Tips for coping with cancer-related fatigue (tiredness)

In this blog, Content Developer Azmina sets out practical tips for coping with fatigue caused by cancer or its treatment.

As many as 9 out of 10 people with cancer (90%) get cancer-related fatigue (CRF) at some point. If you have CRF, you may feel very tired or exhausted all or most of the time.

CRF is different from the everyday tiredness that people without cancer may experience. You may get tired quickly after small amounts of activity. Even after resting or sleeping, you may still feel exhausted.

It is possible to manage CRF and support is available. Your healthcare team may be able to help improve your quality of life.

What causes fatigue?
CRF is complex and the causes are not fully understood. There are many possible reasons why you feel so tired, including:

• the cancer itself
• the side effects of cancer treatments
• anaemia (a low number of red blood cells)
• eating problems caused by sickness or changes in appetite and taste
• other health problems
• the emotional effects of cancer, which can lead to a poor sleeping pattern.
  

Tips for managing fatigue
CRF can affect your daily activities, but there are things you can do to manage fatigue:

• Speak to your healthcare team: Firstly, talk to your cancer doctor, nurse or GP about your fatigue and how it makes you feel. They will check for any causes of fatigue that can be treated, such as anaemia or sleeplessness. There may be other ways to improve fatigue, such as reducing the dose of a tablet that makes you sleepy.
  
  
• Keep a fatigue diary: You may find it useful to record your daily energy levels in a fatigue diary and show this to your doctor or nurse. Write down when you feel your best, when you feel most tired and when you have your treatment or do a certain task. This can help you plan your activities and work out what makes your fatigue better or worse.
  
  
• Use the Macmillan RESTORE tool: Macmillan has developed an online tool called RESTORE with the University of Southampton. This tool is based on up-to-date evidence and gives information on how you can cope with fatigue. RESTORE links to the Macmillan fatigue diary and helps you set goals to manage your fatigue more effectively. Visit macmillanrestore.org.uk
  
• Try to keep active: Staying active is the best way to keep your muscles strong and build up energy. It can also improve your appetite, mood and sleep. If you have CRF, you may become less active over time. This can make your fatigue worse and your muscles may get weaker.

If you have not been very active for a while, it is best to start slowly and get advice from your doctor or nurse. You could set yourself simple goals, like walking from the front door to the back door. Then try to walk a bit further around the house each time.

A physiotherapist can suggest exercises that are safe and suitable. You can also order our free Move More pack, which includes a DVD with gentle activity videos you can do at home.

• Have a healthy diet: If you eat healthy, well-balanced meals, this can help you gain strength and energy. Your GP can give you advice, tell you your ideal healthy weight and refer you to a dietitian for more support. You may be prescribed anti-sickness tablets if you experience nausea or vomiting due to treatment.

Drink plenty of fluids and try different foods if you have taste changes, until things improve. If you have lost your appetite, you can eat regular, small portions of food rather than a big meal, or get high-calorie drinks on prescription. It may help to prepare extra food when you feel less tired and freeze it.

• Have a good sleep routine: Your CRF may make you feel like sleeping all the time, but try to keep to a normal sleep routine. It is important that any rest during the day does not stop you from sleeping at night.
  
  
• Getting a good night’s sleep may reduce your fatigue. It is a good idea to go to bed and get up at about the same time every day, even after a sleepless night. This encourages your body to get into a regular resting pattern. Gentle exercise like walking can help you feel naturally ready to sleep.

For more tips, you can read the information on our website or order our free booklet Coping with fatigue (tiredness). Call our Support Line free on 0808 808 00 00 (7 days a week, 8am to 8pm) to talk to an experienced cancer nurse about managing fatigue.

To see what else Macmillan's cancer information team has been blogging about, please visit our blog home page! You can subscribe to receive our blogs by email or RSS too.

We're with you every step of the way

The Macmillan team is here to help. Our cancer support specialists can answer your questions, offer support, or simply listen if you need a chat. Call us free on 0808 808 00 00.

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