Simple or chronic fatigue is a fairly common problem. Everyone at least once complained of being tired. It can have several causes: lack of sleep and rest, shifted work pace, burnout or personal burnout.
Cancer fatigue is different.
Chemotherapy, like all treatments against cancer, is the cause of very severe fatigue, even extreme.
During cancer treatments, patients may feel permanently fatigued or exhausted. In everyday life, even the simplest actions can be extremely difficult to do.
Cancer fatigue is often associated with other symptoms and side effects of treatment (nausea, vomiting, aplasia).
This is a classic situation because it is one of the most common side effects of cancer therapies.
In medical language, fatigue is called « asthenia ».
As you know if you follow me, I am not a doctor. But as I, too, have gone through this stage of extreme fatigue, I will share with you my tips and tricks to combat chronic fatigue during cancer treatments.
In all cases, the fatigue must be the subject of a medical surveillance to be managed at best and fought effectively.
Cancer, fatigue and weakness
Cancer fatigue is both a symptom of cancer itself and one of the consequences of treatment.
cancer related extreme fatigue: symptoms and causes
Cancer is a pernicious disease that develops without anything appearing.
Pains and discomfort are felt only once the cancerous disease has already progressed well.
Thus, being in a state of severe chronic fatigue is a sign that must push for medical advice.
On the other hand, all chronic fatigue – even intense – does not mean that it is the consequence of cancer. This weakness can be linked to very different causes such as anemia (i.e. a lack of iron in the blood) or an infection or anything else that a doctor will diagnose.
For any chronic fatigue for no obvious reason, it is necessary to go to his doctor so that he can make a clinical examination or even blood tests or imaging (medical exams) that will identify the specific cause of this state of weakness.
Cancer related severe fatigue: treatment
Cancer treatments cause many side effects such as canker sores, nausea, digestive disorders and of course great fatigue.
It often appears as a result of chemotherapy. Fatigue is generally less intense at the end of the treatment, at a distance from the injection. But it becomes more and more severe depending on the number of courses followed.
For me, it is very important to anticipate this state of extreme fatigue.
Anticipation makes it possible not to be in a delicate situation. So, I often advise to identify the imperatives of everyday life. For example, the imperatives can be: take the dog out, go to meetings, pick up the children at school, help a loved one, go shopping, clean the house, take out the trash.
Once these constraints are identified, it is necessary to think about how to delegate these tasks by designating relay persons. They will be able to perform these tasks for you, if you are not able to do so.
Fatigue is very variable depending on the patient. So, if you do not feel tired in chemo, it will be a benefit. The fact of having done this preliminary work of anticipation will not change anything in your life.
On the other hand, if you feel extreme fatigue, you will have the resources to call the relay people you have identified to help you concretely.
This will make your life easier during cancer treatments (and even after!), which is very important.
It is better to appoint several people relays rather than rely on just one person. The burnout of caregivers exists, it must also be taken into account to guard against it.
If none of your loved ones can help you, consider getting closer to personal service companies or contacting volunteers in patient organizations.
Here is a didactic video of the Norton Cancer Institute that explains the reasons for this major fatigue during chemo:
Body aches and fatigue
Cancer itself, treatments (such as surgery and chemotherapy) can cause both pain and fatigue.
In my opinion, you should always discuss this situation with your doctors, because they will know what are the normal side effects of treatment and what have a different cause.
As always, a medical opinion is unavoidable.
To allow your doctors to have an informed opinion, the ideal is to qualify your pain.
Is it deaf? Acute?
Do you have pain all the time? Or intermittently? After specific moments (after the meal, having a bowel movement, at night, waking up, etc.)?
Is the pain localized (at one or more places of the body)?
To help you, you can make diagrams of a human body, putting red dots on painful places and date.
It is also important to be able to grade the pain on a scale of 1 to 10. The 1 corresponds to a very slight pain. The 10 to an unbearable pain.
Here is an image of the scale of a pain from 1 to 10.
This scale can also help you graduate and assess your level of fatigue.
Here’s a video from the National Cancer Network Complete (NCCN®), which explains the link between pain and fatigue in patients treated for pancreatic cancer (but can be used for other cancer conditions).
Brain and mental fatigue
The announcement of the diagnosis and the harshness of the cancer treatments provoke a shock.
The sick person will have to mobilize his resources to respond to this cancer test. It is a physical issue, but also a psychological issue.
Mental exhaustion is common during chemotherapy. It is a heavy treatment, with significant side effects.
In my opinion, to avoid feeling oppressed or totally overwhelmed by the situation, it is good to have an agenda with the things to do day by day. This may be – for example – going to the hospital for a chemotherapy session, simply.
This may be calling a friend you know is usually benevolent.
Learn more about this article that was translated from English by Google Language Tools during the support consultation with psychologists. Do not hesitate to participate in these consultations which can be of great help.
Cancer, fatigue and depression
The upheaval that cancer causes in the sick person’s life can greatly destabilize, even plunge into depression.
It’s not uncommon.
Depression is defined as a difficult reality, such as loss of taste and the desire to do things often coupled with intense fatigue.
Macmillan cancer support can also be featured in this video:
In addition, on the price of antidepressants during cancer treatments, your doctor may prescribe.
