Many health professionals may be part of fatigue treatment. Treatment may involve doctors, nurses, social workers, physical therapists, nutritionists, and a number of others. Education and counseling are part of the treatment and help you learn how to save energy, reduce stress, and distract yourself from the fatigue.
Fatigue is often caused by more than one problem. Treating a certain problem, like anemia, may make you feel better, but other things may still need to be done. For this reason your health care team may have you try many different things to help your fatigue. These may or may not include medicines.
If the cause of fatigue is known, treatment will focus on the cause. For example, if anemia is adding to your fatigue, the anemia can be treated. In another patient, treatment may include correcting fluid and mineral imbalances. But sometimes it is hard even for the doctor to figure out exactly what’s causing a person’s fatigue. Still, a program of regular exercise, managing your stress, and finding ways to deal with anxiety and depression seem to help most people deal with fatigue. Treating sleep problems and correcting nutrition problems can help fatigue, too. Keep in mind that it may take up to 8 weeks of treatment before you notice your fatigue getting better, but for some people it happens faster.
Tips for managing fatigue
Save your energy
Saving or conserving energy is one way to make sure you have enough energy to do what needs to be done each day. You may need to accept the fact that you can’t do everything you want to do. Each day, decide which things are the most important to do and focus on those tasks. Do things slowly, so that you will not use too much energy as you go. Let others help you. This can help them feel useful and get your tasks done, too.
Distraction
Sometimes feeling tired can become so discouraging and frustrating that it’s easy to let it become the focus of your thoughts. Try to distract yourself with other things, like listening to music, having relaxing visits with friends or family, or reading a book. These things can give you an escape from your fatigue without using up too much energy.
Attention-restoring activities
Certain activities can help you relax, focus better, and direct your attention under stress. These activities include things like walking on a beach, sitting in a peaceful setting, gardening, doing volunteer work not related to your illness, or bird watching. Some people use meditation or guided imagery to clear their minds without leaving home, using books, CDs, or other audio instructions.
Reduce stress
Having cancer is stressful and cancer treatment can cause even more stress. Talk with a social worker or nurse on your health care team about your level of stress. This can help you know if it is “normal” stress or more worrisome anxiety or depression. Feeling tired may be linked to feeling depressed and anxious. Support groups, mental health counseling, stress management training, and relaxation exercises are some ways you can improve the feelings related to fatigue and help you overcome the tiredness you feel.
Exercise
Research has shown that there are some ways to improve your energy and activity level that do not involve medicine. Aerobic and strength building exercise programs – started only with your doctor’s OK – can lead to better body function, as well as feeling better about your life and well-being. You may need to see a physical therapist to build stamina and learn the best exercise routines for you to follow at this time. You must be careful about any form of exercise if you have any of these:
- Cancer that has spread to your bones (bone metastasis)
- A low white blood cell count
- A low platelet count
- A fever or active infection
- Anemia
- Unsteadiness, frailty, or other problem that might make exercise unsafe for you
These factors can lead to injury, pain, bleeding, or other problems if they are not taken into account before you start to exercise. If you have any of these factors, your exercise program will need to be set up by a professional who knows about exercise and cancer.
Not only can the right amount and type of exercise help fatigue, it can also help you sleep better. Another benefit of exercise is that it may make your mood better, too.
Nutritional counseling
Many cancer patients have changes in the way they eat, swallow, and taste things during treatment. Talking with a registered dietician may help you learn ways to manage problems like loss of appetite, diarrhea, nausea, or vomiting. The dietician also can make sure you are getting enough fluids and nutrients to help keep your blood chemistry balanced.
Sleep improvement
Sleep problems are common during cancer treatment. You may have trouble falling asleep or sleep too much. Certain drugs that are used to treat pain, nausea, or depression can cause a person to feel tired and sleepy. Talk with your doctor about this. Sometimes adjusting the doses or changing to a different drug may help.
Sleep experts tell us that having a regular time to go to bed and get up helps us keep a healthy sleep routine. Avoiding caffeine in fluids (like coffee, tea, or soda), medicines (like headache remedies), or even in foods (like chocolate) can help, too. Do not exercise too late in the evening; this may cause sleep problems. Naps may be needed, but try to keep them short (under an hour) and early in the day so they don’t interfere with nighttime sleep. If you are having trouble with sleep, it can help to see a mental health professional who can work with you on causes and how to address sleep problems.
Medicines
There is no magic pill that can make you less tired and give you more energy. But there are some medicines that may help you with your fatigue. In some cases, fatigue may be bad enough that your doctor or nurse may recommend a stimulant medicine for a short time. Examples of this type of medicine are methylphenidate hydrochloride (Ritalin®) or modafanil (Provigil®). These have been shown to help at least a little with fatigue. Anti-depressant drugs and steroids have also been used to try and help fatigue. If you are having problems sleeping, your doctor or nurse may suggest a medicine to help you sleep.
More research is needed and is being done in this area, but there are drugs available that may give you relief if your fatigue gets bad.
Other types of treatment
Some cancer centers offer special mental health programs for people dealing with fatigue. Mental health professionals and education specialists may share techniques as well as help people to find and use emotional energy. Some people with cancer find physical techniques helpful, such as massage from a licensed massage therapist. If your cancer treatment center doesn’t have these services, ask a cancer team member if there are other resources for them in your area. You can also call us to see if there are places near you that can help.
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