FATIGUE (TIREDNESS)
What is fatigue?
Fatigue is an overwhelming sense of exhaustion. There is a lowered ability to do physical and mental work, regardless of enough sleep. It means less energy to do the things you normally want to do. This fatigue is different than the everyday fatigue, which is usually temporary and relieved by rest. Fatigue is one of the most common side effects of cancer treatment, whether the treatment is radiation, or chemotherapy. It is more severe and distressing than everyday fatigue. In addition, fatigue can exist beyond when treatment ends.
How do people describe fatigue?
Those who experience fatigue often report having no energy for usual daily activities. You may feel like your arms and legs are heavy. Some describe fatigue as feeling tired, weak, exhausted, worn-out or slow, and being unable to concentrate. Rest does not always relieve it. You may have feelings of sadness, irritability or get easily frustrated and tire quickly. You may still feel tired even after napping or getting enough rest at night.
What causes fatigue?
Fatigue can result from cancer therapy, from spending too much time in bed, or from not getting enough exercise. Anemia (low red blood cell count) and infections as well as pain can cause fatigue. Fatigue can also occur from poor nutrition.
How do people cope with fatigue?
Here are some tips people use:
Plan 2-3 rest periods to conserve energy for important activities.
Plan exercise every day; take a 15-minute walk.
Sit at the sink to brush your teeth, use a chair when showering.
Drink 8 (8 oz.) glasses of water or other decaffeinated fluids per day.
Let others help you with housework, chores or meal preparation.
Eat a diet with fresh fruits and vegetables, and lean meat/fish/chicken and milk products as recommended by your doctor.
Set priorities to do important or fun activities first.
Establish regular bedtime activities.
Keep as active as possible during the day so that normal fatigue occurs at night.
Go to bed earlier when real tired.
Keep track of how you feel by keeping a diary. Each day record your fatigue on a 0-10 scale (0= no fatigue; 10= worst fatigue possible).
If possible, make adjustments to your work schedule.
Consider decreasing your work hours.
Take time off during the weeks you have treatment.
Save some energy for fun things.
Visit a friend, listen to music, or read.
Get help with daily activities.
What can family members and friends do to help me with my fatigue?
Ask family members and friends to help you with housework, chores, yard work or cooking.
Ask family members and friends to take a walk with you and encourage you to walk every day.
Ask family members and friends to offer you fluids throughout the day to increase your fluid intake.
Ask family members and friends to help you set daily priorities.
How can I talk with my family members and friends about my fatigue?
Be open and honest about your feelings.
Ask them for ideas to help with or manage your fatigue.
Ask your family members and friends how your fatigue is affecting them.
What should I report to my doctor or nurse?
Fever spike greater than 100.4º F.
Unable to get out of bed for 24 hours.
If you are unable to think clearly or focus on things such as TV, talking or reading.
If you are unable to do any of your usual daily activities.
Severe chills or sweats.
When contacting your doctor or nurse, know the following information:
a) When your fatigue started.
b) How its gotten worse since the fatigue began.
c) What helps or makes the fatigue worse.
d) How the fatigue affects your usual activities or the activities you desire.
Where can I get more information?
Call your doctor or nurse.
Call the American Cancer Society at: 1-800-ACS-2345 or visit on the internet at: http://www.cancer.org. Click on Patients, Family & Friends, then Coping with Treatment.
Call the National Cancer Institute at: 1-800-4-CANCER or visit on the internet at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer.
Visit the Family Care Research Program on the internet at: http://www.cancercare.msu.edu.
Visit the National Comprehensive Cancer Network on the internet at: http://www.nccn.org. Click on Patient Version.
Visit the University of Pennsylvania on the internet at: http://www.oncolink.upenn.edu. Click on Coping with Cancer.
Visit http://www.cancersymptoms.org.
References:
Stone, P. (2002). The measurement, causes and effective management of cancer-related fatigue. International Journal of Palliative Nursing. 8(3), 120-8.
Whitmer, K. & Barsevick, A. (2001). Patient resources for cancer-related fatigue. Cancer Practice, 9(6), 311-13.
Nail, L.M. (2003). Fatigue. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 47-60). Boston: Jones and Bartlett.
National coalition for cancer survivorship: fatigue at: http://www.canceradvocacy.org/. Click on Essential Care.
