Communicating With Your Healthcare Provider About Fatigue
Many people underestimate fatigue and fail to discuss it with their practitioner. There can be underlying medical reasons for fatigue, such as anemia, that may need to be addressed. Unfortunately, there is no medication, prescription or OTC, that treats fatigue, but your healthcare provider may be able to determine what is contributing to fatigue and offer solutions specific to your situation.
What Is The Right Kind Of Exercise For Cancer Fatigue
It’s important for you to exercise your whole body every day, or at least every other day. A good exercise plan starts slowly, allowing your body time to adjust. Any kind of exercise is acceptable, including walking, riding a stationary bike, yoga or swimming , and strength training. Whatever kind of exercise you do should be at a moderate intensity so you can say to yourself “I am working somewhat hard.” Avoid exercise that makes you feel sore, stiff or exhausted.
Fatigue Isoften Treated By Relieving Relatedconditions
Treatment of fatigue depends on the symptoms and whether the cause of fatigue is known. When the cause of fatigue is not known, treatment is usually given to relieve symptoms and teach you ways to cope with fatigue.
Treatment of anemia
Anemia causes fatigue, so treating anemia when the cause of anemia is known, helps decrease fatigue. When the cause is not known, treatment for anemia is supportive care and may include the following:
- Change in diet
Eat more foods rich in iron and vitamins combined with other treatments for anemia.
- Transfusions of red blood cells
Transfusions work well to treat anemia. Even though problems from a transfusion are low, there are risks of an allergic reaction, infection, graft-versus-host disease, immune system changes, and too much iron in the blood.
- Medicine
Drugs called erythropoiesis-stimulating agents cause the bone marrow to make more red blood cells and may be used to treat anemia-related fatigue in terminal patients receiving chemotherapy.Since ESAs increase the risk of blood clots, few patients are offered this treatment. The Food and Drug Administration has not approved these drugs for the treatment of fatigue. Discuss the risks and benefits of these drugs with your doctor.
Treatment of pain and depression
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Heres what you can expect when it comes to experiencing chemotherapy fatigue, and how to combat the exhaustion.
Rule Out Health Problems
Fatigue is a common symptom of many illnesses, including diabetes, heart disease, arthritis, anemia, thyroid disease, and sleep apnea. Talk to your doctor if you feel unusually tired.
Many medications can contribute to fatigue. These include some blood pressure medicines, antihistamines, diuretics, and other drugs. If you begin to experience fatigue after starting a new medication, tell your doctor.
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Cancer Fatigue Is Different From Fatigue That Healthy People Feel
When a healthy person is tired from day-to-day activities, their fatigue can be relieved with sleep and rest. Cancer fatigue is different. People with cancer get tired after less activity than people who do not have cancer. Also, cancer fatigue is not completely relieved by sleep and rest, interferes with daily activities, and may last for a long time. Fatigue usually decreases after cancer treatment ends, but some people may still feel fatigue for months or years.
Causes Of Cancer Fatigue
- Fatigue in people with cancer may have more than one cause.
- It is not clear how cancer treatments cause fatigue.
- Fatigue related to surgery
- Fatigue caused by radiation therapy
- Fatigue caused by hormone therapy
- Fatigue caused by immunotherapy
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A Physical Exam And Health History Will Be Taken To Look For Causes Of Fatigue That Can Be Treated
A physical exam will be done. This is an exam of the body to check general signs of health or anything that seems unusual. The doctor will check for problems such as trouble breathing or loss of muscle strength. Your walking, posture, and joint movements will be checked.
Blood tests to check for anemia will be done. The most common blood tests to check if the number of red blood cells is normal are:
- Complete blood count with differential: A procedure in which a sample of blood is taken and checked for the following:
- The number of red blood cells and platelets.
- The number and type of white blood cells.
- The amount of hemoglobin in the red blood cells.
- The portion of the blood sample made up of red blood cells.
The healthcare team will take a health history by asking about the status of your cancer and cancer treatments. It is important that you and your family tell the healthcare team if fatigue is a problem. You will be asked to describe the fatigue.
Other questions that you will be asked about include:
When You Are Being Treated For Cancer With Chemotherapy Or Radiotherapy Fatigue Can Become A Life
Fatigue may be experienced as tiredness, weakness, lack of energy, or sheer exhaustion. Learning to recognize and respect your limits often means making adjustments in exercise, work, sleep, eating, and social schedules. Getting extra rest is important and so is eating plenty of nutritious food, because inadequate intake of calories and other nutrients can compound fatigue. Adjusting eating schedules and food choices can help.
General Suggestions
Eat as much as possible at your best time of day. If fatigue worsens later in the day, eat a larger breakfast or lunch.
You may feel more like eating after you have napped or rested.
Eat many small meals and snacks throughout the day.
Avoid skipping meals and snacks. Choose liquid nutritional supplements to replace a meal or snack if easy-to-prepare food is unavailable.
At times when you have more energy, prepare foods in quantity. Refrigerate or freeze them for eating later.
Keep leftovers on single-serving containers so they can be easily warmed in the microwave.
Use frozen or canned convenience foods that require little preparation.
Purchase supermarket deli foods and carryout food from restaurants.
Accept the offers of family and friends to help out.
Check on availability of “Meals on Wheels” in your community.
