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Managing and treating cancer fatigue

There are ways to manage fatigue and the symptoms you might have. It's important to tell your doctor or nurse if you think you might have it.

Treating the causes of cancer related fatigue can sometimes help to reduce tiredness. Help is also available for the symptoms of fatigue. There are some suggestions below.

It might take some trial and error to learn how to manage fatigue and to know what works for you.

The NHS website mention's an app called Untire: Beating cancer fatigue. It has handy tips and advice, online support, it records your energy levels and you can see your progress. 

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 can’t 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
  • give you more energy
  • 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. 

To start with you could go for a short walk each day. Then when you're ready, try to increase the distance you walk. You can walk with family and friends to support you along the way.

A pedometer is a great way of keeping track of how active you are. Nowadays you can use your smart phone or smart watch to do this. You may have a built in app or you could download a free app. These can count every step you take. Because it keeps track of your activity, you can see how your exercise is building up each day.

If you're having treatment or have advanced cancer you should try to keep as active as you can. Talk to your doctor, nurse or a physiotherapist about where to start so that you can find a realistic goal and so you don't overdo things. They can help you plan an exercise programme that suits your needs.

Remember to:
  • not overdo it
  • work at your level of comfort and pace
  • build up gradually - it's not a race
  • drink plenty of water whenever you exercise to prevent dehydration
  • get advice from your doctor before starting any heavy exercise programme

Resting is important to help you cope with fatigue.

Plan your day so you can rest a few times throughout the day. Try to stick to your plan and a routine if you're able to. Try not to lay in bed or stay in your pyjama’s if you have no plans to go out. Make the effort to get out of bed, have a wash, get dressed and go for a short walk if you can.

It’s important not to overdo it even though you think you can. You'll be more tired later on and less able to cope.

You don't have to sleep during these rest times. Just sitting or lying down to rest will help. If you do sleep, keep it short so it doesn’t affect your night time sleep.

If you have things to do in the day make a list. Then put them in order of importance. Here are some tips to help manage your to do list:

  • does anything on the list need a lot of energy?
  • could you do this another way so you can save energy? for example, you can try online shopping instead of going to the shops
  • do you have to do everything today or could you spread it out over the week?
  • pace yourself and don’t do it all at once
  • ask for help from family and friends

Just about everyone needs support from someone else when they have cancer. You can get support from family, friends, doctors or nurses.

You can also get support from other people who've been through a similar thing. Sharing your feelings with someone in a similar situation can make you feel less anxious. You can often get tips on how to cope better from talking about your situation. Talk to your specialist nurse about support groups available to you in your area. Or you can look at cancer charity websites. 

Talking to other people in a support group can also show you that you are not alone. It can confirm that fatigue is something many people with cancer have. 

You could also try having some counselling. It can help to open up to someone who can listen without judgement. There are specialist therapists and counsellors to help people with cancer.

Sleepless nights can make you feel tired, cranky and a bit dazed. It might help to change a few things about when and where you sleep if you often have trouble sleeping at night.

Sometimes getting too much sleep is not helpful either. To make sure you sleep as well as possible try to:

  • go to bed and get up at the same time each day
  • make sure the room you sleep in is comfortable, calm, quiet and not too hot or too cold
  • spend time relaxing before you go to bed, for example have a warm bath, read or listen to music
  • stop caffeine (coffee, tea, chocolate and cola like drinks) and alcohol 6 hours before bed
  • limit daytime naps to 20 to 30 minutes or don't have them at all so they don’t stop you sleeping at night
  • have a light snack before you go to bed to stop hunger waking you up

When you really can't sleep, get up, read or listen to music until you feel sleepy. Or try having a warm milky drink. Then go back to bed and try again. 

Let your doctor or nurse know if you’re having trouble sleeping. It might be a good idea to keep a diary of your sleep pattern if it’s going on for some time. This allows your doctor or nurse to build up a picture.

Eating enough to keep up your energy levels can be hard. This can be due to side effects from your treatment making you feel unwell. Some of the symptoms that could prevent you from eating enough are feeling or being sick, constipation or diarrhoea.

It is important to try and eat a healthy balanced diet when you can, as your diet is very important in giving you energy.

You can do lots of things in your daily life that will help to save your energy. Taking short cuts on some things or getting help from other people can help you feel less tired.

You could try some of the following:

  • ask other people for help with tasks like shopping, housework or collecting children from school
  • plan ahead where possible and allow plenty of time for travelling so you're not rushing
  • put chairs around the house so that you can easily stop and rest if you need to
  • have hand rails fitted to help you balance (your nurse, GP or hospital can help to arrange this for you)
  • wear loose fitting clothes, and things with few buttons to do up
  • sit down to do household tasks or daily activities like washing, getting dressed or chopping vegetables
  • have plenty of nutritious snacks and drinks in, so you can have something quickly when you feel like eating
  • play games that you can do sitting or lying down if you have children. Some examples include reading, puzzles, board games or drawing
  • have ready meals available for those days you don’t want to cook
  • buy ready prepared vegetables or pre-grated cheese

Don't forget to do things that you enjoy. This will take your mind off your cancer and make you feel more relaxed.

Anti depressants can help to treat depression which can be a symptom of fatigue. Some people might benefit from them and others may not.

Doctors are looking at other drug treatments into fatigue.

A fatigue diary helps you keep a record of how you're feeling, how your energy levels change and can show patterns to your fatigue. This can help you plan your day. It can also highlight which activities make you feel better or worse.

Recent research shows that acupuncture can help with cancer related fatigue.

Acupuncture is a type of Chinese medicine. It is used for many different things but has shown to work on relieving symptoms of fatigue. Acupuncture uses very thin needles inserted into the skin at particular points along your body.

Last reviewed: 
03 Jan 2020
  • Management of anaemia and iron deficiency in patients with cancer: ESMO Clinical Practice Guidelines
    M Aapro and others
    Annals of Oncology, 2018. Volume 29, Supplement 4, Pages iv 96 – iv 110

  • Erythropoietin for cancer-associated  malignant anemia: A Meta-analysis
    F Zhao and others
    Molecular and Clinical Oncology, 2017. Volume 6, Issue 6, Pages 925 - 930

  • Tiredness/Fatigue in adults
    National Institute for Health and Care Excellence (NICE), 2015

  • Cancer-related fatigue: Mechanisms, risk factors, and treatment
    J E Bower
    Nature Reviews Clinical Oncology, 2014. Volume 11, Issue 10, Pages 597 - 609

  • Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue A Meta-analysis
    K M Mustian and others
    JAMA Oncology, 2017. Volume 3, Number 7, Pages 961 – 968

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

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