Fatigue, the most common side effect of cancer treatment, is not the same as casual or sleep-deprived tiredness because it cannot be relieved with simple sleep and rest. Cancer-related fatigue affects approximately 94% of cancer survivors and is a sense of heaviness, of not being able to get up and go. Physical fatigue leads to mental fatigue and to mood changes. Cancer-related fatigue can be caused by treatment with chemotherapy, radiation or biologicals. Other factors that influence it are anemia, hormonal disruptions, low oxygen levels, heart problems, infections, pain, stress, inadequate nutrition, dehydration due to diarrhea or vomiting, deconditioning, drowsiness caused by medications, insomnia or sleeplessness, and other medical conditions.
Treatment for fatigue involves a multidisciplinary approach to management of some of the underlying causes. Doctors will conduct an assessment, which will include a physical exam, rating of the level of fatigue, verifying symptoms and side effects of treatment and medications, and blood tests to detect anemia and possible infections.
Evidence indicates that lower volumes and intensities of exercise appear to be most effective in addressing symptoms of fatigue during chemotherapy. Other treatment options include treating anemia, infections and/or depression that could be causing fatigue. In addition to psychotherapy and antidepressants, other medications are being studied to see if they can reduce fatigue, including anti-inflammatory medications and dietary supplements that increase the body’s energy, such as ginseng.
There are some steps that you can take to deal with cancer related fatigue:
- Conserve and maintain your energy. It is important to prioritize and do the things that are most important when you are feeling the best. Nutrition and hydration are very important and contribute to keeping your energy levels up.
- You should rest frequently throughout the day. Taking naps during the day can help relieve some of your fatigue.
- Exercise lightly when you feel up to it. Going for a short walk or enjoying a bit of gardening are some of the activities that can add energy to a fatigued body.
 Dr. Margaret L. McNeely, Physiotherapist. Presentation on rehabilitative services in Alberta. Presented at the All-party Cancer Caucus Meeting May 8th, 2018.