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
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
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
- Panax ginseng (American) (About Herbs)
- Mind-body approaches including these:
- Cognitive-behavioral therapy (CBT)
- Mindfulness-based stress reduction (MBSR)
- Hypnotherapy (hypnosis)
- Tai chi
- Moving More, especially regularly
- Nature immersion, such as forest bathing
- Therapies based on a philosophy of bioenergy fields, including these:
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
- Traditional systems
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 Nancy Hepp, MS; most recent update on January 29, 2021.
- American Society of Clinical Oncology: 8 Ways to Cope With Cancer-Related Fatigue
- National Cancer Institute: Fatigue and Cancer Treatment
- SIO clinical practice guidelines:
- Deng GE, Frenkel M et al. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. Journal of the Society for Integrative Oncology. 2009 Summer;7(3):85-120.
- Deng GE, Rausch SM et al. Complementary therapies and integrative medicine in lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e420S-e436S.
- Greenlee H, DuPont-Reyes MJ et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: A Cancer Journal for Clinicians. 2017 May 6;67(3):194-232.
- National Comprehensive Cancer Network: NCCN guidelines on Cancer-Related Fatigue (login required)
- Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015 Feb 21;15:77.
- Dr. Cynthia Li: Brave New Medicine
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
- Helpsy Inc.: Helpsy Health
- Andrew Weil Center for Integrative Medicine: Breast Cancer: An Integrative Approach (2019-2021)
- Block KI, Block PB, Gyllenhaal C: Integrative Treatment for Colorectal Cancer
- Integrative Cancer Review
- Martin L. Rossman, MD: Fighting Cancer from Within
- Barbara MacDonald, ND, LAc: The Breast Cancer Companion: A Complementary Care Manual: Third Edition
- September 2018 Issue of the Journal of Alternative and Complementary Medicine
- Wayne Jonas, MD: Your Healing Journey: A Patient’s Guide to Integrative Breast Cancer Care
- American Society of Clinical Oncology: Cancer.Net
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Ted Schettler, MD, MPH: The Ecology of Breast Cancer: The Promise of Prevention and the Hope for Healing
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- healthjourneys: Meditations
Written by Laura Pole, RN, MSN, OCNS, and reviewed by Nancy Hepp, MS; most recent update on May 29, 2018.