What is cancer related fatigue?
Cancer-related fatigue (CRF) is a common side effect of both blood cancer and blood cancer treatment.
- It’s more than being tired.
- It’s different from normal everyday tiredness.
- It doesn’t go away with a good night’s sleep.
- More than 80% of people with cancer suffer from fatigue at some point.
Fatigue is feeling tired, weak, slow, and having no energy. It’s not related to how busy you are, and it can affect your social and working lives.
Symptoms
Having no energy, even after a good night’s sleep, is the most common symptom of cancer-related fatigue.
Other symptoms include:
- tiredness
- weariness
- difficulty concentrating
- nausea
- poor appetite
- stress
- pain.
You may be feeling generally worn out and unwilling to participate in activities and things you normally enjoy. Your concentration might not be at optimal levels which could affect how you make decisions. Pain in your legs and back might appear for no reason. Symptoms of fatigue are often very general but can affect you emotionally and physically.
Causes of CRF
There are many causes of CRF. They can be linked to your blood cancer and its treatment.
Common causes
- A reduction or change in your activity levels.
- Hormone imbalances causing disrupted sleep.
- A weakened immune system that requires energy to recover from treatments.
- Uncontrolled pain.
- Loss of appetite and nausea.
- Anaemia from your treatment or blood cancer.
- Anxiety and emotional distress.
What can you do about CRF?
Make sure you tell your treatment team if you are feeling persistently tired.
They can:
- refer you to a dietitian or exercise physiologist for support
- ask you specific questions to see what is causing fatigue
- do blood tests to find out what might be contributing to your fatigue.
Questions to ask your treatment team
- What is causing my CRF?
- What can I do to have more energy?
- How much sleep should I get each night?
- Is it helpful to take a nap during the day?
Helpful strategies to manage CRF
Below you will find a list of strategies to help you manage your CRF. There are a lot of strategies available. These are a few ideas. Your treatment team or peers may have some other helpful resources.
Click on the headings below to read more about each strategy.
The 5 P’s for energy conservation is a strategy you could use to remind yourself how to manage your energy. This could be important at any time during your blood cancer journey. Whether you are having active treatment, are under ‘watch and wait’, having supportive care or are in survivorship.
Plan
Try to plan your activities for when you have the most amount of energy, especially if it is an activity that is going to make you feel good in other ways.
Prioritise
Prioritising your daily activities means deciding what’s most important and needs your attention first. Ask yourself for each activity:
- Is it urgent?
- Is it important?
Balance is key.
Pace
Pacing yourself means balancing getting things done by taking breaks, so you don’t get too tired. Spread your activities out; you don’t have to complete them in one go.
Position
Consider your body position when you do activities.
- Try sitting rather than standing to do tasks.
- Avoid awkward postures like twisting, kneeling, and reaching.
- Keep your limbs close to your body, especially when you are carrying something.
- Coordinate your breathing with movement; this can help you feel stronger.
- Inhale before you lift/push/pull something.
- Exhale as you lift/push/pull something.
Consider your living environment and how accessible it is.
- Store ‘most used’ items within reach. This means between waist and shoulder height for you.
- Keep items in rooms where they are most frequently used, so you don’t have to carry them from one end of the house to the other.
- Use a wheeled cart to move things around the house.
- Place chairs in a position where you might want a rest, like halfway down a long hallway.
Permission/Pause
It is important to stop and rest frequently. Resting and relaxing throughout the activity, day, week, or month, is more important than trying to get everything done at once. Give yourself permission to pause.
Having a sleep routine and a good bedroom environment can help improve sleep and manage fatigue.
Here are some tips on how to do that.
Try a pre-bed routine like:
- relaxation techniques
- avoiding screen use 30-60 minutes before bed
- dim the lights
- soothing tea.
Try different relaxation methods like:
- listening to calming music
- meditation
- deep breathing.
Have a regular sleep and wake up time.
Limit in bed activity by:
- using the bedroom for sleep only (with sex being the one exception)
- removing phones or TV from the room.
Make your bedroom comfortable by:
- having a comfortable mattress and pillow
- dimming lights
- keeping it at a cool temperature (around 16-22C°).
Good nutrition and hydration prevents tiredness and dehydration, which can improve the feeling of tiredness.
Here are some tips to help get you started.
- Try small frequent meals to prevent feeling over full and tired after eating.
- Limit alcohol and caffeine.
- Seek the support of a dietician for a personalised plan. Your treatment team or GP can refer you.
- Download our Eating Well booklet for more comprehensive information and strategies.
- Read more about nutrition and blood cancer on our website.
Watch our webinar on nutrition and blood cancer, made simple.
Therapies that encourage relaxation and rejuvenation might help you manage your CRF. Visit our complementary therapies webpage for more information.
Activities might include:
- yoga
- mindfulness
- meditation
- arts and crafts
- music therapy.
A mindful moment
Listen to our webinar on yoga and blood cancer. You can also download resources to help you get started.
Small amounts of exercise may help you feel more energised. Remember to exercise within your ability. Setting small goals might help.
You could try activities such as:
- walking
- cyclings
- swimming
- yoga
- qigong.
Tasks like gardening, cleaning the house, and collecting mail are also considered exercise. It is important to discuss the type of exercise you’d like to do with your treatment team. They may recommend some activities, but they may also advise against some activities. This is very important if you have cancer in your bones.
Resources
- Choose Health: Be Active is a physical activity guide for older Australians developed by the Australian Government and Sports Medicine Australia.
- Watch the Leukaemia Foundation’s short video on cancer related fatigue.
- Watch this webinar on cancer related fatigue and the role of exercise.
- Read this factsheet on dealing with cancer related fatigue, developed by the Australian Cancer Survivorship Centre.
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Fatigue factsheet
pdf / 2.23 MB
