Fatigue is the feeling of being tired physically, mentally, and emotionally. It is very common with cancer and its treatment, and often happens with radiation therapy. Managing fatigue is an important part of care for you and your loved ones.

Fatigue means having less energy to do the things you normally do or want to do. It can last a long time and can interfere with your usual activities. It is different from the fatigue of everyday life, which is usually short-term and relieved by rest. Cancer-related fatigue is more severe and more distressing. Rest does not always relieve it. Cancer-related fatigue can:

• differ from one day to the next in how bad it is and how much it bothers you
• be overwhelming and make it hard for you to feel well
• make it hard to be with your friends and family
• make you less able to keep up your normal activities, including going to work
• make it hard to follow your cancer treatment plan
• last different lengths of time, which makes it hard to guess how long you will have it

Only you know if you have fatigue and how bad it is. No lab tests or x-rays can diagnose or describe your level of fatigue. The best measure of fatigue comes from your own report to your doctor or nurse. You can describe your level of fatigue as none, mild, moderate, or severe. Or you can use a scale of 0 to 10, where a 0 means no fatigue, and a 10 is the worst fatigue you could imagine. Either way you choose, it is important to describe your fatigue to your cancer team.

Most people begin to feel tired after a few weeks of radiation therapy. Fatigue usually gets worse as your treatment goes on. Stress due to your illness, daily trips for treatment, and the effects of radiation on normal cells may also worsen fatigue.

The cause of cancer-related fatigue is not always clear. But if the cause of fatigue is known, treatment will be directed at the cause. For example, if anemia (low red blood cell counts) is thought to be causing fatigue, the anemia can be treated. In some patients, treatment may include correcting fluid and mineral imbalances in the blood. Increased physical activity, treating sleep problems, and good nutrition all seem to improve fatigue. Education and counseling are part of the treatment; they can help people learn how to conserve energy, reduce stress, and use distraction to focus on things other than the fatigue.

By understanding fatigue, you can cope with it better and reduce your distress. Often, a family member can help you talk to your health care team about your fatigue and how it affects you.

Fatigue will usually go away over time after your treatment is finished. Until then, there are some things that you can do to help you deal with it:

• Make a list of your regular activities in order of how important they are to you. Try to do the important ones first, when you have the most energy.

• Ask for help from loved ones and friends.

• Place things that you use often within easy reach.

• Use methods to reduce stress, such as deep breathing, visual imagery, meditation, prayer, talking with others, reading, listening to music, painting, or any other activity that gives you pleasure.

• Keep a journal of how you feel each day. Take it with you when you see your doctor.

• Balance rest and activities. Avoid too much bed rest, which can make you feel weak. Schedule activities so that you have time for plenty of rest. Most people find that a few short rest periods are better than one long one.

• Discuss physical activity with your doctor before you start any exercise program.

• Unless you are given other instructions, eat a healthy diet that includes protein (meat, milk, eggs, and beans), and drink plenty of water each day.

Let your doctor or nurse know about your fatigue and talk with them if:

• Your fatigue does not get better, keeps coming back, or gets worse.
• You are more tired than usual during or after an activity.
• You are feeling tired and it is not related to something you've done.
• You become confused or cannot focus your thoughts.
• You cannot get out of bed for more than 24 hours.
• Your fatigue disrupts your social life or daily routine.

If you need to take time off from work, talk to your employer. You may also have some rights that will help you keep your job. Call us or visit our Web site to get more information on fatigue, as well as information on the Americans with Disabilities Act and the Family and  Medical Leave Act. Some of these laws can help people with cancer.

Last Medical Review: 12/23/2008
Last Revised: 12/23/2008