Fatigue


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Fatigue has been described as:

'The self-recognised state in which an individual experiences an overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work that is not relieved by rest' (Carpenito, 1995).

Fatigue is a frequent complaint of cancer patients. In reports on cancer patients treated with chemotherapy and radiotherapy or both, this has been indeed the most frequent complaint, and is perceived to be at least as distressing and disabling as the nausea and vomiting that accompany cancer treatments.

Fatigue can be a prevalent and serious problem for the individual with cancer and can negatively impact on the individual's quality of life. It can affect up to 61% of cancer patients, usually occurring 14 days after chemotherapy, and increases over a 5- 6 week course of radiotherapy. It has been noted to reduce dramatically 3 months post treatment.


Fatigue affects all patients differently and can have many different signs. Some of the more common ones are listed below:

Difficulty climbing stairs or doing the smallest of chore. Ever day activities seem impossible.

A feeling of no energy. You feel as if you could spend the whole day in bed.

Having trouble thinking, speaking or making decisions.

Shortness of breath after only light activities. Dizziness.

Difficulty concentrating, eg reading a book, watching TV, doing things you usually enjoy.

There can be many causes of fatigue and knowing them may help you cope with your fatigue a bit better.

The disease itself uses some of the energy you get from your food.

Nausea, vomiting and diarrhoea may restrict the amount of energy absorbed from food.

Pain can also be extremely fatiguing.

If you have had surgery, or an infection of fever, these will cause your body to need more energy.

Reduced food intake due to appetite due to appetite loss can lead to depleted energy reserves.

Anaemia is a common cause of fatigue.

Anxiety, depression, stress and tension can contribute to fatigue as well as poor sleep quality.

Disturbance to normal daily routine.


Some useful hints to try and reduce fatigue are listed below.
They are given as a guide and you will need a little perseverance, trial and error:

Try to eat little and often, i.e. take small meals and snacks throughout the day.
Keep a diary of what and when you eat every day.
Take advantage of the times when your appetite is best.
Drink plenty of liquids.
If your taste changes, try new foods, or eat foods that taste best to you .
Prepare extra meals on days you feel well and put them in the fridge for times when you don't feel like cooking.
Ask for assistance from family and friends with shopping and cooking.
Ask your doctor/nurse for leaflets on dietary advice or to arrange to see the dietician.


It is important to exercise little and often when you are ill.
Research has shown that exercise may reduce fatigue. You need to find the balance between too much and too little exercise. A good balance between rest and exercise is best:

Discuss ways in which family and friends can help reduce some responsibilities eg housework, shopping, cooking until energy levels improve

Keep socially active, but always pace yourself.

Engage in light daily activities, such as walking.

Keep a diary of your daily routine and energy levels and what activities make your most tired. Prioritise your activities, arrange them around your fatigue pattern and allow enough time to do them.


Although patients whom are fatigued feel tired all the time, they may be not getting enough quality sleep.
The following are ideas for a better night sleep.

Wake up at the same time each day.

Exercise regularly.

Eliminate noise and light from the bedroom.

Regulate the bedroom temperature to be comfortably warm.

Have a bed-time snack e.g. warm milk.

Avoid stimulants, eg chocolate, coffee, cola drinks.

Limit alcohol consumption. Although it makes you sleep, it is not quality sleep.


Allow time for relaxation to help to reduce stress.

Be open to others about your worries and fears.

Allow time for activities you enjoy eg gardening, reading, seeing friends.

Light exercise, eg walking.

Avoid anxiety-inducing situations.

Relaxation tapes.

Complimentary therapies aromatherapy e.g. massage, reflexology, aromatherapy.

It is important to plan your days and assess what you can and can't do. Exercise lightly, eat little and often, and talk. Take short naps and rest periods during the day, as long as they do not interfere with the quality of your night time sleeping.