Coping with Cancer-Related Fatigue

 Cancer-related fatigue is common and can affect quality of life but help is available

Cancer-related fatigue is common and can affect quality of life but help is available

We can all identify with the feeling of being fatigued: “exhausted”, “washed out”, “weary” and generally lacking in energy. Life can be stressful sometimes! And it can leave us feeling physically, mentally and emotionally drained from time to time. However, these feelings are often temporary, and energy levels will rise again when we have rested or the stressful event that we were experiencing has passed.

However, for some people who are experiencing cancer, “fatigue” can occur which feels much more severe, longer lasting and more disruptive to daily life than normal fatigue or tiredness. This is called Cancer-Related Fatigue (CRF). People with CRF often describe a persistent lack of energy, whole-body exhaustion and general weakness, which does not go away even with rest. Unfortunately, CRF is a common symptom of cancer and cancer treatment and can affect anybody regardless of their type of cancer, age, or stage of treatment. It has been estimated that one quarter to nearly all cancer patients experience fatigue during and after treatment. It is not surprising therefore, that Cancer-Related Fatigue is increasingly recognised as one of the most common and distressing side effects of cancer and its treatments.

Cancer-Related Fatigue has been defined as:

A distressing, persistent, subjective sense of physical tiredness and exhaustion related to cancer or cancer treatment, that is not proportional to recent activity and interferes with usual functioning.
— NCCN, 2016

What are the signs of Cancer-Related Fatigue?

Some symptoms that you may be able to relate to, according to the American Cancer Society include:

  • Constantly feeling overwhelming tired and lacking in energy
  • Feeling un-refreshed even after resting
  • Feeling exhausted after doing very little (for you)
  • Feeling as though you do not have the energy to complete the smallest task
  • Lacking motivation to do things you once enjoyed
  • Feeling tearful and frustrated
  • Feeling irritable and inpatient
  • Difficulty concentrating and remembering things
  • Difficultly making decisions or judging situations
  • Socially withdrawing as you feel you do not have the energy to mix with family or friends
  • Difficulty getting to sleep despite feeling tired
  • Reduced or diminished sex drive


What causes Cancer-Related Fatigue?

Current understanding of how and why CRF develops remains poor, and is currently under research. However, it is thought to occur because of a complex combination of both physiological and psychosocial factors.


How long does Cancer-Related Fatigue last?

Some people notice their CRF improves after therapy is completed, however for others, some level of fatigue may persist for months or even years following treatment.  Research indicates that for at least some of patients, fatigue may be a significant issue long into survivorship.


What help is available to manage Cancer Related Fatigue?

Unfortunately, a lot of people do not report fatigue to their doctors or other health care professionals because they think that nothing can be done to help it. In fact, there are many things that can be done to alleviate the debilitating effects of Cancer-Related Fatigue.  If left untreated, fatigue may lead to depression and profoundly diminish your quality of life, so it’s important that you speak to your healthcare team if fatigue is an issue for you.

Before you can address Cancer-Related Fatigue specifically, your doctor may need to determine if there are any underlying medical issues which may be contributing to your fatigue.  For example, if you are anaemic, you may need to take nutritional supplements like iron. Sometimes fatigue is confused with depression so it is important that you undergo a full assessment to distinguish between the two. You may experience one or the other, or both at once. But they are not the same. You may need treatment for depression as well as learning ways to manage your fatigue.

As we now know, Cancer-Related Fatigue is caused by many factors. It is not surprising therefore, that managing CRF involves looking at many different aspects of your physical, emotional and psychosocial health and well-being, as well as careful analysis of your unique experience of cancer-related fatigue. Your doctor may refer you to other health care professional who are best placed to help manage and address your unique challenges with Cancer-Related Fatigue. This often involves

  • Teaching you energy conservation strategies,
  • Modifying the activity or the environment,
  • Exercise therapy,
  • Education on diet,
  • Advising you on labour-saving equipment,
  • Exploring stress and anxiety management techniques and
  • Educating you on sleep management.

Cancer-Related Fatigue is best managed by an integrated team of healthcare professionals that place you at the centre of care. Health care professionals involved in helping you to manage your cancer-related fatigue include:


Placing you at the centre of care

How can Strive Clinic help?

The Cancer Rehabilitation and Survivorship Programme at Strive Clinic is a comprehensive, interdisciplinary and evidence-based programme of care for people living with or beyond cancer. If you would like to schedule an appointment for a Cancer-Related Fatigue assessment or if you have other needs after a cancer diagnosis you can call us on 091 393 180 or email for more information.  

Occupational therapy focuses on your unique experience of fatigue and the aspects of your life that have become disrupted by it. Occupational Therapy can help you to maximise your energy levels so that you can get the most out of every day.
— Kimberley Clarke, Occupational Therapist, Strive Clinic Galway