- There are many reasons for fatigue: Establishing the specific causes of your post-treatment fatigue can help you manage it effectively.
- Be realistic: Take a sensible approach to what you can and can’t do. Don’t push yourself and plan ahead when you can.
- Speak to a specialist: Get advice from your GP, care team or a cancer specialist for personalised support and to discuss options for managing your fatigue.
Nine out of ten people with cancer will experience fatigue. Although it affects everyone differently, it can last for years after cancer treatment ends. Extreme tiredness has many causes but is often cited as the treatment side-effect that is most disruptive to a person’s life and can be incredibly frustrating to deal with.
Our guide explains the causes of fatigue after cancer treatment and explores how you can manage tiredness through lifestyle changes, everyday adjustments and specialist support.
Reasons for fatigue
There are many causes of post-treatment fatigue; you might be experiencing one or several. However, pinpointing the specific cause or causes of your fatigue can help you to manage and overcome it.
The cancer itself
Cancer can cause swelling in the body, making it feel heavier and harder to move. It can also reduce your red blood cell count and alter your hormones, making you feel more tired.
The after-effects of treatment
Chemotherapy and radiotherapy can damage healthy cells as well as cancer cells, contributing to fatigue. The hormone therapy used to treat some cancers alters the body’s hormone levels, also causing extreme tiredness.
Some people with cancer experience pain either from the cancer itself or as an effect of treatment. Pain can make it hard to rest and sleep, leaving you feeling drained. It also takes significant physical and emotional energy to deal with pain, which adds to fatigue.
Psychological effects of cancer
Many people with cancer experience depression, anxiety and stress; all of which can lead to physical side effects. Anxiety, for instance, can cause a person to be in a perpetual state of fight or flight. This in turn prompts persistent muscle tension, which results in fatigue.
A low level of red blood cells (anaemia) can be a result of cancer itself or cancer treatment. If you have anaemia, your body doesn’t receive enough oxygen-rich blood and this can leave you feeling weak and/or tired.
Eating after chemotherapy isn’t always easy and cancer itself can reduce your appetite. Fatigue can occur if the body doesn’t get enough food, especially if your calorie intake isn’t enough to cover the energy your body needs for its most basic functions.
There are many ways to manage tiredness after cancer. However, as there are many causes of fatigue, it can also be helpful to speak to a doctor or a cancer specialist and discuss which treatment is best for you.
The lifestyle changes you can make and support you can seek to manage tiredness include:
If you aren’t sleeping well at night, this can disrupt your circadian rhythm, resulting in an increased desire for naps during the day and feeling more tired overall. It can be beneficial to put a sleep routine in place that caters for at least seven hours of quality sleep a night. Set a regular bedtime and stick to it, and establish a wind-down routine that involves limiting your use of electronics. Also ensure your sleep environment is dark, quiet and comfortable.
A well-balanced diet consisting of fresh, nutrient-rich foods can help reduce fatigue. Your body can function more effectively when you meet its nutritional needs and provide all the necessary vitamins and minerals. Dehydration can further contribute to fatigue, so also make sure you are drinking plenty of water each day.
Exercise after cancer treatment can actually reduce fatigue. This is because physical activity releases ‘feel good’ endorphins, making you feel more energetic. The exercise doesn’t have to be intense. There are many benefits to walking after chemo, for example, as not only can it help tackle fatigue but it can also lift your mood and improve sleep quality. If walking isn’t your thing, light gardening or a gentle swim are other good options.
Talking therapies can help you come to terms with your emotions and give you the tools you need to manage them. Being able to process your feelings more effectively can reduce internal ‘noise’ and physical symptoms that interrupt your sleep. Counselling can also help you to reframe your perspective about your fatigue and improve your coping skills.
Complementary therapies, such as massage, yoga and aromatherapy can be beneficial for both the body and mind, indirectly helping to reduce fatigue. For example, meditation can reduce anxiety in cancer patients, and some studies suggest that acupuncture can reduce pain.
There are changes you can make that can help you deal with your fatigue. These adjustments will differ from person to person and will likely shift from day to day depending on how tired you feel. You may also find it helpful to plan things in advance and ask for help from family and friends to make everyday tasks more manageable.
It’s a good idea to categorise the things that have to be done and those that you would like to do, in the home. This can help you to prioritise where to focus the energy that you do have. Small changes can also help you feel less tired such as:
- Ordering your food shopping online rather than going to the supermarket
- Making simple meals or batch-cooking dishes that can be frozen for a later date
- Wearing comfortable clothes that are easy to take off
- Staggering chores
- If you have children, plan activities that aren’t physically demanding or ask friends and family if they will provide some childcare
- Alternate active and quiet tasks, for example, dusting and house admin
- Use a cart to move items around the house, such as laundry
- Consider paying for professional services, such as a cleaner or gardener
When returning to work after cancer, your employer should make reasonable adjustments for you to make things easier and allow you to carry out your tasks effectively. Think about what you need and what will help. These adjustments might include:
- A phased return
- Changing your hours
- Reducing your hours
- Working from home
- Longer breaks
- Lighter duties
- Sharing responsibilities with a colleague
- Closer parking to the office
If you’d like more support around living beyond cancer and managing fatigue, Perci Health is here to help. Our cancer nurse specialists have a broad understanding of cancer and can answer any questions you may have, while our clinical exercise coaches offer practical advice and exercise programmes to improve your strength.