What Causes Cancer-Related Fatigue and How to Manage It
Fatigue is a common symptom of cancer and a side effect of some cancer treatments. Cancer fatigue is more than feeling tired or sleepy. It can feel like an overwhelming lack of energy that interferes with your daily activities.
In this article, we’ll examine the connection between cancer and fatigue, how long it typically lasts, and what you can do about it.
Cancer can cause fatigue in various ways. Depending on the cancer type and stage, it can be due to multiple factors such as:
- low red blood cell count (anemia)
- high or low hormone levels
- breathing concerns
- stress, anxiety, or depression
- lack of nutrients or calories due to low appetite
- lack of physical activity
- loss of muscle mass and strength
- sleep disturbances
A 2014 research reviewTrusted Source suggested that inflammatory processes may play a role in cancer-related fatigue. But the exact reasons cancer can cause fatigue aren’t clear.
Many people report fatigue with cancer treatment. Fatigue can be a side effect of:
While you’re in treatment, your body needs extra energy to heal and repair damaged tissue. And certain treatments, like chemotherapy, cause a build-up of toxins in your body. Some therapies can affect your sleep-wake cycle.
Of course, medical treatment isn’t the only piece of the puzzle. Individual circumstances also affect your level of fatigue. These include:
- number of different therapies and how long they last
- age, general health
- relationships, social connections
- matters relating to work, child care, and other responsibilities
Living with cancer means you might need to make many adjustments to your routine, which can lead to fatigue related to:
A 2014 research review found that in the majority of studies, 30% to 60% of peopleTrusted Source in cancer treatment reported moderate to severe fatigue. Radiation and chemotherapy were two of the most common treatments associated with fatigue.
Additionally, most people in the research review above reported that fatigue resolved within a year following treatment. About 20% to 30% of peopleTrusted Source said it lasted 5 to 10 years or more.
According to the National Cancer Institute (NCI), cancer-related fatigue is more intense than regular fatigue. Resting or napping offers little to no relief. And even when you consistently get a good night’s sleep, cancer-related fatigue can persist. It can become debilitating because the effects are:
How to manage cancer-related fatigue
When you’re drained of energy, exercise might be the furthest thing from your mind. But physical activity might help.
A 2018 research reviewTrusted Source compared cancer survivors who exercised to the participants who didn’t. The researchers concluded that exercise, particularly regular aerobic exercise, has a large effect on cancer-related fatigue.
A 2014 research reviewTrusted Source also suggested that exercise can help with cancer-related fatigue, both during and after treatment, including aerobic exercise routines. Examples of aerobic exercises are:
- brisk walking
- bike riding
Tips to get started
- Discuss exercise plans with your oncologist before beginning a new regimen.
- If you haven’t exercised in a while, start easy and build up slowly to avoid burnout.
- If all you can manage is a 5-minute stroll around the block, consider it a good start.
- Work toward a goal of 30 minutes of aerobics 5 days a week or more.
- Try something you enjoy. And, yes, things like housework and gardening count.
- Stop if you feel too weak or sick.
- Try exercising earlier in the day. Exercising too close to bedtime can interfere with sleep.
- Add some strength training and stretching to your routine.
A 2020 research reviewTrusted Source included 9 randomized, controlled trials and 809 participants. Six of those trials reported significant improvement of cancer-related fatigue with acupuncture. Two trials reported minor adverse effects like bruising and spot bleeding, but there were no serious adverse reactions.
Acupuncture might also help with other cancer-related symptoms. It’s a good idea to speak with your doctor first to make sure acupuncture is safe for you. You can also ask for referrals to qualified acupuncturists.
If you have insurance, it’s also a good idea to reach out to your insurance provider to see if acupuncture is covered and, if so, who’s in your network.
Mindfulness-based stress reduction
A small 2014 studyTrusted Source included 35 cancer survivors with significant fatigue. They were randomly assigned to mindfulness-based stress reduction intervention or a control group.
There are many apps available that can help guide you through a meditation. You can also sit quietly and try to clear your mind on your own.
Yoga is widely available, either at a gym or studio, or through free or paid online videos. If you’re new to yoga, look for classes or videos advertised as gentle or restorative.
Treat related conditions
Cancer and cancer treatment can cause other conditions. Sometimes, you can get relief from fatigue by treating conditions like:
Make sleep a priority
Although napping won’t cure chronic fatigue, short naps can provide temporary relief. But napping too close to bedtime can disrupt your sleep cycle.
See if you can tweak your sleep hygiene to promote better sleep. Put out a virtual “do not disturb” by letting everyone in the household know that your sleep is a priority.
Think about how your energy level rises and falls throughout the day. Try to schedule the most taxing activities during peak energy times. Put less important tasks aside or ask for help.
Even if your appetite is low, it’s important to eat a balanced diet filled with vitamins and nutrients, and to drink plenty of fluids. Ask your doctor if you should be taking dietary supplements.
Fatigue related to cancer and cancer treatment is not at all uncommon. Most people get over fatigue within a few months to a year following treatment. But there are a lot of moving parts to your life, so your experience will be unique to you.
With each treatment, you’ll have an opportunity to talk things over with your oncology team. They can gauge whether your fatigue falls within a normal range. If not, they can look for a cause and offer treatment.
A 2014 research review suggested that a quarter to a third of cancer survivorsTrusted Source have persistent fatigue, lasting up to 10 years post-diagnosis. The longer it goes on, the more it can affect daily routines.
If you’re still experiencing fatigue 6 months after treatment, follow up with your oncologist or family doctor.
Most people in treatment for cancer will experience fatigue at some point. It’s often temporary, clearing up in the months following treatment. But it can turn into a long-term concern that interferes with your activities.
You don’t have to accept debilitating fatigue as your new normal. There are some steps you can take on your own to try to improve matters. But fatigue can sometimes signal an underlying concern that can be treated.
If fatigue is interfering in your daily life, having a discussion with your doctor is well worth your time.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.