There are lots of ways to manage fatigue and the symptoms you might have. It is important to tell your doctor if you think you may have fatigue.
Treating the symptoms of fatigue
Treating the causes of cancer 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 know what works for you. But the first step is to tell your doctors and nurses about your fatigue. More than half of cancer patients with fatigue never tell their doctor about it. But if you tell your doctor or nurse, they can find ways of helping you.
Most people with cancer will have anaemia at some point during their illness. Although it's not usually life threatening fatigue caused by anaemia can have a big effect on your daily life.
You might need a blood transfusion to bring your red cell count up again and make you feel more energetic. There are different types of anaemia and you may have anaemia for a number of reasons.
In some situations it might not be helpful to have a blood transfusion. Your doctor or specialist nurse can assess you to see if it 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.
A number of studies have shown that EPO can raise haemoglobin levels in the body and improve people's quality of life. But some research has found that EPO may also increase the chance of some types of cancer coming back after treatment.
The benefits of EPO might outweigh the risks for some people but it should be prescribed carefully.
You could feel so tired that doing any exercise seems ridiculous. But sometimes the less you do, the less you feel like doing. We know that light to moderate exercise every day helps people with cancer to feel better and can give them more energy. There is now a great deal of research which shows that exercise can help reduce cancer related fatigue.
To start with this could be just a short walk each day. Try and increase the distance you go gradually. You can walk with a friend to support you along the way.
A pedometer is a great way of keeping track of how active you are. Pedometers are about the size of a matchbox. They clip on to your waistband or belt or around your wrist or in your pocket. The pedometer counts every step you take so you can easily keep track of how your exercise is building up each day.
You can buy a pedometer from a sports shop. As a guide health experts advise that a healthy adult should walk about 10,000 steps a day. Obviously if you are having treatment or have advanced cancer that might be too much for you. Talk to your doctor or a physiotherapist about where to start so that you can find a realistic goal.
Try doing your exercise at different times in the day to find out when suits you best. Some people find the early morning a good time. Doing a bit of exercise every day will make you feel less tired and your appetite is likely to improve too.
Overall you might be more able to cope with things and be happier in yourself. But don't overdo it. You are doing too much if you are really aching the next day. Drink plenty of water whenever you exercise to prevent dehydration. And remember to get advice from your doctor before starting any heavy exercise programme.
Exercise can also help people in the advanced stages of cancer. You might not be able to go for a long walk but even gentle exercises in bed or standing up can help. Your hospital physiotherapist can help you plan an exercise programme that suits your needs and how much you can do.
It is important to set yourself a few rest times throughout the day especially if you have advanced cancer and are very tired.
This can be difficult to stick to and you might try to push yourself to keep going. But that won't help. You'll be more tired and less able to cope.
You don't have to sleep during these rest times. Just sitting or lying down to rest will help.
Remember you don't have to do everything only the things that are important to you right now. Everything else can wait.
Just about everyone needs support from someone else when they have cancer. You can get some support from family and friends or doctors and nurses.
But support from other people who've been through the same thing can make all the difference.
Talking to other people in a support group can 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 therapist 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 a lot of sleep may not help if you have cancer related fatigue. This is because lots of other things are causing your fatigue.
To make sure you sleep as well as possible try:
- going to bed and get up at the same time each day
- making sure the room you sleep in is comfortable, calm, quiet and soothing and a nice temperature
- spending time relaxing before you go to bed. For example have a bath, read or listen to music
- stop drinking caffeine (coffee, tea, chocolate and cola drinks) after early afternoon
- limiting daytime naps to 45 minutes so they don’t stop you sleeping at night
- not drinking too much alcohol before bed
- having a light snack before you go to bed to stop hunger waking you up
When you really can't sleep, get up and watch TV, read or listen to music until you feel sleepy. Or try taking a warm bath or a warm milky drink. Then go back to bed and try again.
Let your doctor know if you often have trouble sleeping.
Eating enough to keep up your energy levels can be hard if side effects from your treatment are making you sick or have diarrhoea.
It is important to try and eat what you can, as your diet plays an important role in controlling fatigue.
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 (the 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 or getting dressed
- have plenty of nutritious snacks and drinks in, so you can have something quickly and easily 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
Don't forget to do things that you enjoy. This will take your mind off your cancer and make you feel more relaxed.
Keep a record of how you are feeling and how your energy levels change. This will help you know if you are more or less tired than before and help identify which activities make you feel better or worse.
When you're tired and don't feel like cooking, buy ready made meals. Or buy ready prepared vegetables or pre-grated cheese. Every bit of work done for you will save your energy.
Researchers are looking into a number of different types of drug treatments. These include psychostimulants such as ritalin and modafinil which are drugs doctors use to treat attention and concentration disorders.
Other drugs doctors are looking into include anti depressants. The results from the research into these drug treatments is mixed with some studies showing they can be helpful and others not.
Remember that fatigue for people having treatment for cancer is different from the fatigue some people feel long after finishing their treatment.
Things that can cause long term fatigue include:
- bone marrow transplants. In some cases fatigue can go on for many years after the transplant
- cancer treatment in childhood, especially for brain tumours
- taking the drug tamoxifen for several years
Many people with cancer find it helpful to talk to other people who have the same symptoms as them.
Sharing your feelings with someone in the same situation may make you feel less anxious about your fatigue. And you can often get tips on how to cope better from talking about your own situation.