Key takeaways
- There are many reasons for fatigue: Establishing the specific causes of your post-treatment fatigue can help you manage it effectively.
- Be realistic: Take a sensible approach to what you can and can’t do. Don’t push yourself and plan ahead when you can.
- Speak to a specialist: Get advice from your GP, care team or a cancer specialist for personalised support and to discuss options for managing your fatigue.
Fatigue is very common after a diagnosis of cancer. Although it affects everyone differently, it can last for many months after cancer treatment ends. Cancer related fatigue (CRF) has many causes and is often the most disruptive to a person’s life.
Fatigue is extreme tiredness and exhaustion. It doesn’t always go away with rest or sleep and may affect you physically and emotionally. It’s a very common side effect of breast cancer and its treatments, and may last for weeks, months or longer after your treatment has finished.
Our guide explains the causes of fatigue after cancer treatment and explores how you can manage tiredness through lifestyle changes, everyday adjustments and specialist support.
Reasons for fatigue
There are many causes of CRF; you might be experiencing one or several. However, pinpointing the specific cause or causes of your fatigue can help you to manage it.
There may be many reasons for it, including:
- the cancer itself
- cancer treatments
- anaemia (low number of red blood cells)
- loss of appetite
- pain
- other health conditions, such as diabetes
- trouble sleeping
- your feelings, such as anxiety
Pain
Some people with cancer experience pain either from the cancer itself or as a side effect of treatment. Pain can make it hard to rest and sleep, leaving you feeling drained. It also takes significant physical and emotional energy to deal with pain, which adds to fatigue.
Psychological effects of cancer
Many people with cancer experience depression, anxiety and stress and poor sleeping patterns; all of which can lead to physical side effects and fatigue.
Anaemia
A low level of red blood cells (anaemia) can be a result of cancer itself or cancer treatment. If you have anaemia, your body doesn’t receive enough oxygen-rich blood and this can leave you feeling weak and tired.
Poor appetite
Eating after chemotherapy isn’t always easy and cancer itself can reduce your appetite. Fatigue can occur if the body doesn’t get enough food, especially if your calorie intake isn’t enough to cover the energy your body needs for its most basic functions.
Managing tiredness
It’s important to talk to your hospital team or GP about CRF. They can then check to see if you are anaemic. The lifestyle changes you can make and support you can seek to manage fatigue include:
Quality sleep
If you aren’t sleeping well at night, this can result in an increased need for naps during the day and feeling more tired overall. It can be beneficial to put a sleep routine in place that caters for at least seven hours of quality sleep a night. Set a regular bedtime and stick to it, and establish a wind-down routine that involves limiting your use of electronics. Also ensure your sleep environment is dark, quiet and comfortable.
Eating well
A well-balanced diet consisting of fresh, nutrient-rich foods can help reduce fatigue. Your body can function more effectively when you meet its nutritional needs and provide all the necessary vitamins and minerals. Dehydration can further contribute to fatigue, so also make sure you are drinking plenty of water each day.
Physical activity
Exercise after cancer treatment can actually reduce fatigue. This is because physical activity releases ‘feel good’ endorphins, making you feel more energetic. The exercise doesn’t have to be intense. There are many benefits to walking after chemotherapy, for example, as not only can it help tackle fatigue but it can also lift your mood and improve sleep quality. If walking isn’t your thing, light gardening or a gentle swim are other good options.
Counselling
Talking therapies can help you come to terms with your emotions and give you the tools you need to manage them. Being able to process your feelings more effectively can reduce internal ‘noise’ and physical symptoms that interrupt your sleep. Counselling can also help you to reframe your perspective about your fatigue and improve your coping skills.
Complementary therapies
Complementary therapies, such as massage, yoga and aromatherapy can be beneficial for both the body and mind, indirectly helping to reduce fatigue. For example, meditation can reduce anxiety in cancer patients, and some studies suggest that acupuncture can reduce pain.
Making adjustments
There are changes you can make that can help you deal with your fatigue. These adjustments will differ from person to person and will likely shift from day to day depending on how tired you feel. You may also find it helpful to plan things in advance and ask for help from family and friends to make everyday tasks more manageable.
At home
It’s a good idea to categorise the things that have to be done and those that you would like to do, in the home. This can help you to prioritise where to focus the energy that you do have. Small changes can also help you feel less tired such as:
- Ordering your food shopping online rather than going to the supermarket
- Making simple meals or batch-cooking dishes that can be frozen for a later date
- Wearing comfortable clothes
- Staggering chores
- If you have children, plan activities that aren’t physically demanding or ask friends and family if they will provide some childcare
- Alternate active and quiet tasks, for example, dusting and house admin
At work
When returning to work after cancer, your employer should make reasonable adjustments for you to make things easier and allow you to carry out your job effectively. Think about what you need and what will help. These adjustments might include:
- A phased return
- Changing your hours
- Reducing your hours
- Working from home
- Longer breaks
- Lighter duties
- Sharing responsibilities with a colleague
- Closer parking to the office
If you’d like more support around living beyond cancer and managing fatigue, Perci Health is here to help. Our cancer nurse specialists have a broad understanding of cancer and can answer any questions you may have, while our clinical exercise coaches offer practical advice and exercise programmes to improve your strength. Find out more about them, and book on-demand appointments by signing up for a Perci Health account.