Coping With Fatigue After Cancer Treatments

by Jane Ashley

Everyone seems to realize that fatigue is a part of cancer treatment, but most of us assume that fatigue will go away soon after treatment. We hope and expect that we’ll get back to “normal” and that life will be just like it was before.

Yoga For Fatigue

But for many of us, the fatigue just doesn’t go away. Fatigue lingers, sometimes for years after treatment. For most of us, it gradually gets better … but we’re just never quite the same. We don’t have the stamina we once had.

Don’t feel guilty — it’s real.

Studies over the last 20 years confirm that lingering fatigue is one of the most common complaints of patients who have completed cancer treatment. The studies suggest that virtually every cancer patient regards fatigue as a significant problem and that post-treatment fatigue may last for years after treatment.

Despite the prevalence of post-treatment fatigue, researchers don’t know the physiological causes.

One study found that patients over the age of 65 (many who were treated decades before) experienced more fatigue on a treadmill and walked slower than people who had never had cancer. The study is an ongoing project of the Baltimore Longitudinal Study of Aging — they began including endurance and fatigue in 2007.

The Complexity of Fatigue

Gingseng Fights Fatigue

Since researchers haven’t learned what causes our on-going fatigue, cancer-related fatigue (CRF) may be caused by some things coming together to cause our fatigue. CRF overlaps with cognitive issues (aka chemo brain) and sleep issues. In spite of blood work being normal, many cancer survivors experience CRF.

Some of the causes of fatigue include:
• Anemia
• Cardiac function
• Deconditioning/lack of exercise
• Dehydration
• Depression
• Diet
• Metabolic abnormalities
• Sleep disturbances/insomnia
• Stress/anxiety
• Thyroid malfunction

Most patients resort to trial-and-error to combat and cope with their fatigue.

Proven Ways to Help Fatigue Symptoms

Insomia Avoid Caffiene

There are several well-researched ways to decrease our fatigue. We might have to try once or twice and tweak what we do, but there is encouraging research to support some ways to help our cancer-related fatigue (CRF).

• Exercise. The University of Rochester Medical Center (Wilmot Cancer Institute) analyzed over 100 randomized clinical trials testing treatments for cancer-related fatigue. Their analysis looked at more 11,000 patients. Exercise, regardless of what type, was the most effective treatment for CRF. Researchers at Wilmot have 15 years of research from various sources which support the fact that exercise is the best treatment for cancer-related fatigue. Exercises that seem to work best include walking, gentle yoga and resistance bands. Yoga appears to be particularly beneficial for cancer survivors.

• Ginseng. A Mayo Clinic study showed that higher doses (2,000 mg. of American ginseng) reduced cancer-related fatigue significantly after just eight weeks. (NOTE: The ginseng utilized was American ginseng , not the traditional over-the-counter ginseng which may be processed with ethanol.) At four weeks, no improvements were seen, but at eight weeks, a 20-point improvement occurred.

Tips to Help with Daily Life

The real causes of post-treatment fatigue aren’t known. That’s why it’s difficult to treat. But all of us learn “tricks and tips” to live productive lives.

• Pace yourself. Don’t bite off more than you can chew. Start small and build up your stamina until you everything on your list. You don’t have to finish a project in a single day.

• Be realistic. You know how you feel — others don’t. Your yard doesn’t have to win an award. Your house doesn’t have to be squeaky clean. You don’t have to go to every family gathering that lasts past midnight.

• Alternate tasks. Do a strenuous task for 30 minutes. Switch to a seated project like paying the monthly bills. Then so back to the strenuous task again.

• Weather extremes. Avoid working outside in extreme temperatures or high humidity.

• Delegate tasks if possible. If someone offers to do the dishes or mow the lawn, accept their offer. Ask for help when you need it.

• Stay hydrated. Especially in the summer, stay hydrated. Dehydration may cause weakness or dizziness.

• Enjoy a hobby. Mental fatigue affects our ability to do physical activities. Postpone chores that aren’t essential to enjoy a hobby that you enjoy.

Is Insomnia to Blame?

Many cancer patients complain of insomnia. The reasons are varied, including anxiety, fear of recurrence, pain and discomfort, excessive trips to the bathroom at night and more.

If you don’t sleep well at night, you’re going to feel tired during the day. Melatonin is a proven sleep aid and is well worth trying. Don’t drink caffeine after 2 p.m. Limit computer and smartphone time before bedtime. Sleep in a quiet, cool, dark room. Hot flashes rob many women of a good night’s sleep.

Talk to your oncologist or primary care physician about ongoing insomnia and inability to sleep.

What Next?

Be patient with yourself. Every person is different. But try to do a little bit more every week. Begin walking around the neighborhood. One block, then two blocks. If you enjoy swimming, start swimming again. It’s easy on the joints. Begin that hobby that you’ve always wanted to do. A mental reward after cancer treatment is part of recovery.

One step at a time — one day at a time.

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