Cancer Related Fatigue

Cancer Related Fatigue (CRF): 11 Ways to Help Your Treatment Team Help You

Bethany Smith, RD, LD, CDE

Nutritionist, Georgia Cancer Specialists, PC

Despite the number of patients who suffer from CRF (90% or more), the causes and best treatment options are still unclear.  Often, cancer centers do not address CRF with patients, simply because they aren’t aware of successful ways to manage fatigue.  At least 30% of patients report fatigue lasting months to years beyond treatment.

If you are suffering from cancer-related fatigue, ask for help in managing this often under-reported, under-diagnosed and under-treated symptom.  Remember – quality of life matters – and fatigue often impacts this the most.  Use these suggestions below:

Talk with a Registered Dietitian about diet and hydration.**

Schedule time for rest as well as activity and meals. 

Exercise

  • 15-30 minutes most days of the week
  • If you have not been exercising, talk with your healthcare team before you begin.
  • If you want to start walking, begin very slowly with five minutes each day, monitor how you feel, then increase the length of time each week.

Control your pain

Discuss your current medications with your physician, nurse, dietitian or pharmacist. 

  • Medications for pain, high blood pressure, depression, nausea and allergies can all cause fatigue.

 Request lab tests**

  • CBC, CMP, thyroid panel

When it comes to sleeping, quality counts – not quantity. 

  • Staying in bed all day will not make CRF better.  Try to go to bed and get up at the same time each day. 

Treat depression. 

  • Talk with a friend, pastor or family member, or ask your physician for a referral to a counselor or psychologist.  Antidepressant medication is not always necessary, but talking with a professional may help. 

Choose activities that help restore your thought processes.**

  • Often the mind is tired, not just the body.   To help restore your mind, sit outside at a park and watch children play or listen to a relaxation CD.  If you feel strong enough, take a yoga or meditation class.

See your primary care physician to help evaluate any other illnesses you may have.

  • Do you have another health condition that could be causing fatigue?  Lung disease, congestive heart failure and uncontrolled diabetes can all make you feel tired. 

Talk with your oncologist if you are interested in trying a medication to help with fatigue. 

  • If all of these suggestions do not help, there are prescription medications available to treat fatigue.   Amphetamines, such as methylphenidate (Ritalin®), or antidepressants may be helpful

References:

  1. Ahlbert K, Ekman T, Gaston-Johansson F, Mock V.  Assessment and management of cancer-related fatigue in adults.  Lancet 2003; 362: 640-47.
  2. Escalante CP, Manzull E, Valdres R.  A cancer-related fatigue clinic:  opportunities and challenges.  J NCCN 2003; 1: 333-43.

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