Understanding and Managing Cancer Fatigue

Cancer fatigue or cancer-related fatigue, is a pervasive side effect of cancer and its treatments. This form of extreme exhaustion impacts not just energy levels but also physical, emotional, and cognitive well-being, often making everyday activities a challenge.

Jenny Bradt, D.P.T., a Mayo Clinic physical therapist specializing in cancer rehabilitation, describes it as "overwhelming fatigue that cannot be resolved with rest or typical methods of re-energizing." Symptoms can emerge at any point during the cancer journey and may persist for weeks, months, or even years.

Touré Barksdale, M.D., a Mayo Clinic cancer rehabilitation and palliative medicine specialist, emphasizes the individualized nature of this condition: “There is no one-size-fits-all treatment because everyone experiences fatigue differently.”

What Causes Cancer Fatigue?

Several factors contribute to cancer fatigue, including:

• The cancer itself, which can weaken muscles, damage organs, or alter hormone levels.
• Side effects of treatment, such as anemia, pain, insomnia, poor nutrition, and emotional distress.
• Hormone therapies for certain cancers and hormone-sensitive cancers can disrupt hormone levels, which also can lead to fatigue
• Pre-existing conditions like hypothyroidism, sleep apnea, or chronic pain, which may worsen during cancer treatment.

How Does Cancer Fatigue Impact Patients?

The effects of cancer fatigue are not limited to physical exhaustion. Many patients experience:

• Cognitive fatigue (brain fog): Challenges with memory, focus, and thinking, which can interfere with relationships and daily activities.
• Emotional fatigue: Anxiety, depression, and lack of motivation, often exacerbated by changes in functional ability.

Bradt notes that even small shifts in daily routines, such as not tidying up as usual, can signify fatigue.

Managing Cancer Fatigue Through Physical Activity

Exercise plays a key role in alleviating cancer fatigue. Regular, heart rate-raising activities, even in small amounts, can improve energy and mood.

“Most guidelines recommend 150 minutes of exercise per week, but any amount is beneficial,” says Bradt. Physical and occupational therapy can further assist by helping patients:

• Build strength and endurance.
• Improve mobility and motor skills.
• Conserve energy and moderate activities.
• Incorporate mindfulness practices to reduce stress.

Bradt advises pacing oneself: “On your good days, don’t try to conquer the world. On bad days, get out of bed and do what you promised yourself you would do.”

A Holistic Approach to Cancer Fatigue

Effective management of cancer fatigue requires a whole-person approach. Integrative oncology — a whole-person approach to cancer care — combines conventional Western medicine with complementary therapies and can be used throughout treatment and into survivorship.

Dr. Barksdale advocates for individualized care that addresses physical, psychological, social, and spiritual health. Integrative oncology complements conventional treatments with therapies like acupuncture, energy management, and stress reduction, tailored to the patient’s unique needs and preferences.

“We use all the resources we have to address what is happening for people in that moment,” says Bradt.

Learn More

Learn more about cancer fatigue and find a clinical trial at Mayo Clinic.

Join the Cancer: Managing Symptoms Support Group on Mayo Clinic Connect, an online community moderated by Mayo Clinic for patients and caregivers.

Summarized from original story published in the Mayo Clinic Comprehensive Cancer Center blog