What Should I Do If I Have Fatigue
- Exercise: Try to do some exercise ask your doctor for advice about the best exercise for you.
- Rest: Build rest periods into your day and save your energy for doing the things that are most important to you. If you are going somewhere special, have a rest before you go out.
- Get help: Ask for help at work or at home, especially with cooking, housework or childcare.
- Eat well: Try to eat a well-balanced diet. Eat little and often if your appetite is poor. You could read our booklet Diet and Cancer for tips to help you eat well.
- Avoid stress: Talk to friends and family about any worries you have and take time to enjoy yourself. Counselling may help if youre finding it hard to cope.
- Relaxation therapies may help, such as visualisation, yoga and meditation. Your local cancer support centre may have sessions where you can learn these techniques. Free guided meditation videos are available online.
- Sleep: If you are not sleeping well, try relaxation techniques and avoid stimulants like caffeine and alcohol before bedtime.
- Complementary therapies: Try complementary therapies like meditation, acupuncture or massage. Check with your doctor or nurse first some therapies might not be suitable for people with certain cancers or having certain treatments.
- Keep a diary of your energy levels: Use the diary pages below to take note of the times when you feel most and least tired. This can help you to plan your activities. Your doctor may also find your fatigue diary useful.
Nutrition Needs Change And Cause Or Increase Fatigue
For many patients, the effects of cancer and cancer treatments make it hard to eat well. The body’s energy comes from food. Fatigue may occur if the body does not take in enough food to give the body the energy it needs. In people with cancer, three major factors may affect nutrition:
- A change in the way the body uses food. A patient may eat the same amount as before having cancer, but the body may not be able to absorb and use all the nutrients from the food. This is caused by the cancer or its treatment.
- An increase in the amount of energy needed by the body because of a growing tumor, infection, fever, or shortness of breath.
- A decrease in the amount of food eaten because of low appetite, nausea, vomiting, diarrhea, or a blocked bowel.
What Caregivers Can Do
- Help schedule friends and family members to prepare meals, clean the house, do yard work, or run errands for the patient. You can use websites that help organize these things, or ask a family member to look into this for you.
- Try not to push the patient to do more than they are able to.
- Help the patient set up a routine for activities during the day.
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Sex And Fertility Issues
Many people find that they lose interest in sex during chemotherapy. This is usually temporary, and your sex drive should gradually return after your treatment has finished.
Some chemotherapy medicines can also reduce fertility in men and women. This is often temporary, but it can be permanent in some cases.
Before starting treatment, ask your care team whether your fertility may be affected. If youre at risk of infertility, they will discuss your options with you.
You should avoid becoming pregnant or fathering a child during your treatment, as chemotherapy medicines could harm the baby. Use a barrier method of contraception, such as a condom.
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Other Possible Causes Of Fatigue During Cancer Treatment
Vitamin D deficiency is common in the general population. Correcting this deficiency in otherwise healthy people has been shown to improve self-reported fatigue. If youre fatigued due to vitamin D deficiency going into treatment, cancer therapy may be less successful and result in more side effects like peripheral neuropathy .
For example, one study of breast cancer patients being treated with paclitaxel showed that pre-treating vitamin D deficiency reduced the incidence of peripheral neuropathy and also led to fewer treatment disruptions and better treatment outcomes.
Consider getting your vitamin D levels checked periodically. In my practice, I often check it at least twice a year to get a better understanding of the patient’s vitamin D rhythms from summer to winter. I recommend levels of approximately 50-80 nanograms per milliliter .
When you check your levels is important, though. Levels tend to be higher during the summer, when people are spending more time in sunlight, and lowest at the end of winter. So, if you check it in the middle of the summer and your level is 30, thats low for the targeted endpoint of 50-80 ng/ml. But if its 30 at the end of winter, that means it likely was in the therapeutic range during winter, and your levels may be sufficient.
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About Radiation Therapy To The Brain
Radiation therapy uses high-energy rays to treat cancer. It works by damaging the cancer cells and making it hard for them to reproduce. Your body then is naturally able to get rid of these damaged cancer cells. Radiation therapy also affects normal cells. However, your normal cells are able to repair themselves in a way that cancer cells cant.
Radiation can be given to treat primary tumors in your brain or tumors that have spread to your brain from another part of your body . Your doctor will decide whether youll receive partial or whole brain radiation. Youll have either external beam radiation therapy or stereotactic radiosurgery depending on your treatment plan.
During external beam radiation, a treatment machine will aim beams of radiation directly to the tumor. The beam passes through your body and destroys cancer cells in its path. You wont see or feel the radiation.
