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Fight Fatigue. Feel Better.

Six Strategies for Dealing with Cancer-Related Exhaustion

by Arash Asher, MD

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Fatigue is the most common and often the most distressing side effect of cancer treatment. For some survivors, the issue can persist for months after treatment ends.

Before diving into the practical steps you can take to deal with this trouble­some side effect, let’s take a closer look at what cancer-related fatigue is. Almost everyone has experienced some level of fatigue at one time or another. However, the fatigue you may have experienced before your cancer diagno­sis is often very different from fatigue caused by cancer treatment. For ex­ample, if you stay up late dancing the night away at a wedding, you may feel exhausted the next day. But if you take a nap and get some extra sleep the next night, chances are you’ll feel refreshed and back to normal.

With cancer-related fatigue, however, the exhaustion you feel seems to be out of proportion to your level of activity. Washing a couple loads of laundry or running a few errands could be all it takes to trigger cancer-related fatigue. Moreover, a nap or extra sleep at night often won’t solve the problem. It’s kind of like when you have the flu; you feel tired, foggy, and perhaps a bit blue.

So now that you have a better un­derstanding of cancer-related fatigue, what can you do about it? Here are a few suggestions.

Make time for exercise.
It may seem counterintuitive to exercise when you’re feeling wiped out, but research has consistently shown that moderate exercise (walking, pedaling on a sta­tionary bicycle, etc.) can reduce fatigue. Plus, emerging evidence indicates that exercise can reduce the risk of some cancers returning and can prolong life. Just be sure to talk with your doctor before beginning an exercise routine.

The fatigue you may have experienced before your cancer diagnosis is often very different from fatigue caused by cancer treatment.

Author of Article photo

Dr. Arash Asher

Invest in your sleep.
Our anxiety, worries, medication side effects, hor­monal changes, and busy lives can keep us from getting enough sleep. Aim to get at least eight hours of sleep per night. Getting some natural light during the day and keeping your bedroom pitch dark at night (perhaps with the help of blackout shades) is an easy way to improve the quality of your sleep.

Try yoga.
Gentle yoga (such as Hatha yoga) also has been shown to reduce fatigue and improve vitality. Not only may practicing yoga help you relax and strengthen your body, but it also may improve your quality of sleep.

Minimize your stress.
This may be easier said than done, but managing your stress is im­portant. Learning to cope with the challenges of a medical illness is one of the most empowering skills you can master. Avoiding social isolation, practic­ing mindfulness meditation, working fewer hours, seeking support from a therapist or support group, exercising, and spending time in prayer or other spiritual activities can all help man age stress and, in turn, reduce your fatigue.

Delegate and conserve.
Ask others to help with chores and tasks that aren’t essential for you to do yourself. Close family and friends are often looking for ways to be helpful, and accepting their help will allow you to conserve your energy for the tasks you have to do on your own. Set realistic goals for what you want to accomplish each day, but realize that it may still be impossible to accomplish everything you want to get done while you’re in treatment and recovery. Identify the time of day when you have the most energy, and use this window of time to do your most important tasks.

Talk to your doctor.
Some people may benefit from stimulant medications if their fatigue is severe and nothing else has helped. Ask your doctor about poten­tial drug interactions and appropriate dosing. Remember, unless you bring it up, your doctor may not evaluate you for fatigue. If you’re going through depression, have significant anemia, or have other medical problems, let your doctor know. Treating these issues may help reduce your fatigue.

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Dr. Arash Asher is the director of cancer survivorship and rehabilitation at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center in Los Angeles, CA. Dr. Asher’s expertise is in the nonpharmacologic management of pain, cancer-related fatigue, cognitive dys­function, neuropathy, exercise prescription for people with cancer, and the management of other musculoskeletal problems. Dr. Asher is board certified in Hospice and Palliative Medicine by the American Board of Physical Medicine and Rehabilitation.

This article was published in Coping® with Cancer magazine, January/February 2015.