Questions To Ask The Health Care Team
You may want to ask your cancer care team the following questions.
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Do you think my cancer treatment will cause cancer-related fatigue? If so, when?
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If I’m experiencing fatigue, what do you think the reason is?
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Will I need additional tests to find out more about my fatigue?
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What can be done to help me cope with cancer-related fatigue?
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Should I talk with a registered dietitian, counselor, physical therapist, or other health providers about ways to help me manage my cancer-related fatigue?
Refocus Relax And Recover
An average human-being is likely to become stressed and as a result fatigued. Now, a patient with cancer can expect to have their stress levels multiplied. Luckily, there are ways to reduce stress and avoid becoming fatigued.
For example, patients with cancer have found mindful-based stress reduction to be helpful in becoming better aware of their own feelings, thoughts, and emotions. A more relaxing way to refocus is to try massage aromatherapy. Recommend massage aromatherapy to patients experiencing high levels of anxiety, depression and sleep-wake disturbances.
Fatigue Is The Most Common Side Effect Of Cancer Treatment
Cancer treatments such as chemotherapy, radiation therapy, hormone therapy, bone marrow transplantation, and immunotherapy can cause fatigue. Fatigue is also a common symptom of some types of cancer. People with cancer describe fatigue as feeling tired, weak,worn-out, heavy, slow, or that they have no energy or get-up-and-go. Fatigue in people with cancer may be called cancer fatigue, cancer-related fatigue, and cancer treatment-related fatigue.
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Can Sleep Be Improved To Reduce Cancer Fatigue
Sleep is an important part of wellness. Good sleep can improve your mental and physical health. Several factors contribute to how well you sleep, and there are things you can do to improve your sleep, including:
- Doing relaxation exercises, meditation or relaxation yoga before going to sleep.
- Avoiding long afternoon naps.
- Going to bed only when sleepy. Use your bedroom only for sleep and sexual activities.
- Setting a consistent time to lie down and get up.
- Avoiding caffeine and stimulating activities in the evening.
- Establishing a relaxing pre-sleep routine.
Making Choices And Changes
I knew I was going to stay in charge because Im a stubborn person, said the Minnesota-born Peterson. But thank God Im stubborn, because thats why Im here. I dont give up.
Nevertheless, the setbacks arrived. She fractured both wrists in a fall and had surgery to repair the left one in 2014 and the right in 2018. Shes still seeing an orthopedic surgeon for the latter, which hasnt healed well. A perforated stomach ulcer in 2015 required surgical repair and months of therapy at home to regain her strength.
Fluid had built up around her left kidney, so she underwent more surgery to place a stent in her ureter, the tube that connects the kidney to the bladder. The stent was uncomfortable and was eventually removed in late 2017. In the same year, she developed a suspicious mass on her gallbladder, which was subsequently removed. It ended up being benign.
Its not just cancer, Peterson pointed out. Things are never the same. It isnt just one battle. You have to be willing to stick it out and fight.
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How To Recognize Fatigue
You may think you’re simply tired, but if your feelings of listlessness and disinterest go on for weeks, you probably have fatigue. Symptoms of fatigue include:
Several breast cancer treatments can cause fatigue.
Surgery can disrupt your bodys normal rhythm and can often cause fatigue that lasts longer than you may expect. General anesthesia and after-surgery discomfort, pain medication, and restricted activity can also cause fatigue.
Chemotherapy medicines often reduce the number of red blood cells, immune cells, and platelets your bone marrow produces. Chemotherapy medicines also can damage some cells or limit their ability to function. Low blood cell counts can contribute to fatigue. For example, if you have a low red blood cell a condition known as anemia you’ll probably have less energy. If your immune cell count is low, you’re less able to fight off infections. Infections and fever can lead to fatigue. Chemotherapy also may cause early menopause, which changes the balance of hormone in your body and can lead to fatigue.
Hormonal therapy reduces the effect of estrogen in your body, just like going through menopause, which can make you feel tired and weak. Many pre-menopausal women have menopausal side effects while taking hormonal therapy, such as hot flashes, which can disrupt your sleep and lead to fatigue. Hormonal therapies include:
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emotional stress
Treating Low Levels Of Red Blood Cells
Anaemia is when you have a low number of red blood cells in your blood.
Some people with cancer will have anaemia at some point during their illness. Fatigue caused by anaemia can have a big effect on your daily life.
There are several reasons why you may have anaemia. One cause could be the cancer itself, affecting how you make red blood cells. Or from the treatment stopping your body from making red blood cells.