Stereotactic radiosurgery can be used in some tumors and is even more precise. It targets a small area in your brain with high doses of radiation and delivers lower doses of radiation to the normal tissue around it. Youre able to receive higher doses to the tumor at each treatment session, which shortens the overall course of treatment.
Radiation therapy takes time to work. It takes days or weeks of treatment before cancer cells start to die, and they keep dying for weeks or months after radiation therapy.
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What Can You Do To Lower Your Risk Of Long
Until we know more about long-term survivorship issues following chemotherapy for adults, there are a few things you can do:
- Ask your oncologist about any late effects that you may expect from the particular chemotherapy drugs you were given. Are there any screening tests that she would recommend?
- Keep a record of your chemotherapy regimen with you in case you see a healthcare provider who is unfamiliar with your medical history.
- If you smoke, quit.
- Make regular appointments with your dentist and eye doctor.
- Engage in regular physical activity.
- Limit your intake of alcohol.
- Let your healthcare provider know if you experience any new symptoms or worsening of current symptoms you have.
For childhood, adolescent, and young adult cancer survivors, long-term follow-up guidelines have been developed to address not only the long-term side effects discussed but other survivorship issues.
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Should I Change The Way I Eat To Combat Cancer Fatigue
Cancer fatigue may be worse if you’re not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy. The following strategies can help you improve your nutritional intake.
- Basic calorie needs. A person with cancer whose weight has been stable needs about 15 calories per pound of weight each day. For example, a person who weighs 150 pounds needs about 2,250 calories per day to maintain weight. You should add 500 calories per day if you have lost weight.
- Protein rebuilds and repairs damaged body tissue. You need about 0.5-0.6 grams of protein per pound of body weight to rebuild and repair body tissue. For example, a 150-pound person needs 75 to 90 grams of protein per day. The best sources of protein include foods from the dairy group and meats .
- Fluid needs. Unless your healthcare provider tells you otherwise, you should aim for about 64 ounces per day to prevent dehydration. Fluids include juice, milk, broth, milkshakes, Jello® and other beverages. Of course, water is fine, too. Its important to note that beverages containing caffeine do NOT count. And if you are losing fluid from excessive vomiting or diarrhea, you will need extra fluids.
- Supplemental vitamins. Talk with your healthcare provider to find out if vitamin supplements are a good idea for you. Vitamin supplements don’t provide calories, which are essential for energy production. So vitamins cannot substitute for adequate food intake.
Can Stress Management Help With Cancer Fatigue
Managing stress can play an important role in combating fatigue. Here are some ways you can manage stress:
- Adjust your expectations. For example, if you have a list of 10 things you want to accomplish today, pare it down to two and leave the rest for other days. A sense of accomplishment goes a long way to reducing stress.
- Help others to understand and support you. Family and friends can be helpful if they can “put themselves in your shoes” and understand what cancer fatigue means for you. Cancer support groups can be a source of support as well. Other people with cancer truly understand what you are going through.
- Relaxation techniques including guided meditation, deep breathing or visualization can help reduce stress and minimize cancer fatigue.
- Divert your attention. Activities that divert your attention away from fatigue can also be helpful. Activities that require little physical energy but demand attention include knitting, reading or listening to music.
If your stress feels overwhelming, talk to your healthcare provider. They are there to help.
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Questions To Ask The Health Care Team
What physical side effects are likely based on my specific radiation therapy treatment plan? When will they likely begin?
How can these side effects be prevented or managed?
How can I take care of the affected skin during my treatment period?
Who should I tell when a side effect appears or gets worse?
Are there specific side effects I should tell the doctor about right away?
Who can I talk with if Im feeling anxious or upset about having this treatment?
If Im having side effects that affect my nutrition, can you recommend an oncology dietitian?
What are other ways I can take care of myself during the treatment period?
Are there any restrictions on exercising or other physical activity during this treatment?
Could this treatment affect my sex life? If so, how and for how long?
Could this treatment affect my ability to become pregnant or have a child? If so, should I talk with a fertility specialist before cancer treatment begins?
What are the potential long-term effects of this type of radiation therapy?
If Im worried about managing the financial costs of cancer care, who can help me?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
After radiation therapy is completed, what will my follow-up care plan be?
Why is follow-up care important for managing side effects of treatment?
What To Look For
- You feel tired and it doesnt get better with rest or sleep, it keeps coming back, or it becomes severe.
- Youre more tired than usual during or after an activity.
- Youre feeling tired and its not related to an activity.
