Fatigue is the feeling of being tired physically, mentally and emotionally. It is a very common feeling with cancer and cancer treatment, including radiation therapy. Managing fatigue is an important part of care for both patients and caregivers, as fatigue robs your mind and body of energy to do the things you normally do or want to do. It can last a long time and can get in the way of your usual activities.
Fatigue is different from the tiredness of everyday life, which is usually short-term and relieved by daily rest. Cancer-related fatigue is generally worse, more distressing and may not get better with rest.
What Fatigue Feels Like
Cancer-related fatigue may:
- Differ from one day to the next with regard to severity and how much it bothers you
- Be overwhelming and make it hard to feel good
- Make it hard to spend time with friends and family
- Make you less able to keep up with normal activities, including work obligations
- Make it hard to follow a treatment plan
- Last different lengths of time, making it hard to guess how long it will continue
Only you know if you are experiencing cancer-related fatigue and how bad it is. No lab tests or X-rays can diagnose or describe your level of fatigue. The best measure of fatigue comes from your own understanding. Reporting changing levels of fatigue to your doctor or nurse can be a challenge, but it is important.
You can help measure and describe your lack of energy by:
- Rating fatigue as none, mild, moderate or severe
- Using a scale of 0 to 10, where 0 means no fatigue and 10 is the worst fatigue you could imagine
Most people begin to feel tired after a few weeks of radiation therapy. Fatigue usually worsens as treatment continues. Stress due to your illness and daily trips for treatment may increase fatigue.
Coping With Fatigue
The cause of cancer-related fatigue is not always clear. But if the cause is known, treatment will be directed at the cause. For example, if anemia (low red blood cell counts) is thought to cause fatigue, the anemia can be treated. For some patients, treatment may include correcting fluid and mineral imbalances in the blood. Increasing physical activity, treating sleep problems and eating well all seem to improve fatigue. Education and counseling also are important parts of treatment; they can help people learn how to save energy, reduce stress and use distraction to focus on things other than exhaustion.
The good news: Fatigue usually goes away over time after your treatment is finished. Until then, here are some suggestions to help:
- Make a list of the things you need to do and rank them in importance. Try to do the important ones first, when you have the most energy.
- Ask for help from loved ones and friends.
- Place things that you use often within easy reach.
- Try to reduce stress. Things like deep breathing, visual imagery, meditation, prayer, talking with others, reading, listening to music, painting or any other activity that gives you pleasure may help you feel less stressed.
- Keep a journal of how you feel each day. Take it with you when you see your doctor and share any insights or patterns.
- Balance rest and activities. Try not to spend too much time in bed, which can make you feel weak. Schedule activities so that you have time for plenty of rest. Most people find that a few short rest periods are better than one long one.
- Talk to your doctor about what physical activities may be best for you before you start any exercise program.
- Unless you are given other instructions, eat a healthy diet that includes protein (meat, milk, eggs and beans) and a lot of water each day.
When to Get Help
Talk with your doctor or nurse about your fatigue if:
- Your fatigue does not get better, keeps coming back or gets worse
- You are more tired than usual during or after an activity
- You are feeling tired and it is not related to something you’ve done
- You become confused or cannot focus your thoughts
- You cannot get out of bed for more than 24 hours
- Your fatigue disrupts your social life or daily routine
If you need to take time off from work, talk to your employer. You may have rights that will help you keep your job. Call your doctor or nurse to ask more questions about fatigue, as well as to get information on the Americans with Disabilities Act and the Family and Medical Leave Act. Some of these laws can help protect people with cancer.