For some people it might be helpful to have a blood transfusion, but not everyone needs this. You usually have regular blood tests to check the levels of red blood cells. This is what your doctor or nurse use to see what would be helpful for you.
Another treatment for anaemia is a drug called erythropoietin or EPO. EPO is a hormone made by your kidneys that encourages the body to make more red blood cells. Studies have shown that EPO can raise red blood cell levels in the body and improve people’s quality of life. EPO can be helpful for some people who cant have a blood transfusion for any reason.
Research shows that light to moderate physical activity every day helps people with cancer. It can:
- make you feel better
- improve your appetite
- help with your mood
It’s important to work at your level when you start off, build up safely and gradually. It’s also important that you do something you enjoy.
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How Can I Conserve Energy When I Have Cancer Fatigue
Plan and organize your work
- Change storage of items to reduce trips or reaching.
- Delegate when needed.
- Combine motions and activities and simplify details.
Schedule rest
- Balance periods of rest and work.
- Rest before you feel tired.
- Frequent, short rests are beneficial.
Pace yourself
- Do not hold your breath.
- Wear comfortable clothes to allow for free and easy breathing.
Identify anything in your environment that may contribute to cancer fatigue
- Avoid extreme temperature.
- Eliminate smoke or noxious fumes.
- Avoid long, hot showers or baths.
Prioritize
- Use your energy on important tasks.
Where Does It Come From
Cancer-related fatigue can be a result of different things related to the cancer disease process itself or as a side-effect of the drugs for cancer treatment.
The National Comprehensive Council Network and the Cancer Council explains fatigue results generally from aneamia that occurs when the cancer reaches the bone marrow. The cancer itself can also produce toxins that impairs normal cell functions . Affected cells may also produce less potassium and calcium important minerals needed for proper muscle function.
Because of the cancer cells parasitic nature, they compete for important nutrients at the expense of the normal cells growth and metabolism. As a result you are left feeling tired and weak.
The medications involved in chemotherapy such as vincristine, vinblastine, and cisplatin, can cause CRF.
Radiation therapy can cause fatigue that adds up over time . It occurs regardless of treatment site and may last 3-4 weeks after treatment stops. Post-treatment, it may even persist for 2-3 months.
Cancer treatments that use natural cell proteins like interferons and interleukins, in high amounts can be toxic to the immune and endocrine system. Thereby leading to persisting fatigue.
Other factors that contribute to cancer-fatigue include: inadequate nutrition, sleep problems, other diseases aside from cancer, no physical activity or exercise, other medication, pain, anxiety and depression.
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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.
Make Sleep A Priority
Although napping wont cure chronic fatigue, short naps can provide temporary relief. But napping too close to bedtime can disrupt your sleep cycle.
See if you can tweak your sleep hygiene to promote better sleep. Put out a virtual do not disturb by letting everyone in the household know that your sleep is a priority.
Think about how your energy level rises and falls throughout the day. Try to schedule the most taxing activities during peak energy times. Put less important tasks aside or ask for help.
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Success Story To Be Shared
The medical community often hesitates to get too excited about individual success stories for fear of encouraging false hope. But Datko allows for the fact that Petersons should be celebrated and shared. If for no other reason than to encourage others to carve out their own journey. And sometimes, well, you never know.
Betsey is now over four and a half years out from the diagnosis of metastatic breast cancer and without any evidence of active cancer, Datko said. We are careful not to say she is cured because she may not be, and only time will tell. But there is a chance she is cured. She has a frail body but a positive mindset that gets her through any hurdle. I admire her fighting spirit.
Peterson admitted she worries less about what her next doctors appointment is going to bring and more about how shes going to get there. Shes grateful for the unwavering support shes had from Scott, her husband of 33 years. She reads more. She started a bible study for women and invites them to her house so she doesnt have to drive anywhere. She no longer beats herself up about taking supplements or if shes eating the latest cancer-fighting miracle food.
And so much of her grace comes from the joy she takes from her time at UCHealth Medical Fitness.
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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Seeing A Healthcare Provider For Fatigue
When your chief complaint is fatigue, cancer isn’t likely to be the first thing on your healthcare provider’s mind. Fatigue is related to many other conditions, and your healthcare provider will want to rule out the most common causes first.
This will be accomplished through a physical and routine blood work. Your healthcare provider will likely order a few different blood tests, especially tests to check on your thyroid function.
During your visit, your healthcare provider may ask several questions relating to your quality of life and what factors may contribute to your fatigue. Possible questions include:
- How many hours do you work? Are you stressed at work?
- Have you had any major life changes, such as marriage, birth, or death?
