5 mins. read

Practical tips from an occupational therapist for improving CRF

A Perci Occupational Therapist shares helpful ways to think about fatigue, and ways to manage it at home and work

Key takeaways

  • When you feel energised, do little and often, balancing activity with rest so you don’t overdo it
  • The five Ps of fatigue management, Pacing, Planning, Prioritising, Permission and Positioning, can help you decide when and how to spend your energy at home
  • While at work or when returning, think carefully about the days and hours that will help you balance work and recovery, as well as how you’ll travel
  • Activities that help improve your cancer-related fatigue will be unique to you. Take time to find out what works.

It’s common for people experiencing cancer-related fatigue to get stuck in a cycle of feeling tired for a time, then overdoing it when they feel better, which causes more fatigue and requires more recovery time. By thinking consciously about how and when to spend your energy, and giving yourself plenty of rest, you can give your fatigue a chance to improve and begin to build up your activity levels. In this article, a Perci occupational therapist introduces the ‘boom and bust cycle’, five Ps that can help you at home and simple strategies to support you at work.


Why do I feel energised for a day or two, then tired again?

Occupational therapists call this the ‘boom and bust cycle’. Those recovering from cancer treatment will feel very fatigued for days, then might wake up and feel energised, so they cram lots of activities into that one day and overdo it. Then the next day, they can’t get out of bed, and the cycle continues. 

Try to think of your energy like a phone battery. If you’re operating at less than 75% battery because you have cancer-related fatigue, and you drain your whole battery very quickly, it’s going to take a long time to recharge again. The key is to do little and often so you don’t use up all your battery and it doesn’t take as long to recharge.

What strategies can I use at home if I’m experiencing CRF?

When managing cancer-related fatigue at home, it can be helpful to think about what OTs call the ‘Five Ps of fatigue management’: 

1. Pacing

Balance any activity you do with quality rest and take frequent breaks. As your fatigue improves, you can build up from one task at a time, to two, and so on.

2. Planning

Can you schedule activities at the times of day when you generally feel the most alert, and on days of the week when you’re more likely to feel rested?

3. Prioritising

Choose the most important activities to do each day. Remember to choose activities that you want to do, and not just what you should do, as these don’t always give you energy.

4. Permission

Give yourself permission to ask for help from others, and give others permission to do tasks for you. People want to help, so let your friend do the washing up when they visit.

5. Positioning

It’s easy to expend a lot of energy on things that aren’t important, like going up and down stairs, bending and twisting, and standing up when you could be sitting. For example, can you sit down to prepare food?

What strategies can I use at work?

Many people living beyond cancer give up work because they can’t manage their fatigue. But there are lots of ways to  manage your energy at work and help you cope. 

  • Part-time hours
    If your company agrees to part-time or a phased return to work, be careful not to schedule all your work time in one block, as you’ll then need days to recover. For instance, work Monday, Wednesday and Friday instead of three days in a row.
  • Non-commuter hours
    It’s easy to waste vital energy waiting for buses or standing up on trains during busy commuter times, so ask for hours that mean you can travel when it’s quiet and you can sit down. 
  • Take breaks
    Consider not just physical fatigue, but mental fatigue as well. Back-to-back meetings can be very draining so schedule in breaks and don’t be afraid to tell people, ‘Can I come back to you after I’ve had a break?’
  • Make time for relaxation
    Relaxation can help make sure you don’t become overwhelmed and stressed, which can be very draining. Spending time outside while at work is a great way to relax, or perhaps your company can create a relaxation room? 

What else might help for improving CRF?

Activities that help improve your cancer-related fatigue will be unique to you. For example, some people find seeing family incredibly energising, while for others it’s draining. Some other ideas include walking in nature and swimming; creative activities like painting, music or cooking; gentle exercise like yoga or Tai Chi, massage, meditation or relaxation therapy. 

Support groups or cognitive behavioural therapy may also help you cope with cancer-related fatigue. Acupuncture has also been found to be very helpful for some, but check with your medical team first that it won’t interfere with any treatment you might be having.

While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.