Discussing Fatigue With Your Physician and Strategies To Keep Motivated

Feeling physically, emotionally, and mentally exhausted even though getting enough rest and sleep is something that I experienced after receiving chemotherapy for my non-Hodgkin lymphoma. The term used by the medical profession is “Cancer-related fatigue”. My exhaustion was so incapacitating that I needed to take a leave of absence from my position as a nursing instructor. I felt devastated by both my cancer diagnosis and the impact of the chemotherapy on my quality of life.

Cancer-related fatigue

It may be a minor side effect for some but for others like me, it can affect your day-to-day activities. The fatigue can influence mood and emotions, relationships with friends and family, ability to cope with treatment, job performance, and hope for the future.²

I experienced all of these during my course of chemotherapy. The feeling of sadness and fear of the future became part of my daily life. The exact cause of cancer-related fatigue is unknown. It may be related to both the disease process and treatments including surgery, chemotherapy, and radiation therapy. Other causes may include anemia, decreased nutrition, medications, pain, stress, and depression.

Talking to your doctor about fatigue

Your physician will screen for fatigue, but it is important that YOU describe your experiences and history of fatigue. The best measure of fatigue comes from the way you describe your level to your healthcare team. You may use a scale of 0 to 10, where 0 means no fatigue at all, and 10 means the worst fatigue you can imagine. The following may also help describe factors related to your fatigue:

• When did the fatigue start? Mine would begin after my chemotherapy and last for several days before the next treatment.
• How long does the fatigue last?
• Does anything make it better? Worse? For me, sleep and bed rest were the only options.
• Are there times when you notice it more?
• How has the fatigue affected the things that you do every day or enjoy most?

Lifestyle changes

Lifestyle changes and discussion with your healthcare team may help with managing your fatigue. Research studies have shown that physical activity during and after cancer treatment can decrease fatigue. Yoga and massage therapy have also been reported to help. I discovered yoga and was amazed at how it helped give me energy. Both massage and reflexology helped me relax and feel less stressed. Mindfulness-based stress reduction has also helped with reducing cancer-related fatigue.

Other strategies you can do:

• Plan your day so that you have time to rest. Take short naps rather than long ones.
• Talk to your healthcare team about any issues with your dietary intake. Nutritional deficits can add to problems of fatigue and weakness.
• Regular exercise like walking is a good way to lessen fatigue.
• Ask your family and friends to help with things that you find too hard or tiring to do.
• Plan your day’s activities ahead. Decide which things are a priority. Spread out the activities so that you can rest in between.
• Try to sleep between 7-8 hours a night.

I found that whether sitting on the beach, bird watching, or taking a walk through the park, simply being outside helped me feel refreshed and energized. The above strategies may help you discuss your fatigue with your healthcare team and mutually identify steps to mitigate it.