What is cancer fatigue?

Cancer fatigue is different from the tiredness that we all can experience after physical activity, a hard day’s work, or lack of sleep. Fatigue caused by cancer is unpredictable and unrelated to activity or exertion. Cancer-related fatigue can be due to different cancer treatments such as chemotherapy, radiotherapy, immunotherapy, or surgery. Cancer fatigue can stay for a long time and does not improve by rest or sleep. People who experience cancer-related fatigue might not be able to complete their daily tasks, leaving them to feel frustrated which can lead to depression or further worsen depressive symptoms. Chronic cancer fatigue may persist for more than 6 months after treatment ends which obviously causes distress and can decrease the quality of life.

Cancer fatigue can cause your limbs to feel very heavy and you may experience weakness all over your body. It can be hard to focus on activities and some people have issues remembering things when they are fatigued. This post-treatment cognitive impairment is commonly referred to as “chemo brain”. It is mostly seen in people who receive chemotherapy, but patients who receive radiation and surgery can also experience chemo brain where they feel foggy, have trouble recalling events, and complain of poor attention and problems with memory. Not everyone who experiences cancer related fatigue will also experience chemo brain, but many do. Chemo brain, like cancer related fatigue, typically improves within 9-12 months after completing chemotherapy. A small number of people will experience chemo brain long-term.

There are different management strategies for cancer fatigue. It is important to consult with your medical care team if you experience any of these symptoms. Your medical care team can suggest medications, social support, counselling, or meditation.

Lifestyle changes that can help you cope with fatigue:

• Exercise as much as you can to help reduce your fatigue and possible chemo brain. Start with low level activities like walking and increase gradually. Even a 10-minute walk a couple of times per day can help relieve symptoms of fatigue. Working with a cancer-specialized physical therapist who can teach you exercises to improve your muscle mass while in treatment or after can be very beneficial to combat fatigue.
• Reading, writing, playing games, or listening to music can help relax you and also help with your memory.
• Conserve your energy by setting priorities, pacing, or delegating tasks. It is helpful to schedule your activities when you feel your best. Complete one activity at a time and postpone non-essential ones.
• Do your best to get regular sleep. Try to limit daytime naps so you can sleep through the night more easily. Avoid alcohol, caffeine, or eating sugar before bedtime. Avoid watching tv or using your cell phone in bed. Reading, writing, or listening to music before bedtime can reduce your stress and can ease your sleep.

Nutrition care and meal planning tips to reduce fatigue

• Eat small, frequent meals. Ditch the idea of 3 square meals a day and try for 4-6 smaller meals that are energy dense.
• Consume high protein foods at each meal and snack to ensure you are consuming adequate protein throughout the day such as lean meat, legumes, cheese, fish, eggs, and peanut butter. Protein helps your body to build and repair its muscles, tissues, and cells
• Consider adding a high-calorie smoothie or supplementing your meals or snacks with a high-calorie oral nutrition supplement to ensure you are consuming adequate calories or protein. Maintaining adequate nutrition during treatment can be a challenge due to quite a few treatment-related side effects. Sometimes adding 1 or 2 oral nutrition supplements or a smoothie to your day can be the reason you stay weight stable during treatment.
• Drink plenty of fluids during the day to stay hydrated. Dehydration can worsen your fatigue symptoms. Try popsicles, soups, herbal teas, smoothies, and electrolyte beverages.
• Eat easy to chew food that does not exhaust your energy during mealtime. Cottage cheese, yogurt, ice cream, soups, and pureed foods do not require much effort to chew or swallow.
• Prepare your meals ahead of time when you feel energetic and double your recipe to store in freezer for when you are not feeling like cooking
• Use canned, frozen, ready to heat, and ready-to-serve options when you’re feeling tired.
• Shop online and use community resources like meal delivery services such as Meals on Wheels. Every recipe page on our website has a digital shopping list and option to order groceries from local markets to have delivered to your home.
• Monitor your weight weekly and report any weight loss to your medical team immediately. Also monitor for dehydration and make sure your urine is clear or light yellow. Dark yellow or brownish urine is a sign of dehydration which should also be reported to your medical team.