Cancer treatment fatigue: when you’re exhausted in body and mind

Some people feel only a little tired. Others are so drained that daily tasks like showering or cooking feel like a mountain.

Some cancer treatments can cause problems with memory or concentration. They can range from small lapses to bigger trouble focusing.

Emotional stress, anxiety and depression can add to fatigue. Looking after your feelings is part of looking after your energy.

Many people feel frustrated when fatigue lasts longer than expected. Some worry that friends, family or coworkers will get upset with them.

Cancer itself can use up the body’s energy and cause changes that lead to tiredness. Muscle and weight loss can add to it.

After surgery, the body uses energy to heal. Other treatments can cause fatigue too, and how much often depends on the schedule. Fatigue from some treatments builds up to around the middle of treatment, levels off, then eases after it ends.

Things that can add to fatigue

• Dehydration, for example from sickness or diarrhea
• Loss of appetite
• Night sweats
• Poor sleep

Emotional stress, anxiety and depression can all make fatigue worse. Talk therapy can help with the stress, fear and hopelessness that feed it.

• Days after treatment when energy dips
• Tasks that leave you wiped out
• The time of day you feel most alert
• Whether poor sleep the night before makes a difference

Tell your care team if you feel very weak or tired, can’t do your normal activities, or are still exhausted after rest or sleep.

Words you could use

• “My energy has been about a 3 out of 10 most days.”
• “I can’t do what I could do last month.”
• “Rest isn’t helping.”

If mornings are your best time, plan calls, visits or anything that matters to you then. Keep low-energy times for rest or easy things.

1. List what you want to do today.
2. Mark each one: must do, could do, or can wait.
3. Pick one or two “musts”.
4. Hand off, simplify or drop the rest.

• Break big jobs into short chunks with rests between
• Keep often-used things within easy reach
• Order groceries for delivery if you can
• Sit to wash, dress or cook

Pushing through on a good day can leave you flat for the next few. Try stopping while you still have a little energy left.

Asking family and friends to help with cooking, driving and errands can ease fatigue.

Start slowly and build up over time. If you need to stay in bed, even stretching or moving your arms and legs can help you stay flexible and feel better.

Ideas

• A short walk to the end of the street
• Chair exercises
• Gentle stretches in bed
• Walking around the house every hour

Yoga, tai chi and qigong combine gentle movement, breathing and meditation. They may help with fatigue.

A physical therapist can help you build a safe plan that fits your treatment and how you feel.

• Keep daytime naps under an hour
• Keep regular times to get up and go to bed
• Wind down with something calm before bed

Several small meals may be easier than three large ones. Ask a dietitian about keeping your strength up.

Stay hydrated, and limit caffeine and alcohol.

• Keep important names and numbers in one place
• Use lists, a planner or voice notes
• Set reminders on your phone

• Do demanding tasks when you feel most alert
• Do one thing at a time
• Keep a steady daily routine

Tell your care team about memory or focus problems, and ask whether an occupational therapist could help.

Cognitive behavioral therapy (CBT) and other talk therapy can help with stress, fear and hopelessness that make fatigue worse. Relaxation and guided imagery may help too.

It makes sense to miss your old energy. Try comparing yourself with last week, not with the person you were before cancer.

Kinder thoughts to try

• “My body is healing, and that takes energy.”
• “Rest is part of my treatment.”
• “Small things still count.”

Many people feel guilty about the strain on family. Letting people help is not a failure.

Fatigue and depression can overlap. If you feel sad, hopeless or numb for more than two weeks, talk to your doctor.

In the U.S., people who have cancer are generally protected at work under the Americans with Disabilities Act. You can ask for changes at any time.

Examples

• A modified schedule or shift change
• Breaks, or a private place to rest
• Moving minor tasks to a coworker
• Working from home

Let others know what you are able to do as you heal, and what not to expect. You don’t have to keep the house perfect because you always did.

Online tools such as Lotsa Helping Hands or SignUpGenius can help organize who does what.

• “A good night’s sleep doesn’t fix this kind of tired.”
• “If I cancel, it isn’t about you.”
• “Mornings are my best time. Can we meet then?”
• “The most helpful thing would be…”

• Ask “What would help most today?”
• Offer specific help, like driving or a meal
• Plan short visits, and leave before they get tired
• Try not to say “You look fine”

Free and confidential answers to cancer questions, Monday to Friday, 9 a.m. to 9 p.m. Eastern time, in English and Spanish. Live chat is at cancer.gov/contact.

The helpline is open 24 hours a day and can help you find practical support near you.

Free counseling with oncology social workers, support groups and some financial help, for people with cancer and their loved ones.