Cancer related fatigue (CRF) is tiredness like you never had before- not relieved by rest, sleeping or having caffeine. It is an overwhelming lack of energy that can prevent you from doing your normal day to day activities 1. Fatigue is one of the most common symptoms and can be due to the cancer itself or an effect of the treatment. It can also be caused by anaemia (low red blood cells), low mood and depression, pain or other health issues. For most people it improves after cancer treatment ends but some it can continue for months or years after cancer treatment.
In this article I will explore the symptoms you may experience when you have cancer related-fatigue and few ways to help you manage.
What does cancer related fatigue feel like?
Fatigue can cause a range of general symptoms 2:
Low energy levels
Lack of motivation
Difficulty sleeping
Difficulty concentrating or remembering things
Losing interest in thing you normally enjoy
Feeling breathless after light activity
Change in mood and emotions
These are also symptoms that could be linked to other conditions so do get advice from you nurse or doctor if you notice any of these.
How can you manage fatigue?
First talk to your nurse or doctor who can investigate if your symptoms are medical related for example due to cancer treatment, anaemia (low red blood cells), pain or other health problems such as low thyroid function 3
Once you have discussed with your medical team try the following tips to help manage your fatigue.
Eating well
If you feel tired you may struggle to prepare meals or miss meals due to tiredness, which in turn means you may not eat well so your energy level falls further. Unfortunately, this may lead to an ongoing cycle of poor eating and low energy.
Top tips:
Aim for regular meals and aim for 4-6 small meals/snacks
Aim for a mix of protein, carbohydrates, fruits and vegetables throughout the day
Keep hydrated- drinking 7-8 glasses fluid a day to prevent dehydrated which can leave you feeling tired
Batch cooking meals when your energy levels are at its highest then freeze for another day (for more advice on storing food click here)
Order shopping online and stock up on food that are easy to heat or prepare
Choosing healthier ready meals or ingredients make meal prep easier
Use frozen or tinned pre-chopped vegetables that can be cooked quickly
If you are also experiencing a poor appetite have a look check out What to eat during chemo part 1 and part 2)
Keeping active
Being active helps to reduce fatigue. It is a good idea to start slow and take regular breaks. Start with short walks around your home then trying going for a short walk outside. Keep building this up slowly, aiming for a few minutes longer each time.
Activity also has lots of benefits from helping you sleep and improving your appetite, helping to maintain your lean muscle and improving your mood.
Sleep routine
Having a good bedtime routine or 'sleep hygiene' can help improve your ability to get to sleep and feel more rested when you wake up. Sleep hygiene is simply good sleep habits that help you fall asleep and stay asleep. Try these tips below:
1. Keep to set wake-up and bedtimes as this can help you get into a good sleep rhythm
2. Keep active during the day and if you can get some daylight
3. Avoid caffeine, alcohol and nicotine as they are stimulants which can keep you awake!
4. Avoid watching TV, working or using your phone in bed so you keep the mental connection of sleep with being in bed
5. Avoid eating a large meal close to bedtime as you may still feel full
6. Relax and unwind at least 30 minutes before bed. This can be anything you find relaxing like listening to relaxing music, reading, meditation/mindfulness techniques
7. Make sure your sleep environment is comfortable. Keep your room cool, use blackout curtains, use ear plugs if it’s noisy and some people find calming scents like lavender helps.
8. Avoid looking at screens before bed as the blue light they emit has shown to keep you awake by suppressing melatonin production. It can also keep your ‘mind active’ as you coud continue thinking about what you have just seen or read.
Planning your day
It may be helpful to plan your day and prioritise the activities that are most important to you and if possible, ask family or friends to help with other tasks. It may be helpful to plan your activities around treatment too, if you know you will be feeling more fatigued.
Also make time to have some time to do the things you enjoy and spend time with family and friends.
Are you struggling with low energy levels? Download our free 7-day meal plan designed for optimal recovery and say farewell to exhaustion!
Further support:
https://untire.me app for tips to deal with fatigue and exercises to improve your energy level.
Discuss with your nurse or doctor if you need help with managing fatigue they may consider referring you to an occupational therapist or physiotherapist who can help with exercises.
References:
1. Hofman M, Ryan J, Figueroa-Moseley C et al. Cancer-related fatigue: the scale of the problem. Oncologist 2007; 12 (Suppl 1): 4–10.
3. https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/tiredness
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