- Youre too tired to do the things you normally do.
- Your arms and legs feel heavy and hard to move.
- You have no energy.
- You spend more time in bed and/or sleep more. Or, you may have trouble sleeping.
- You stay in bed for more than 24 hours.
- You become confused or cant concentrate or focus your thoughts.
- Your tiredness disrupts your work, social life, or daily routine.
It may be hard for you to talk about it, but tell your cancer care team about your fatigue. Tell them how its affecting your life. Someone on your team should be able to help you if they know youre having this problem. Managing fatigue is part of good cancer care. Work with your cancer care team to find and treat the causes of your fatigue.
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Dietary Supplements Are Being Studied For Cancer Fatigue
American ginseng in the form of capsules of ground ginger root may be used to treat fatigue. In a clinical trial, people with fatigue who were being treated for cancer or who had finished cancer treatment received either ginseng or a placebo. The group receiving ginseng had less fatigue than the placebo group.
Other dietary supplements, such as coenzyme Q10 and L-carnitine, are also being studied in clinical trials. No positive results have been published. See the PDQ summary on Coenzyme Q10 for more information.
Nausea Vomiting And Taste Changes
You may experience nausea and vomiting after your last chemotherapy treatment. It should go away in 2 to 3 weeks.
Your appetite may continue to be affected due to taste changes you may have experienced during your treatment. Your taste should go back to normal 1 to 2 months after chemotherapy. In the meantime, there are things you can do to help with these changes. Talk with your nurse if youd like more information.
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Mechanisms For Intervention Effects
The literature reviewed above suggests that a variety of different intervention approaches may be useful for cancer-related fatigue, including physical activity, psycho-education, cognitive-behavioral, and mind-body approaches. These interventions have different targets and may work through different mechanism, including cognitive, behavioral, and biological mechanisms. For example, cognitive approaches to treating cancer-related fatigue specifically target maladaptive thoughts about fatigue, including catastrophizing138. Given that catastrophizing predicts more severe and persistent fatigue symptoms in cancer patients19, reducing the use of this coping mechanism may be one of the âactive ingredientsâ that promotes reductions in fatigue. Even more physical approaches may work by changing thoughts and beliefs about fatigue for example, patients felt more confident about their ability to manage fatigue after learning certain yoga postures148, which might lead to reductions in fatigue symptoms.
How Long Does Fatigue Or Weakness Last
Fatigue that is due to cancer and its treatment can last for weeks, months, or years. It often continues after treatment ends.
- For people who have surgery for cancer with no other treatment, fatigue often decreases or goes away over time as they recover from surgery.
- For people getting chemotherapy, targeted therapy, or immunotherapy in cycles, fatigue often gets worse at first and may get better until the next treatment, when the pattern starts again.
- For those getting radiation therapy, fatigue usually gets worse as the treatment goes on and often lessens within a few months after treatment is complete.
- Differ from one day to the next in how bad it is and how much it bothers you
- Be overwhelming and make it hard for you to feel well
- Make it hard for you to be with your friends and family
- Make it hard for you to do things you normally do, including going to work
- Make it harder for you to follow your cancer treatment plan.
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What Are The Complications Of Cancer Fatigue
Persistent fatigue can interfere with your ability to participate in lifes activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working.
As many as 1 in 4 people with cancer develop depression. Sometimes, its hard to determine if fatigue leads to depression or vice versa.
Your Healthcare Team Will Continue To Look For Patterns Of Fatigue
A fatigue assessment is repeated to see if there is a pattern for when fatigue starts or becomes worse. The same method of measuring fatigue is used at each assessment. This helps show changes in fatigue over time. The healthcare team will check for other causes of fatigue that can be treated. See the Causes of Cancer Fatigue section.
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Why You’re So Tired After Radiation Therapy
Brandi Jones MSN-Ed, RN-BC is a board-certified registered nurse who owns Brandi Jones LLC, where she writes health and wellness blogs, articles, and education. She lives with her husband and springer spaniel and enjoys camping and tapping into her creativity in her downtime.
When you undergo radiation therapy to treat cancer, your healthcare provider may provide you with a list of possible side effects of treatment. Things like nausea, diarrhea, and hair loss usually catch a person’s attention first because they seem to be the worst.
However, fatigue is one of the most common side effects. A lack of energy and excessive tiredness is common for cancer patients no matter their therapy, but those undergoing radiation therapy experience fatigue more frequently. It also worsens as treatment continues.
This article reviews symptoms of fatigue, why radiation causes it, tips to manage and cope with fatigue, and when to call your healthcare provider