Fatigue

People with cancer commonly experience fatigue as a result of the challenges of cancer and particularly of cancer treatments.

People with cancer commonly experience fatigue as a result of the challenges of cancer and particularly of cancer treatments. This type of fatigue “may feel like persistent physical, emotional, and mental exhaustion. Cancer-related fatigue is different than feeling tired after not getting enough rest. It interferes with daily life. It does not match the person’s level of activity. It does not improve with rest.” Fatigue may continue long after cancer treatment ends.¹

Managing Fatigue

Helpsy Health

Even when people are getting the best of cancer treatment, they often feel like they need more help with organizing their care and managing symptoms and side effects. Helpsy empowers members to take control of their health through a real-time virtual nurse support service. This service is available via mobile devices, a Helpsy website and automated phone calls.

Dr. Markham’s Recommendations

Cancer clinicians and researchers are diligently looking for effective ways to manage cancer-related fatigue. Merry Jennifer Markham, MD, describes eight ways to cope with cancer-related fatigue:³

Get treated for medical conditions or causes that make fatigue worse.
Get moving.
Take time to relax.
Eat well.
Practice good sleep habits.
Engage in mind-body strategies.
Consider therapy and counseling.
Get a massage.

Several complementary approaches can be helpful for fatigue. The Society for Integrative Oncology (SIO) clinical practice guidelines list integrative therapies with evidence for effectiveness in fatigue:⁴

Cognitive-behavioral therapy (CBT)
Mindfulness-based stress reduction (MBSR)
Hypnotherapy (hypnosis)
Qigong
Tai chi
Yoga

Moving More, especially regularly
Nature immersion, such as forest bathing
Therapies based on a philosophy of bioenergy fields, including these:

SIO cautions that acetyl-L-carnitine (CAM-Cancer) and guarana (About Herbs) should not be recommended for improving fatigue during treatment.

A diet designed to address fatigue in breast cancer survivors has shown positive results in a small pilot study.⁵

Medical cannabis may also help relieve fatigue. A study involving responses from more than 1200 cancer patients in Israel found that the majority of patients reported relief from symptoms including fatigue.⁶

An exercise counseling session during which symptoms were reviewed and current functional status, as well as current and previous exercise habits and capabilities were assessed. Individualized exercise recommendations were developed, including short- and long-term exercise goals and plans for follow-up sessions. At a follow-up session, improvements were noted in fatigue and in global health, mental health, and physical health scores.⁷ A 2019 study found that scheduling exercise to accommodate cyclical variations in fatigue due to chemotherapy may increase adherence to supervised exercise.⁸

Some studies have found that massage may help to reduce fatigue.

In addition to complementary therapies, consider seeing a professional such as a therapist, oncology social worker or oncology navigator to help you explore your stressful situation and identify an approach that is right for you.

Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols, see our Integrative Programs and Protocols page.

Programs and protocols

Alschuler & Gazella complementary approaches⁹
Block program¹⁰
McKinney protocols¹¹

Traditional systems
- Ayurveda
- Traditional Chinese medicine

Commentary

Laura Pole, RN, OCNS, October 18, 2018: BCCT advisor Janie Brown, RN, MSN, MA, is an oncology nurse and co-founder of a cancer retreat program and centre in Vancouver, British Columbia. Her BCCT story, The Power of the Integrative Approach in Breast Cancer Treatment, is a treasure trove of helpful information. She describes how her partner with breast cancer and her team made decisions about chemotherapy, wove in useful complementary therapies to prevent and minimize treatment side effects and created a caring community. The integrative plan staved off the usual chemotherapy side effects of peripheral neuropathy, mucositis, fatigue, nausea and neutropenia.

Written by Laura Pole, RN, MSN, OCNS, and reviewed by Nancy Hepp, MS; most recent update on September 14, 2020.