Thus, during the consultation with your doctor, you must specify all the treatments that you receive.
How to fight fatigue?
The fight against fatigue during cancer treatments concerns patients as well as doctors who care for patients.
Indeed, to warn patients of this possibility is also for me a way to treat this fatigue by mentally preparing sick people.
I am always very surprised to hear that doctors say that treatments do not cause fatigue… in order not to frighten their patients.
In my opinion, it is a shame to act like that, because it does not help everyone sick and their loved ones.
I am not the only one to think it.
Dr. William Breitbart of the Sloan-Kettering Memorial Cancer Center who confirmed that we could anticipate the possibility of fighting fatigue, but also the pain associated with cancer and chemotherapy and radiotherapy:
Sleep and cancer
To fight against fatigue, it is better to have a restful sleep. And to judge by appearances, it is not simple in full treatment of cancer.
First, you need to create a sleeping environment by sleeping in a well-ventilated room, having a good mattress and changing the sheets regularly (as I describe in my article on aplasia).
We must try to have schedules that will promote sleep cycles.
Taking naps (one around 10 am, the other before 3 pm), helps to have a restful sleep. To take naps, you must choose a quiet place, turn off the TV, turn off the computer and turn off your phones.
Whether for a nap or for the night, there is a very good method to help falling asleep.
To do this, once you are installed, leave your radio on (or your mp3 player) at a very low volume and listen to programs that you like, which are sources of relaxation for you (historical emissions, audio book, classical music).
Breathe deeply and slowly, emptying your mind.
Relaxation will be conducive to your sleep.
Chemo, fatigue and nutrition
Eating disorders in chemotherapy are very common. Nausea and vomiting greatly affect the quality of life of patients and increase the risk of fatigue.
During cancer treatments, it is very important to have a good nutritional intake, because undernutrition is a major risk.
If you have a lot of nausea, talk to your doctor so that he can follow this side effect.
In France, in the prevention of undernutrition, we have Protibis biscuits developed by an oncologist who works at the Nice Hospital (Professor of Medicine Isabelle PRECHEUR). These biscuits are a kind of shortbread with natural or chocolate flavors.
There are probably equivalents in the United States, England, Australia and all over the world.
As I describe in my article on eating disorders in chemotherapy, there are tips and tricks for improving meal intake during cancer treatments. We must try to eat raw products (avoid prepared dishes and fast foods), fairly neutral with few or no odors.
Maintaining a quality diet is one way of fighting fatigue.
Cancer, Compassion and fatigue
In our societies, time has accelerated. Everything must go fast, everyone must be « efficient ». People must stay in the race.
When you have cancer, it’s impossible.
Thus, fatigue, even intense, even in chemotherapy, is very unacceptable for our society and the environment. It is a weakness that is often heavy to bear and a vector of misunderstanding.
It’s hard to find compassion.
In this context, being supported psychologically helps not only to hold, but also to find ways to communicate serenely with loved ones.
In my opinion, participating in the support groups of the sick is also a solution, a way to express what we feel, but also to realize that we are not alone in feeling this. This is the lot of many people who receive cancer treatments.
After these group sessions of words, it is good to feel that we are a little lighter than before thanks to the compassion and solidarity of the participants.
Cancer treatment, fatigue and exercise
According to me, there are two complementary types of exercise that will help people with cancer to fight fatigue.
It’s primarily physical exercises. And, the mental exercises that will allow you to recharge your batteries.
Cancer and physical exercise
A priori, it is contradictory to do physical exercises to fight fatigue.
Of course, the first reflex is to rest by rearranging your life and putting in place measures that will allow you to have a quality sleep.
To maximize benefits, maintaining a minimum of physical activity will help the body fight fatigue, even severe.
This physical maintenance is essential to live cancer treatments « at best », but also to prevent the risk of relapse.
Depending on your situation, it will of course be necessary to adapt the exercises.
In your daily life, you can, for example, walk quietly in your neighborhood, go to the pool to walk in the water, do water aerobics, do Tai Chi exercises or Qi-Gong.
Many hospitals offer exercise classes for people with cancer. Do not hesitate to register.
On tips for fighting severe fatigue during cancer treatments, here is a video from the Mayo Clinic that I find very well done:
Cancer Treatments and Mental Exercise
Fatigue can be combated by maintaining a minimum of physical activity. It can also be toned down with exercises like sophrology, relaxation and mindfulness meditation.
The latter was developed by American psychiatrist John KABAT-ZINN with MBSR Mindfulness Based Stress Reduction and Zindel SEGAL of the University of Toronto with Mindfulness Based Cognitive Therapy.
These exercises are in the form of cycles of several weeks according to a well-established protocol.
Numerous studies have verified the benefits of these meditation practices and several hospital services have incorporated them.
The success of mindfulness meditation is global.
Here is an explanatory video made by The University of Vermont Medical Center on the benefits of meditation exercises for people with cancer:
To conclude and in addition to what you have just read, here is an article written by the National Cancer Institute on the multiple dimensions of fatigue in cancer treatments
Feel free to leave a comment to share your own tips against fatigue.
photo credits : fotolia / pixabay