How can I address lingering fatigue from my cancer treatment?

Carey Ramirez, certified nurse practitioner and advanced certified hospice and palliative nurse at City of Hope National Medical Center in Duarte, California Photo courtesy of City of Hope

Cancer-related fatigue, which is defined as physical, emotional or mental exhaustion that interferes with normal activities, is one of the most common chronic symptoms related to cancer and its treatment. This complex side effect may stem from a variety of underlying causes, including the cancer itself and treatment side effects. Your treatment may lead to anemia, hormonal changes or a loss of muscle strength. Toxins that remain in your body after chemotherapy can trigger fatigue, or you may have low energy as your immune system recovers from treatment. Fatigue also can be related to the emotional toll of your cancer journey, which may be exacerbated by or intensify other symptoms. For example, if you find yourself constantly worrying about your cancer, you may lie awake at night, which makes fatigue even worse. On the flip side, fatigue related to treatment may cause you to decrease the amount of time you spend with friends and family, contributing to anxiety or depression.

Unlike with general feelings of tiredness, cancer-related fatigue doesn’t improve after a good night’s rest. Your oncologist or primary care doctor should assess the severity of your fatigue and identify any contributing factors that can be treated. If you have anemia, which is a low red blood cell count, you may benefit from iron supplements or growth factors, which tell your body to make more blood cells. If depression contributes to your fatigue, your doctor may refer you to a mental health professional or start you on antidepressants.

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There are other things you can try at home to help address and manage your lingering fatigue. Try to prioritize activities to conserve energy or pace yourself. Listen to your body, take naps and don’t overexert yourself. Consider having a nutritional consultation to optimize your nutrition and hydration. Try gentle exercise, whether tai chi, yoga or walking. Although it may seem counterintuitive, evidence shows exercise can improve energy and alleviate fatigue. An occupational therapist, physical therapist or rehabilitation specialist can help you start an exercise program.

Finding ways to reconnect with activities that are meaningful to you also can be surprisingly helpful. Many people with cancer become obsessed with the disease and its treatment. You have had less time to do the things that bring you a sense of joy. Engaging in activities that restore your sense of purpose after cancer can go a long way in easing anxiety and depression and in helping to overcome those feelings of fatigue.

FIGHTING CANCER FATIGUE // Cleveland Clinic explores ways to prevent and manage cancer fatigue. // Yale Medicine discusses possible causes of cancer-related fatigue after treatment.

The expert’s response was edited for clarity and based on an interview with Kendall K. Morgan.