Managing symptoms of fatigue

There are things you can do to help manage the symptoms of fatigue.

Eating well and drinking lots of fluids can help increase your energy levels. Your doctor or nurse can give you advice on your diet.

Being physically active may also improve your energy levels and increase your appetite. Start slowly and increase the amount of activity you do over time. Try setting yourself small goals that you can achieve, such as walking to the front door. Some exercise, even a small amount, is better than no exercise at all. It’s important to get advice from your doctor before you do any new physical activity. They may refer you to a physiotherapist for further advice.

You may find that you feel more stressed when you are having treatment. This can make you feel more tired. Try to make time to relax. There are relaxation techniques you can use to relieve tension and increase your energy. Complementary therapies may also help you cope with fatigue and help you to relax. Speak to you GP about using these therapies.

There aren’t any licensed drug treatments for fatigue but they are being researched. Steroid drugs can be helpful for some people. Your cancer specialist can talk about this with you.

Diet and fatigue

Eating well can help to boost your energy levels. Here are some useful hints:

  • Keep a diary of what and when you eat every day to see if you have more energy after certain meals.
  • Try to take advantage of the times when your appetite is best.
  • Drink plenty of fluids.
  • If your taste changes, try different foods or eat the foods that taste best to you.
  • Ask your doctor or nurse for any booklets or leaflets that give dietary advice.
  • Ask your doctor to refer you to a dietitian, who can give you helpful ideas.

Our eating well section has more information on coping with eating difficulties caused by cancer or its treatment.

Physical activity and exercise

There’s good evidence that physical activity, such as gentle strengthening exercises combined with some walking, can actually help to reduce the symptoms of fatigue. Being active may help to boost your appetite, give you more energy and improve your general well-being, so it’s important to try to exercise a bit, even if you don’t feel like it. It’s best to try to get a good balance between being active, exercising and getting plenty of rest.

It’s best to choose an activity or exercise that you enjoy. Try to maintain the amount of activity you do. However, if you have fatigue, this may not always be possible. Remember that some exercise is always better than no exercise. Simple goals such as walking from the front door to the back door may be an achievable goal for you. But try to increase your level of activity and build up the amount of exercise you do a bit at a time.

Before you start to do any physical activity or increase the amount you do, it’s important to get advice from a healthcare professional.

Always talk to your cancer specialist or GP before you start. They can advise you on the type and amount of exercise that’s safe for you. It’s also important to discuss any other medical conditions you have, such as high blood pressure, diabetes or lung problems, as these may be affected by physical activity.

You might find it helpful to get advice about exercise from a specialist cancer physiotherapist. Your GP or cancer specialist can arrange a referral for you.

A physiotherapist can help you:

  • build up your physical fitness
  • improve your energy, strength, joint range,
  • coordination and balance
  • manage the side effects of treatment
  • set some realistic goals for keeping active.

The physiotherapist may suggest referring you for a supervised group exercise programme. These groups are run by healthcare professionals or experienced fitness trainers. Many people find the social side of being in a group enjoyable, and it may also help give you a bit more motivation to exercise.

General suggestions for exercise

It’s helpful to set yourself some personal goals using the simple steps below. Try not to do too much, too soon.

  • Plan some activity or light exercise into your day.
  • Try some regular, light exercise such as walking, and simple strengthening exercises like standing up and sitting down.
  • These have been shown to reduce fatigue, and can help some people sleep better.
  • Exercises such as yoga, qigong and tai chi may be particularly good as they involve gentle movement, stretching, breathing and balance.
  • If exercise is impossible, try to stay active in your daily routine.
  • Pay attention to how your body reacts to activity and exercise. How did you feel? How well did you sleep afterwards?
  • Drink plenty of fluids before, during and after exercise.
  • Keep a record of your activities so that you and your healthcare team can monitor your progress. You could write them down in the fatigue diary [PDF].
  • Allow your muscles time to recover after activity by balancing activity with rest.
  • Don’t exercise if you feel unwell, are in pain or have any other symptoms that worry you, such as feeling breathless. Let your doctor know if you feel unwell or have worrying symptoms.

'One of the main debilitating side effects of treatment is fatigue. Contradictory to what you may think, by being active you become less tired.'

Dr Anna Campbell

Relaxation to help with fatigue

Making time for activities that help you relax is very important in dealing with and preventing fatigue. Stress uses up energy and can make you feel more tired.

It’s very likely that you will feel more stressed than usual when you start your cancer treatment. The following suggestions may help you relax:

  • Talk to others about anything that is worrying you.
  • Try an activity such as reading, seeing friends and listening to music. This may help take your mind off worrying thoughts.
  • If you can, try to avoid situations that make you anxious.
  • If you can, take regular light exercise such as walking.

Many people find it hard to relax and unwind, especially if the stresses and strains of the day are difficult to forget. Using specific relaxation techniques can help to relieve tension and boost your energy levels. There are two types of relaxation exercises:

  • physical ones, which work on tension in your body - these include tensing and releasing each part of your body in turn and breathing exercises
  • mental ones, which help to relax your mind - these include imagery exercises.

You may want to experiment until you find the best exercise for you. You can ask if there is a nurse or other healthcare professional, such as an occupational therapist or psychologist, who can help you find the technique that’s best for you. Using relaxation CDs or DVDs can be a good way to learn different exercises.

When you’re ready to try a relaxation exercise, find a quiet, warm, dimly lit, relaxing place where you won’t be disturbed, then lie or sit in a well-supported position. You’ll get the maximum benefit from these techniques if you practise them for 5-15 minutes each day.

Complementary therapies for fatigue

There are a number of different complementary therapies that may help you cope with fatigue. They include:

  • meditation
  • acupuncture
  • reflexology
  • aromatherapy
  • massage
  • music therapy.

You may need to pay for these but they are sometimes available on the NHS. Your GP, specialist nurse or a palliative care nurse may be able to refer you. You may also be able to get them through a cancer support group.

Some doctors have been reluctant for their patients to use complementary therapies, mainly because they have not been properly tested in clinical trials. But many people who use them find that they’re relaxing and help improve their general well-being. They can also help people feel more in control of their health and of what’s happening to them.

We have more information on complementary therapies which you may find helpful.

Drug treatments for fatigue

At the moment, there aren’t any licensed drug treatments to help prevent or improve fatigue. Steroid drugs, such as dexamethasone, can sometimes be helpful. Your specialist can discuss this with you.

Research into other drug treatments is ongoing. You may be asked to take part in a clinical trial. Your doctor or specialist nurse can give you further information about any drug trials that you may be suitable for.

Back to Tiredness (fatigue)

What is fatigue?

Fatigue is feeling very tired most, or all, of the time. It can sometimes be caused by cancer or cancer treatment.

What causes fatigue?

There are many causes of fatigue. Knowing about them may help you to cope with your fatigue a bit better.

Tips for better rest

Tiredness can affect your sleeping patterns. There are ways to manage this so you get the most out of your rest.