- How often do you exercise?
- Do you sleep well? How much sleep do you get?
- How is your diet?
- Do you have a family history of thyroid disease?
It is important to remember that fatigue is not exclusive to cancer. If you are experiencing fatigue, it may be related to a less serious condition or have a lifestyle cause.
Ways To Manage Fatigue
Tell your health care team if you feel extremely tired and are not able to do your normal activities or are very tired even after resting or sleeping. Keeping track of your levels of energy throughout the day will help your doctor to assess your fatigue. Write down how fatigue affects your daily activities and what makes the fatigue better or worse.
You may be advised to take these and other steps to feel better:
NCI’s Fatigue PDQ® summary has more information on how fatigue is assessed and treated. View the patient or health professional version.
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How Is Cancer Fatigue Managed Or Treated
The first step in treating fatigue is knowing the problem exists. Many people don’t bother to mention fatigue to their doctors because they believe it is normal. It’s vital that you discuss this and all symptoms or side effects with your healthcare provider. Then, efforts can be directed at determining the cause of the problem and prescribing appropriate treatment. Your particular cancer treatment regimen, with its known side effects, may provide clues for your doctor or health care professional. A simple blood test, for example, can determine if you are anemic.
There is no single medication available to treat fatigue. However, there are medications available that can treat some of the underlying causes.
When youre struggling, you may want to see a palliative care specialist. These experts help people with cancer manage symptoms like pain, nausea and depression.
Your provider or palliative care team may recommend these actions to ease fatigue:
Aerobic Exercise During And Following Treatment
Aerobic exercise utilizes large muscle groups for prolonged periods of time.Examples of aerobic exercises include walking, running, cycling, and swimming.Aerobic exercise is an effective intervention for CRF, sleep disruption, depression, anxiety, cardiopulmonary function and QOL among cancer patients and survivors.,,,,,,,-,-
Aerobic exercise is beneficial when performed by cancer patients who are undergoing treatment. Mock and colleagues reported that home-based walking at a moderate intensity , performed for 10 to 45 minutes per day, 4 to 6 days per week, for one to six months, during chemotherapy and radiation treatment for breast cancer reduced CRF, sleep disruption, depression, and anxiety while improving cardiopulmonary function and QOL.-,ENREF 90 ENREF 90 Another study in female breast cancer patients who were undergoing chemotherapy concurrent with participation in a progressive aerobic exercise intervention showed improvements in anxiety. The exercise intervention began with 3 sessions per week, 15 minutes per session at 60% of VO2peak and progressed to 45-minute sessions at 80% of VO2peak. The patients used a treadmill, cycle ergometer, or elliptical trainer.
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Not Sleeping Well Causes Fatigue
Some people with cancer are not able to get enough sleep. The following problems related to sleep may cause fatigue:
- Waking up during the night.
- Going to sleep at different times every night.
- Sleeping duringthe day and less at night.
- Being inactive during the day.
- The time of day that cancer treatment is given.
Poor sleep affects people in different ways. For example, the time of day that fatigue is worse may be different. Some people with cancer who have trouble sleeping may feel more fatigue in the morning. Others may have severe fatigue in both the morning and the evening. People with cancer who are inactive during the day, have restless sleep, or who have obesity may have higher levels of fatigue.
Even in people with cancer who have poor sleep, fixing sleep problems does not always improve fatigue. A lack of sleep may not be the cause of the fatigue. See the PDQ summary on Sleep Disorders for more information.
What Is Cancer Fatigue
Cancer-related fatigue, also called cancer fatigue, refers to the chronic and excessive feelings of tiredness and weakness that affect people with cancer. The condition arises as a symptom of the disease and a side-effect of common cancer treatment methods, such as chemotherapy and radiation therapy.
To date, about 80% to 100% of cancer patients are said to experience cancer-related fatigue that affects their overall quality of life.
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Tips For Overcoming Cancer Fatigue
Cancer and cancer treatments take a heavy toll on the body. Patients often report feeling tired and fatigued.
If youre feeling like less than yourself while fighting cancer, youre not alone. This is a common symptom of most forms of cancer, but you can overcome the tiredness. Here are five ways to overcome fatigue and become yourself again.
How Long Can Fatigue Last
Cancer related fatigue is different from tiredness which is usually short term and you feel better after you stop, sleep or rest. Cancer fatigue doesnt usually go away with sleep or rest. It can be severe and last a long time.
Fatigue can last for different amounts of time depending on whats causing it. Most people start to feel better after treatment finishes. But it can take several weeks or months before you feel like your old self. In some people it may take a lot longer.
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