Managing Symptoms: Fatigue

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The Abramson Cancer Center of the University of Pennsylvania
Last Modified: February 7, 2002

What is Fatigue?
Fatigue is consistently having less energy than usual for your normal activities. A person experiencing fatigue may feel overly tired, weak, shaky, or exhausted, may have difficulty concentrating, and may feel listless or very emotional.

What Causes Fatigue?
The exact cause of fatigue is not known. There are many factors that may contribute to fatigue, such as:

  • Cancer itself
  • Cancer treatment like chemotherapy, radiation therapy, immunotherapy and surgery
  • Depression or anxiety
  • Shortness or breath
  • Low number of blood cells
  • Poor nutrition
  • Infection
  • Some medications
  • Too little or too much activity
  • Changes in sleep patterns
  • Pain
  • Nausea, vomiting or diarrhea

When should I call my doctor or nurse?
If you have:

  • Difficulty performing your normal activity.
  • A sudden and dramatic decrease in your level or energy.
  • Confusion or any other change in mental status.

What can I do?

  • Get 6-8 hours of sleep per day.
  • Establish a nighttime sleeping routine:
    • Go to bed and wake up at the same times each day.
    • Do relaxing activities before going to sleep like reading, or listening to music.
    • Keep the bedroom cool, quiet and comfortable.
    • Keep a diary to identify periods of least and most energy.
  • Pace yourself throughout the day:
    • Do the most strenuous activities during times of the day when you have the most energy.
    • Plan your day to do important or fun activities first. Limit non-necessary activities.
    • Perform daily grooming activities such as: showering, shaving, brushing your teeth, and combing your hair while sitting down.
    • Avoid prolonged or strenuous activities.
    • Take rest periods during activities that make you feel tired.
    • Climb stairs as little as possible.
  • Take short naps, but not for more than 1 hour a day, or you may not be able to sleep at night. A half-hour to 45-minute nap is the most refreshing.
  • Avoid being too hot or too cold
  • Wear loose fitting clothes and low-heeled shoes
  • If possible make adjustments to your work schedule
    • Discuss your treatment schedule and the anticipated effect it may have on your work schedule, if any, with your immediate supervisor prior to starting therapy.
    • Consider decrease in your work hours, or take time off during the weeks you're receiving treatment.
    • Check if you are eligible for time off through the national Family Medical Leave Act and/or other types of leave available through your employer.
    • Use portions of lunch and break periods for rest, naps or light refreshing exercise like short walks.
  • Eat a well balanced diet
    • Eat and drink foods high in protein such as fish, cheese, milk, and peanut butter.
    • Eat 6 small meals throughout the day rather than 3 large meals.
    • Drink 6-8 glasses of fluid a day. Consider milk shakes or fruit juices. Be careful not to fill up on fluid at the expense of eating more nutritious foods.
    • Use nutritional supplements.
    • Prepare and freeze extra meals on high energy days to use as needed.
  • As you can, perform regular, light exercise such as walking.
  • Save some energy for fun things such as: visiting a friend, listening to music and reading.
  • Ask for, and accept, offers of help from family members and friends for cleaning, grocery shopping, or cooking.

How is fatigue treated?
Treatment of fatigue will depend on its cause. Your doctor or nurse may recommend:

  • Medications to promote red blood cell production and/or red blood cell transfusions.
  • Medications to treat pain, depression, nausea, and difficulty sleeping or other symptoms.
  • Oxygen to relieve shortness of breath.
  • Physical therapy consultation for reconditioning exercises or energy saving techniques.

Do not take any medication unless instructed by your doctor or nurse.

If you have any questions about fatigue, or need additional information, ask your doctor or nurse. Please let your doctor or nurse know if your would like information on other topics.