piss and vinegar.
    Yes, I get pissed more easily and my loose tongue can spit vinegar all over the place!
    (I might have kicked 2nd base guy above in his 3rd base and laughed hysterically……..
    How do you like me now!!!?)
    …..Or not………it could go either way……..

    But seriously………….
    It seems that the holiday season can tend to become overwhelming with expectations.
    It’s time to be joyful and happy,
    (at least smile and pretend, dammit, why do you have to ruin it for every one else??!)

    You are supposed to want to bake cookies and lovingly wrap them in foo foo, blah, blah, blah
    (but instead, end up eating all the damn cookies everyone brings in to work…..and gain 10 lbs)
    You are supposed to deck the halls with fresh cut greens and twinkling lights….everywhere!
    And sing and prance and dance while doing it!! Fa la la la blah, blah, blah…………….
    (I do love to go for night rides to look at everyone else’s lights, though…….
    (that cheers me up…………..then again,
    I just found out I now have mild cataracts forming,
    and driving at night now bothers my eyes
    so do bright lights………….
    and I believe it is from the demon pill that is prematurely aging me)
    (Oh,….joy….another gift……….)
    But anyway, I am still going to try to do a little something to brighten my own damn day
    Why the hell shouldn’t I buy myself a nice little gift? And screw the guilt, I put up with enough crap all year round…….

    Okaaayy, where was I???
    Oh yeah, going outside is one of the best mood meds, I agree.
    And I actually have to admit that I have 2 giant pine trees in my yard
    and a holly bush
    and I cut off some branches and arrange them wherever the whim takes me
    and I mutter and curse to myself and limp and gimp around the yard
    stepping in the mole holes and accidentally grabbing prickers that lurk everywhere unseen
    and sticking myself endlessly with the stupid pine boughs
    but it smells so good and enhances the mood and the pine pitch will wear off in a few days
    however fleeting, there is something about an arrangement of woodland treasures
    in honor of the holidays and whatever else you need it to be (and it is much easier than dragging all those damn boxes of decorations down from the attic or from out in the garage and you find out the mice enjoyed them too, yuck….I’d rather have dirt under my nails, thank you, and I can just throw the greens in the woods when they are gone)
    Just being outside for at least 30 minutes, can do wonders for my mood.
    And the worse the weather, the better, it really can be exhilarating and invigorating
    or at least worth the effort before nice dry, cozy jammies and a nice nap

    Yesterday it was pouring rain, a nice quiet Sunday in November
    I went outside anyway and started clipping away at the pine trees and holly bush and whatever other evergreen thing or vine or weed I hadn’t trimmed all summer
    because I was too tired……..
    ……….so the weeds just laughed and took over the yard…
    I got soaked, I got pricked only once or twice and I got some dirt under my fingernails
    I was in heaven! I threw some greens in various old baskets and planters
    and placed them outside where I would see them when I come home
    There……..that’s better……………
    I’ll add some more later…………..
    Anyway, here are a few ideas to help you thru the next month or so….
    1) Buy yourself a nice present or two, without guilt
    2) Eat a cookie or two, without guilt, and sure, sure, try to eat healthy sometimes, too
    3) Don’t invite people to your house, go to theirs, that way you can leave when you want,
    without guilt (and definitely employ a wingman that can read your signals, if need be, and don’t be “polite” and turn down leftovers if something was good)
    4) Buy yourself some new fuzzy pajamas, slippers or blankie (this does not count towards #1 above)
    5) Take a walk outside, breath deep and exhale slowly, repeat
    listen and watch for birds, they never seem to get tired
    and don’t feel guilty because a damn bird can do more than you at the moment
    6) Feed the birds, but don’t worry, they won’t become dependent on you, so don’t let them make you feel guilty if you miss a day…or two…
    7) Get a chia pet and grow it ( actually I have never done it, but they have been selling the damn things for 40+ years, there must be something about it that is worthy……which also reminds me,
    get a clapper too, it is hilarious indoors, hooked up to strings of Christmas lights in a room full a laughing people (and yes, I did that long ago and probably gave those people alcohol)
    8) Get an amaryllis plant and grow it, that is my preference, last year I waited till just after Christmas and bought a couple for 2 bucks each! And yes, I am watering the dead bulb now in hopes that it will do something, I still see green stuff, so maybe…………….
    9) Make sure you set up time for yourself after Christmas so you can shop for all the clearance stuff for next Christmas…. and all the winter stuff will be on sale too……
    might as well get a jump on next year……….
    ………….then try not to forget where you put it once the time comes to use it……..
    10) Drink more hot cocoa…….with marshmallows……there is something about it………………
    hot tea and honey will work, too…
    and eat more pancakes and real maple syrup if you can….for dinner….something about that, too…..
    yes, of course, add bacon…….
    and yes, I love Norman Rockwell and Currier and Ives, hey, I’m 57, I grew up with this stuff…….
    I bought my first clapper at Woolworths, remember that olde 5 and dime store with the breakfast lunch counter? That place had chia pets and everything!
    In conclusion (finally!)
    ……………?…?….I forgot what the question was…………..again
    Hope the holiday season (and relatives) treats you with kindness!
    ……….I’m taaad, I gotta try to get some sleep now……..

    1. Dear Tarzangela……that was a very funny read…thank you.
      I am still tired and it was 5 yrs on April 08th since my last radiation after lumpectomy, chemo and rads. Not sure if depression is tucked in there or if after effects of docetaxol remain with you forever.
      Thanks for the chuckles and I will redouble my efforts to get on the treadmill and out more often .

    2. Tarzangela, Your comments always make me laugh. And your tips are pretty darn good! Hoping the holiday season doesn’t make you too taaad! Thanks for chiming in and for making us laugh.

  6. Helpful post as always, Nancy. I have to admit I struggle with the advice I’m given for managing fatigue (the “5 Ps” as the Occupational Therapist at the hospital said) – because, basically, I don’t want to feel fatigued!!!! (I know – neither does anyone else…)
    I read somewhere that exercise can help to reduce fatigue – but I’m hopeless at doing sedentary exercises at home. I want to go out for a walk – but often I don’t have the energy (doh!)
    Today I watched an interesting TV programme featuring Darcey Bussell (retired ballerina at the Royal Ballet in the UK) where people were talking about how dancing can help certain mental conditions, such as dementia, Parkinsons, anxiety.
    Then someone said that people tend to feel like they have more energy after a dance session, even if they felt tired beforehand. It might be something to do with the music, connected with physical movement. So I’m going to give that a try.
    I’ll have to start off with barre work (fortunately I studied ballet for about 4 years when I was 11) because otherwise I might fall over, thanks to brain mets.
    But who knows – maybe some day I’ll be dancing the part of the Sugar Plum Fairy in the Nutcracker ballet!! 😀

    1. Julia, Exercise is beneficial in so many ways, and even though you might feel like it’s the last thing you want to do, in most cases, doing it anyway will help you feel better. Of course, just saying this doesn’t make doing it easy! And now that winter’s here…it gets even harder. Well, for me anyway. Love your idea of taking up dance. Good for you! Thank you for reading and sharing too.

  7. I noticed that there was a clinical trial looking at the effects of Ritalin on cancer related fatigue. So I am trying this out and it seems to be working! I started with a low dose but it didn’t seem to work so my dr increased to dose and i seem to be having more energy. You might want to visit with your dr about giving it a try.

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