Many people with cancer experience decreased energy, also known as fatigue. The wide range of emotional and physical effects of cancer often means your energy “tank” can be low. Information about cancer-related fatigue and practical tips for improving your energy levels during cancer may help you understand this fatigue and take action to improve your symptoms. 

What is cancer-related fatigue? 

It is very common for people with cancer to experience fatigue. While fatigue is often referred to as “being tired,” cancer-related fatigue is different. Cancer-related fatigue feels like physical, emotional, and mental exhaustion but without any obvious identifiable cause, like lack of sleep or exhausting activity. It often interferes with daily life and functioning and may be short-term (lasting weeks to months), or long-term (lasting many months). It may persist after treatment has ended while the body is still recovering.  

Wondering if you might be experiencing cancer-related fatigue? Here are some of the symptoms that people commonly report:  

• Diminished energy or increased need to rest 

• Weakness or limb heaviness 

• Decreased motivation 

• Sleeping too little or too much 

• Unrefreshing sleep 

• Struggling to overcome inactivity 

• Increased emotional fluctuations 

• Difficulty completing daily tasks 

• Problems with memory 

• Tiredness lasting over multiple hours  

What causes cancer-related fatigue? 

Cancer-related fatigue can be caused by different factors, sometimes multiple factors at the same time. Here are some typical causes: 

• Cancer itself 

• Cancer treatments, like surgery, chemotherapy, radiation, or hormone therapy 

• Pain associated with cancer’s symptoms or side effects 

• Decreased nutrition caused by other side effects of cancer treatments, like loss of appetite, dehydration, nausea, vomiting, diarrhea, or mouth sores 

• Low levels of red blood cells that some people with cancer experience from the cancer itself or treatment — this is also known as “anemia” 

• Lack of physical activity 

• Medications 

• Emotions such as depression or chronic worry. 

Why is it important to address cancer-related fatigue?  

Studies show that cancer-related fatigue can significantly impact the quality of life and mood. Addressing it and finding ways to raise your energy levels can help promote emotional regulation, decrease distress, improve physical health/somatic symptoms, and overall make it a little easier to cope with cancer. 

Tips for improving your energy  

Move your body 

Even though exercising is probably the last thing you want to be doing when the exhaustion of cancer-related fatigue hits, try to get up and move around. Though it might not seem logical, studies have shown that maintaining or starting an exercise routine during treatment can increase your energy level. If light to moderate exercise has been approved by your doctor and if you’re feeling physically up to it, aim to get 20-30 minutes of activity each day. You can try fast walking, cycling, swimming, or strength training. Exercise abilities may go up and down during treatment based on numerous factors, so it is important to keep a flexible mindset and adapt to changing needs. Remember that any activity is better than no activity, so if all you can manage some days is a couple of walking loops around your living room, do that and be gentle with yourself.  

Attend to your mental health 

Talking with a mental health therapist specifically trained to help people with cancer might help you process emotions, reframe your thoughts, and improve coping skills to manage the life changes associated with cancer. With improved coping skills comes increased emotional capacity and increased ability to navigate the daily challenges that come with cancer.  

Practice healthy sleep habits 

Sleep hygiene means having a consistent nighttime routine and creating a bedroom environment that lends itself to restful sleep. Good sleep hygiene helps you get better sleep and eliminates lack of rest as a potential cause of cancer-related fatigue. Here are some tips to get started:  

• Minimize screens 30-60 minutes before bed 

• Make the room as dark as possible 

• Cover any shining lights 

• Reduce extra noise  

• Establish a nighttime routine 

• Reduce napping or sleeping during the day  

Conserve your energy when possible 

When you have cancer, you have a finite amount of energy and quite a few things that require your attention. You might consider trying these suggestions: 

• Prioritize activities and daily needs at the top of each day 

• Set realistic and flexible expectations for yourself 

• Try to follow a structured daily routine 

• Schedule activities during peak energy periods 

• Schedule time for rest during energy lows 

• Pace yourself throughout the day 

• Ask for help and delegate tasks to those around you 

Get adequate nutrition and hydration 

Cancer-related fatigue can be exacerbated by a lack of good nutrition and fluid intake. When someone doesn’t get enough calories or nutrients, our minds and our bodies can feel exhausted much faster. When we don’t drink enough water (or other non-caffeinated fluids), we are at risk of feeling mentally foggy and physically unwell. Do your best to eat a balanced diet and drink at least 8 cups of fluids each day to ensure your body has the fuel it needs.  

Practice mindfulness 

Meditative practices like yoga and mindfulness can help to improve the quality of your breathing and reduce the physical impacts of anxiety and worry that may contribute to your fatigue. Mindfulness, which is the state of being focused on the present moment, can be incorporated into your daily life and used during times of stress to help cope with cancer-related worries. While these practices do not directly improve cancer-related fatigue, they can help alter your experience of it. You can practice meditation and yoga on your own or try this mindfulness exercise.  

Be aware of and treat any underlying cause 

Cancer-related fatigue is hard to address when there are underlying medical conditions that might be causing or worsening your fatigue. Talk to your doctor or Iris team about medical conditions, medications, and other factors that might be contributing to your energy levels.  

When to contact your doctor  

If you experience any of the following, let your oncologist’s office know so that they can help address your fatigue and make recommendations to improve your current quality of life:

• Fatigue that limits your ability to care for yourself 

• Increasing shortness of breath with minimal exertion 

• Uncontrolled pain 

• Inability to control side effects from treatments (such as nausea, vomiting, diarrhea, or loss of appetite) 

• Uncontrollable anxiety or nervousness 

• Ongoing depression 

You can also contact an Iris nurse or mental health therapist to get personalized support for your cancer-related fatigue.  

Communicating with your medical team 

Open and honest communication with your doctor and medical team can help you better understand your cancer-related fatigue. Asking for information can empower you and may help provide ways to increase your energy levels during and after cancer treatment. Consider the following list of questions to guide your conversations with your doctor. 

• What can I do to prevent fatigue?  

• When should I expect to feel the most fatigue? What time of day? What period of my overall treatment plan? 

• Are there medications that you can prescribe to treat my fatigue? Are there supplements I should consider taking? 

• At what point should I worry about my fatigue?

Take Aways 

While cancer-related fatigue is common for people coping with cancer, knowing when to seek additional help can ensure support and interventions when needed. Cancer-related fatigue impacts mood and quality of life — consider communicating with your medical team or Iris Care Team for added support or for help in tailoring the above tips as you navigate this particularly challenging aspect of cancer care.