Cancerwise

If you’re always feeling exhausted, you’re not alone. This is especially true if you just finished or are still undergoing cancer treatment.  

“Fatigue is the most common side effect experienced by patients both during and after cancer treatment,” says internal medicine specialist Carmen Escalante, M.D.

But cancer-related fatigue tends to go undiagnosed, both because many patients are reluctant to discuss it and there’s no real way to test for it. 

“There are no imaging studies or blood tests available to quantify fatigue,” explains Escalante. “So, when we evaluate patients for cancer-related fatigue, we have to consider many factors.” 

The good news is that it’s still possible to reduce cancer-related fatigue. Escalante explored this topic in a recent Cancerwise podcast with internal medicine specialist Lucy Potter, M.D.  

Here are three highlights from their discussion. 

You don’t just have to accept cancer-related fatigue 

Some patients don’t want to talk about cancer-related fatigue because they don’t want to complain. Others worry that if they tell their care teams about their fatigue, it could result in a change of medication, making their cancer treatment less effective.   

“But don’t believe that fatigue is just a part of the package, and you have to accept it if you want optimal cancer treatment,” says Escalante. “Because that is not true. Fatigue is a legitimate side effect, and there are several things we can do to improve it. So, patients should definitely bring it up.” 

Cancer-related fatigue can be treated

Physicians tend to focus on three main strategies when treating patients for cancer-related fatigue.  

Exercise

This may sound counterintuitive, because the last thing we usually want to hear is that we need to get moving when we’re really tired.  

“But the best data we have shows that both fatigue and quality of life improve significantly when people exercise regularly,” Escalante says. “It can also help with weight control, depression and anxiety. So, there are many benefits to exercising, even if you’re receiving cancer treatment.” 

If you’re able, aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. But start with what you can, as even small amounts of physical activity are beneficial during treatment. 

Prioritizing tasks and activities

This means reviewing your daily or weekly activities and defining which ones are the most important to you. Which tasks must you absolutely complete, for example, and which ones can you delegate or put off indefinitely? 

“Prioritization also means knowing what time of day you have the most energy, so you can take on your hardest tasks then,” adds Escalante. 

Saving your energy for the most important activities  

This means saving up your strength for the activities you really value. It also means finding ways to make them less strenuous.  

“Many of my patients enjoy gardening,” explains Escalante. “But getting up and down from the ground can be very tiring. So, can you work on a raised garden, instead, or sit at a table and pot plants?”