Fatigue in Cancer Patients
One of the most common symptoms our patients complain of is fatigue; it is also one of the most debilitating.
Cancer-related fatigue is multifactorial. Chronic illness, chemotherapy, radiation therapy, anemia, pain, lack of sleep, medications, emotions, and poor nutrition are reasons patients experience fatigue. Persistent fatigue is something that should be discussed with your provider, especially if ongoing or prolonged. Fatigue can impact a patient’s quality of life; it is important to realize that cancer fatigue differs from healthy people. People with cancer describe fatigue as feeling tired, weak, worn-out, heavy, slow, or having no energy, no “oomph” or “get-up-and-go.”
Cancer fatigue can impact all areas of a patient’s life by making them too tired to want to participate in daily activities, relationships, social events, and community activities. As a result, they may miss work or school, spend less time with family and friends, or spend more time sleeping. In addition, it is not uncommon that physical fatigue leads to mental fatigue and mood changes. This can make it difficult to pay attention, remember things, or think clearly. Clinicians face many challenges when trying to manage patients with fatigue. Trying to find an underlying reason usually is how we first approach a patient with fatigue. Is it a sleep issue? Can medication or sleep hygiene be utilized in helping? The emotional stress of cancer can also cause physical problems, including fatigue. So, it is important to consider anxiety and depression as potential causes as well.
Many patients wish there was one “magic pill” to take away the fatigue. In many cases, we can use medications that can help with being more alert during the day, and the palliative team is happy to utilize these medications when appropriate. But I often try to explain how the mind and body are struggling with both the physical and psychosocial aspects of illness and how mental exhaustion will contribute at times. Validation of their feelings is also an important element in dealing with fatigue. Give patients the credit that they are trying the best they can with what they are feeling. Telling them to allow themselves the time to rest and understand that their body is fighting a difficult battle often helps patients feel that it is okay to feel fatigued. Usually, planning activities that help them feel more awake but take less energy, such as watching a sunset, taking a walk, or sitting outside with a cup of tea or coffee, allows them to not focus on the fatigue they feel but instead enjoy the moment.
Some other ways to combat fatigue:
Set small attainable goals- we tend to put so much pressure on ourselves, limit or set smaller daily goals.
Energy conservation- taking time to rest, short naps during the day to recharge.
Proper nutrition- to work efficiently, your body needs the energy that a healthy diet provides. Consulting with our nutritionist can be the first step in assessing your diet. Certain supplements can also be added to your regime.
Sleep-If you’re sleeping less at night, or if your sleep is frequently interrupted, this may contribute to fatigue.
Mental rest and wellness- including yoga, meditation, acupuncture. Utilizing our psychologists and/or social workers for supportive care and mental health counseling can benefit your treatment plan.
Exercise- get moving! Light to moderate exercise, if able, may help to prevent fatigue. In addition, physical therapy has many benefits in helping patients to improve physical performance and reduce fatigue.
Managing cancer-related fatigue is an important part of cancer care. Discussing this with your provider is essential. The supportive and palliative team is also available to help manage or decrease this debilitating symptom that so many patients experience.