Check on the availability of a “Take Out Taxi” service in your area. These services will pick up foods from participating restaurants and deliver them to your door.
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Fatigue And Memory Problems May Be Related
During and after cancer treatment, you may find that you cannot pay attention for very long and have a hard time trying to think, remember, and understand. This is called attention fatigue. Sleephelps to relieve attention fatigue, but sleep may not be enough when the fatigue is related to cancer. Take part in restful activities and spend time outdoors to help relieve attention fatigue.
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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Answers From The Community
-
Ejourneys
Exercise does it for me. I don’t exercise on infusion days, but I resume the day after at decreased intensity and slowly build my way back up. Even if I have to take naps, I still exercise that day. It cuts my fatigue and helps boost my immunity the endorphins released are great for my mood. I also drink plenty of water to get the toxins out of my system and I eat healthy foods.
I also listen to my body when it needs to rest. If I need to take a nap, I don’t fight it.
How Is Cancer Fatigue Diagnosed
Your healthcare provider will assess your symptoms. You may be asked to complete a questionnaire or rate your fatigue level. Your provider may ask you to keep a journal to track your level of fatigue and factors that might contribute to fatigue.
Blood tests can check for anemia, signs of infection or other problems that cause fatigue.
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Lifestyle Suggestions For Fighting Fatigue
Suggestions include:
- Dont smoke cigarette smoke contains many harmful substances. There are many reasons why smokers typically have lower energy levels than non-smokers for example, for the body to make energy it needs to combine glucose with oxygen, but the carbon monoxide in cigarette smoke reduces the amount of oxygen available in the blood.
- Increase physical activity physical activity boosts energy levels, while a sedentary lifestyle is a known cause of fatigue. Physical activity has many good effects on the body and mind. A good bout of exercise also helps you sleep better at night. Seek advice and encouragement regarding the steps you can take toward a more active lifestyle and talk to your doctor if you havent exercised in a long time, are obese, are aged over 40 years or have a chronic medical condition.
- Move more, sit less reduce sedentary behaviours such as watching television and using computers, and break up long bouts of sitting.
- Seek treatment for substance abuse excessive alcohol consumption or recreational drug use contribute to fatigue, and are unhealthy and potentially dangerous.
- Workplace issues demanding jobs, conflicts at work and burnout are common causes of fatigue. Take steps to address your work problems. A good place to start is to talk with your human resources officer.
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Fatigue Can Linger And Get Worse
Unfortunately, fatigue isnt a side effect that occurs on the first go-round of chemotherapy and then fades away in subsequent cycles. gets a little bit worse as you go from one cycle to the next, says Dr. Reese. Youll feel a little more tired the second time around than you did the first, and it will last a day longer. The same holds true for any cycles that may follow.
While this persistent tiredness can leave you feeling discouraged, its important to think about why youre likely feeling fatigued to begin with. Chemotherapys role in ovarian cancer treatment is to attack quickly dividing cells in the body. In an ideal scenario, only the cancer cells would be affected, but its impossible for the medication to pinpoint and destroy only diseased cells. That means healthy cells become innocent bystanders of chemotherapy, as well.
Its when these healthy cells start to die that fatigue can set in. By keeping in mind how important this treatment is to getting you well, you can mentally prepare and handle fatigue as you visualize the bigger picture: long-lasting health and a cancer-free future.
Is It Fatigue Or Depression
Some signs of fatigue or weakness often look a lot like those of depression, and its easy to confuse the two. Depression involves an inability to feel pleasure people who are depressed feel sad or unworthy. They may give up hope. You can have fatigue and not be depressed, although some people have both fatigue and depression.
Sometimes it may be hard to find a label for what youre feeling. Your doctor might want you to see a mental health professional to get another opinion on whether depression is part of the problem. If it is, treatment can help.
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Exercise Has A Positive Effect On Fatigue During And After Cancer Treatment
Exercise may help people with cancer feel better and have more energy during and after treatment. The effect of exercise on fatigue in people with cancer is being studied. One study reported that breast cancersurvivors who took part in enjoyable physical activity had less fatigue and pain and were better able to take part in daily activities. In clinical trials, some people with cancer reported the following benefits from exercise:
- More physical energy.
- More enjoyment with life.
- A greater sense of well-being.
Moderate activity for 3 to 5 hours a week may help cancer fatigue. You are more likely to follow an exercise plan if you choose a type of exercise that you enjoy. Your healthcare team can help you plan the best time and place for exercise and how often to exercise. You may need to start with light activity for short periods of time and build up to more exercise little by little. Studies have shown that exercise can be safely done during and after cancer treatment.
Mind and body exercises such as qigong, tai chi, and yoga may help relieve fatigue. These exercises combine activities like movement, stretching, balance, and controlled breathing with spiritual activity such as meditation.
Cognitive behavior therapy
- Stress from coping with cancer.
- Fear that the cancer may come back.
- Feeling hopeless about fatigue.
- Lack of social support.
- A pattern of sleep and activity that changes from day to day.
Other ways to manage fatigue
Exercises To Help You Feel Stronger
These exercises help you build muscle and feel less fatigued. Here are some examples of strengthening exercises you can do. Your doctor, PT, or OT can give you more recommendations.
Ankle circles
Figure 1. Ankle circles
Ankle pumps
Figure 3. Marching in place
Sitting kicks
Figure 5. Arm raises
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