Merry Jennifer Markham, MD, FACP, is an Associate Professor in the Division of Hematology and Oncology at the University of Florida (UF) College of Medicine. She specializes in the treatment of gynecologic cancers and lymphoma, and she is the Program Leader for the UF Health Cancer Center’s Multidisciplinary Gynecologic Oncology Program.
You’re tired. You feel wiped out and can’t seem to find an ounce of energy. This isn’t the “I need to get more sleep” feeling you sometimes had before you were diagnosed with cancer. It’s a persistent and distressing sense of physical or emotional exhaustion that doesn’t match the amount of activity you’re doing.
It’s cancer-related fatigue.
Fatigue can be a common side effect of almost any type of cancer treatment, including chemotherapy and radiation therapy, and can occur weeks or months after treatment ends. Cancer itself can also cause fatigue. For many people, fatigue interferes with normal, everyday functioning and significantly impacts their quality of life.
But there are several strategies you can use to manage it.
1. Get treated for medical conditions or causes that make fatigue worse. Tell your doctor if you’re experiencing fatigue. You should be screened for:
Pain or its treatment, especially narcotic pain medication
Emotional distress, such as anxiety or depression
Poor nutrition or electrolyte imbalances, such as abnormal levels of sodium, potassium, calcium, and magnesium
Anemia, an abnormally low level of red blood cells
Sleep disturbances, such as sleep apnea or restless leg syndrome
Medication side effects
Other medical conditions, such as heart, lung, or hormone problems
2. Get moving. Whether it’s walking, swimming, or going to the gym, move your body every day, if you can. Physical activity is one of the best ways to counteract cancer-related fatigue. Talk with your doctor about how to start exercising safely.
3. Take time to relax. Schedule some rest in your day so that you conserve energy for when you need it. Limit naps to less than 1 hour so that you can still sleep at night.
4. Eat well. Keeping up with your nutrition is important on many levels. Even if you can’t eat a lot right now, grazing on healthy snacks throughout the day can help give you needed nutrients and energy. You may also want to talk with a registered dietitian nutritionist (RDN) about how to eat well.
5. Practice good sleep habits. Take simple steps to get a restful night’s sleep, such as turning off the TV or computer at least an hour before bedtime and avoiding caffeine in the afternoon or later. Remember to keep your naps to less than 1 hour.
6. Engage in mind-body strategies. Some people find that mindfulness-based approaches or activities, such as yoga or meditation, help. There’s also evidence that acupuncture can help with fatigue.
7. Consider therapy and counseling. A therapist or counselor experienced with working with people with cancer can provide you with coping strategies or other psychosocial interventions that may help with fatigue.
8. Get a massage. There’s increasing evidence that massage therapy may help with cancer-related fatigue. Research has shown that massage can improve quality of life in people with cancer and may improve sleep.