Feeling tired Feeling exhausted is one of the most common side effects of cancer treatment. It’s frustrating, so do what you can to make your daily chores less tiring and keep in mind that your energy levels are likely to get back to normal after the treatment stops.
Fatigue comes from fighting cancer Chemotherapy and radiotherapy have a negative impact on your body’s normal cells as well as the cancer cells they’re trying to destroy. The effort your body goes through to repair those damaged normal cells can leave you feeling exhausted. Fatigue can also be a side effect of biological therapy, hormonal therapy and some types of surgery.
Both chemo and radiotherapy can also reduce the number of red blood cells in your body and that can cause anaemia. If you have anaemia you may feel light-headed and you may find it hard to sleep. Your care team might recommend you have a blood transfusion to quickly boost your red blood cell levels. Or they could suggest you take a drug that stimulates the production of red blood cells.
Try new housework habits
Take your time Aim to get a little done each day, not everything at once. Try sitting down while doing tasks like ironing, preparing food and washing up.
Change your tools Buy or borrow long-handled dusters and dustpans so you’re not up on ladders or down on your knees. Instead of hanging out clothes, use a clothes horse or a dryer. Reaching above your head can be tiring.
Spread the load Don’t be shy about asking friends and family to do the heavy household tasks like laundry and putting out the bins.
Get smart about shopping
Make a list Your memory may be fuzzy from fatigue. Write things down.
Use a trolley Lifting heavy bags is tough. Use a wheeled trolley instead.
Shop online Major supermarkets in the cities and some regional centres offer online shopping. Put in an order online and they’ll deliver to your door.
Change the way you cook
Cook in big batches If you’re feeling well enough to cook, cook extra and freeze the leftovers to use on days that you’re tired.
Take the plates to the pots Don’t drag heavy saucepans off the stove to serve up a meal; instead take the plates to the stove and dish it up there.
Eat little and often Smaller meals are quicker to prepare and may be easier to digest. They’ll also help keep your body fuelled up throughout the day.
Take up some exercise
Get moving Gentle exercise like walking and swimming can reduce your fatigue and may even help with nausea. On days when you exercise, make a note of how it makes you feel. Do you have more energy? Do you sleep better? It could be the motivation you need to get active another day. But don’t overdo it. Gentle exercise energises you; excessive exercise is exhausting.
Get a better sleep routine
Set the body clock Go to bed at the same time every night, and get up at the same time, too. It can help your body to lock into a sleep routine.
Have a bedtime snack A light snack or a warm drink, such as hot milk or a herbal tea, can help settle you into sleep. Avoid stimulants like caffeine, alcohol, chocolate and sugary foods. Cut them out of your diet altogether, or at least avoid them in the last few hours before bedtime.
Words to know
Anaemia a drop in red blood cells leading to a decrease in the amount of oxygen in your body, leaving you tired, breathless and more prone to infection
Fatigue excessive tiredness all or most of the time
Expert's insight: Elizabeth Pearson Elizabeth Pearson heads up the Occupational Therapy Department at Melbourne’s Peter MacCallum Cancer Centre. As part of a small team of five, she advises people with ongoing fatigue issues and sleep problems.
“There are five areas to cover when managing fatigue. The first is symptom management. Always make sure your symptoms are adequately managed, whether it’s anxiety, pain, nausea or depression.
“If those problems are being managed, exercise is essential. The thing about cancer-related fatigue is that it’s not relieved by resting more. Maintain a similar level of activity after a diagnosis to what you were doing beforehand. Of course, exercise will be helpful for people in the early stages of cancer, but it’s obviously more difficult for people with an advanced disease.
“I’d advise light to moderate exercise about four times a week. Walking for half an hour a day is a good one, and it’s easy to do with a friend, partner or a neighbour. You should feel good the next day from doing it. Importantly, develop a routine. If you have a dog, the routine is often already in place. Pedometers are also a good motivator. You can set targets on how many steps you take per day.
“The third area is sleep efficiency. Quality sleep will help your body recover, so go to bed at your regular time, and use your bed for sleep and intimate relations only. Read a book elsewhere, watch television in the living room, and don’t get involved in stimulating activities before going to bed.
“Fourth is stress management through relaxation. Some people get benefit out of meditation. If you can relax your body, your quality of rest should improve, giving you a sense of control and wellbeing.
“The final area is nutrition and hydration. Develop a diet that’s going to give you energy. Some people change their diet dramatically after a cancer diagnosis. Don’t cut out carbohydrates and proteins altogether. When you’re ill, you’ll need more energy to repair your tissues and muscles.”
More help
Practical Ways of Dealing with Cancer-related Fatigue www.petermac.org The Peter MacCallum Cancer Centre has produced a comprehensive booklet about fatigue management. Go to the website and follow the links Health Professionals > Occupational Therapy > Managing Fatigue then download the booklet called Practical Ways of Dealing with Cancer-related Fatigue.
Photo by Bruce Daly
LYNETTE BEATTIE Lynette Beattie is no stranger to the fatigue caused by treatment for cancer. She had surgery and her first round of chemotherapy when she was diagnosed with ovarian cancer in 2008.
Recently she commenced a second round of chemo when cancer was found in several lymph nodes. As before, she is experiencing fatigue, which she manages with exercise, diet, rest and naturopathy. A writer by trade, Lynette has penned her memoir and regularly posts poems, pictures and writing online* for family and friends.
“Physically, I tend to feel as if my bones have gone soft. I don’t like standing and I can’t really sit up in an upright chair much. I have a wonderful recliner chair, which tips me back and allows me to read a little.
“Generally, I get very good at seeing things that need doing and just walking away. I just can’t face them. It’s lethargy I suppose – not being able to keep up with everything.
“Exercise is good for fatigue. You mightn’t feel like doing it, but you feel better afterwards. I find that swimming is very good. It doesn’t feel as difficult as walking or going to the gym. The water’s supporting you and you get into a rhythm. I swim a lot if I’m having bad chemo. I do 20 laps the morning that I have chemo, just to be fit for it. I go to a naturopath and she gives me a few herbal mixtures that are supposed to help with fatigue. I’m also really careful with my diet. I make a fresh juice every morning and drink a lot of water.
“I do a lot of sitting and reading and writing. I sleep in the afternoons and I’m always in bed by 10pm. With chemo I wake up early, about 4.30am or 5.30am. But I’m a morning person anyway.
“Concentration is a problem. I do such forgetful things. I bought a ticket at the train station today and just walked off without it. They call it ‘chemo brain’, but I can tell you it’s real.”
* MyLifeLine.org provides free websites to people with cancer to record their thoughts and keep family and friends up to date.