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Don’t Let Fatigue Get You Down

Tips and Techniques for Managing Cancer-Related Fatigue


Fatigue is the most common and distressing symptom experienced by people with cancer. It can be part of the disease process or its treatments, and it can persist after treatments are completed. Cancer invades every part of your life. Similarly, fatigue can cast a shadow over everything you do, feel, and even how you think about yourself. Learning about fatigue, its causes, and ways to potentially lessen its effects can improve your overall quality of life.

Here are simple tips and techniques for managing fatigue that you can discuss with your healthcare providers and your family. Many are low-cost, low-tech solutions. Some are prescription drugs; others just feel good (like massage). One or more of these may be able to help you lessen your fatigue level and help you feel better.

Most Helpful
Clinical studies conducted to date on fatigue indicate that the most helpful way to manage fatigue is to exercise. More than 30 controlled clinical studies show that exercise can be effective in reducing fatigue associated with cancer. Exercise strengthens the body and may help strengthen immunity.

The types of exercise that would be most beneficial vary according to your current lifestyle, the stage of your disease, and the nature of your treatment. Low-impact exercises, such as walking, can help your overall mood and energy level. Resistance exercises with elastic bands may also help you to feel better and increase your energy level. This type of exercise can be done while you are sitting down if you have trouble walking. Ask your doctor what exercises you can do safely without exhausting yourself.

The most helpful way to manage fatigue is to exercise.

Likely to Be Helpful
The following techniques are also likely to be helpful in managing fatigue:

♦ Energy Conservation and Activity Management
Energy conservation is the practice of using peak energy times to do certain tasks, while being careful not to exhaust yourself for the rest of the day. Activity management is a combination of selecting when to do certain tasks, pacing yourself, and determining what you can do versus what you can delegate to others.

♦ Education
Learning about cancer’s effects on the body and how you can alter your self-care may help in coping with fatigue in a more positive way.

♦ Massage and Healing Touch
Massage manipulates the body’s soft tissues. It can be done to particular parts of the body or the whole body. The manipulation can be very gentle, or it can be more forceful, depending on the type of massage. Very vigorous massage, such as deep tissue or Swedish, should be avoided if your platelet count is low. Some massage is done with heated stones. Some cancer treatments can make your skin more sensitive to heat, so you should be very cautious about this type of massage. The objective of massage is to restore function and release tension.

Healing touch is a technique performed by a specially trained practitioner that may or may not involve lightly touching the person. It is said to restore energy fields around the body.

♦ Relaxation Techniques Progressive
relaxation combines breathing techniques, visualization, and body positioning to help ease tension in every part of the body.

♦ Screening for Other Medical Conditions
Many medical conditions besides cancer can contribute to fatigue (for example, undiagnosed hypothyroidism or adrenal insufficiency). Simple blood tests can uncover these problems, and appropriate treatment can help alleviate fatigue caused by the conditions. Ask your physician if you have been screened for hypothyroidism, cardiac and lung problems, imbalances in sex or adrenal hormones, fluid or electrolyte imbalances, anemia, and depression. Sedative effects of some drugs and drug-drug interactions also can worsen fatigue.

♦ Techniques to Improve Sleep Quality
These consist of simple behavior modification practices, such as avoiding caffeine and stimulating activities in the evening, going to bed at the same time every night, avoiding long naps late in the afternoon, and using the bedroom solely for sleep and sexual activities. This can help normalize your internal “sleep clock” and maximize your quality of sleep.

May or May Not Be Helpful
Erythropoietin treatment falls in the category of treatments that may or may not be helpful in managing cancer-related fatigue. It is given to correct anemia, which most people with cancer will have sometime during their illness. Anemia occurs when the amount of red cells in the blood is too low to supply your oxygen needs. Human recombinant erythropoietin can stimulate the bone marrow to make more red blood cells. Having a greater number of circulating red blood cells in the body may help lessen symptoms of fatigue.

This treatment carries with it a risk of hypertension and making your blood clot more easily. It can cause some tumors to grow more rapidly. Talk with your physician to see if erythropoietin might be appropriate for you.

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Reprinted by the permission of the Oncology Nursing Society from

This article was published in Coping® with Cancer magazine, November/December 2011.