20 January 2020

This content was originally posted on our My Ovacome forum on 9 October 2019.

Fatigue means feeling tired and low in energy which doesn’t resolve with rest. It can be caused by cancer and its treatment, for example damage to the bone marrow that makes red blood cells can cause anaemia which often makes people tired. It’s one of the most common side effects of chemotherapy, so in this post we’ll look at some ways of managing it.

We tend to feel more tired when we’re not getting enough calories from our food, such as on a busy day when we don’t have time for meal breaks or if we have a bug causing vomiting or diarrhoea. Eating enough calories can help to maintain energy levels and reduce fatigue. You can find more information on eating healthily on the Macmillan website. Sometimes you eat less than usual during chemotherapy because of nausea or reduced appetite, or you don’t fully digest your food because of vomiting or diarrhoea. If you’re affected by this, you can ask for a referral to a dietitian and/or have anti-sickness or diarrhoea medication. There are many kinds of these medications available, so you may need to try more than one before finding the drug that works best for you. Taking the medication consistently rather than only when symptoms occur or get worse can help to keep them controlled. You can find more information about managing these symptoms at on the Cancer Research UK website and on the Macmillan website.

If there are some foods that you can manage without feeling too sick, you can focus on eating these until you feel better. If you don’t feel hungry, try eating small amounts throughout the day rather than just at mealtimes. If your team think that you aren’t getting enough energy from food, you may be advised to use high-calorie supplements such as shakes or powders that can be mixed into food. You can find more information about this here.

There can also be an emotional aspect. The intense thoughts and feelings that people often experience when they’re diagnosed with cancer and going through treatment can impact on fatigue, especially if they affect sleep. Talking about your experiences and how you feel with friends and family, a support group and/or a counsellor may help with this. You can find information about talking about cancer and who you can talk to here. You can call the Ovacome support line and post on the My Ovacome forum. We also have a list of local support groups on our website, or your team may know of a group in your area.

If you’d like to have talking therapy one-to-one, you may be able to access this through your GP, the hospital, your local Maggie’s Centre or another cancer support centre or hospice. If you want to find a counsellor for yourself, the British Association for Counselling and Psychotherapy accredits therapists and you can search their directory through their website and find a local therapist with an interest in cancer.

Treating the underlying cause(s) of fatigue may help to reduce it, but for some people no specific cause is found, or they may still have a degree of fatigue even when some of the causes have been treated. There are ways of living with fatigue and managing your activities around it. Some people keep a diary of their fatigue symptoms so that they can plan their activities for when they have the most energy. You can find an example of what to include in your diary here. There are also apps such as Untire, which has been developed specifically to help with cancer-related fatigue and includes advice, an online support community and a programme that you can follow.

There are ways to manage fatigue to reduce its effects on your daily life. For example, gentle exercising, eating well and asking others for help with tasks like shopping, housework and childcare can help to boost your energy levels while conserving the energy that you have. Cancer fatigue may not be relieved by rest or sleep, and getting too much rest can actually make you feel more tired. It’s often helpful to try and move around, even if only a short walk inside the house at first, and build up to more exercise as you feel able, such as a walk round the block or activities like yoga or gentle exercise to music. It’s important to be aware of how you feel and find the right kind and level of activity for you that you enjoy and that you can sustain without it being too tiring. You can find more information about exercise and cancer here. You can also watch a presentation by cancer exercise specialist Liz Davies from Ovacome’s Members Day here. Complementary therapies such as relaxation, massage or yoga may also help, if your team advise that these are safe for you to have. Organisations such as Penny Brohn Cancer Care offer activities for people affected by cancer, including exercise, complementary therapies and courses on approaches to living well.

There are many aspects to fatigue, both in terms of how it can affect people and how it can be managed. Your experience may vary during your treatment and recovery and you may find different management techniques helpful at different stages. Your team will be experienced in helping people affected by offering treatments and advice on managing it. If you have any tips on managing fatigue that other members might find helpful, or would like to share your experience of it, please post on the forum.

Our Health and Wellbeing Day in London in September included a session on managing fatigue by Lizzie Jones, specialist Macmillan occupational therapist. You can find her presentation slides here.

Below are some useful websites if you would like to read more about this:

Macmillan Cancer Support

Cancer Research UK