Fatigue is the most common symptom in people with advanced cancer. This is not normal tiredness. The fatigue associated with advanced cancer can range from feeling tired to being absolutely exhausted. As well, cancer related fatigue is less likely to be relieved by rest or sleep and it can disrupt everyday life.

Cancer related fatigue may result from the sheer duration of your illness, stress and anxiety, treatment or its side-effects, lack of appetite and therefore nourishment or additional medical conditions (eg. cardiac disease). Other symptoms such as ongoing pain, vomiting, diarrhoea and breathing difficulties can also lead to fatigue.

When fatigue is related to treatment, it will often vary according to when you receive chemotherapy or radiotherapy. It is normal to feel most fatigue a few days after chemotherapy, whereas fatigue may peak several weeks after radiotherapy. Typically, fatigue will decrease after that, but it may persist for some time after treatment.

Regardless of its cause, fatigue may make you emotional and impatient, which can test your relationship with family and friends. You may also find that you no longer enjoy what you do, that you want to isolate yourself from friends and family and that you have trouble thinking, speaking or making decisions.

Some specific signs of cancer-related fatigue include:

  • Feeling much more fatigued than usual, feeling like you have less energy or needing to rest often.
  • Feeling weak or feeling like your limbs are just too heavy.
  • Not being able to concentrate or pay attention as much as you used too.
  • Not finding interest in your usual activities.
  • Having difficulty sleeping (insomnia), or sleeping too much (hypersomnia).
  • Not feeling as rested as you would expect after a good night’s sleep.
  • Finding it really difficult to overcome inactivity.
  • Being really upset because you are always fatigued.
  • Having difficulty completing your daily tasks.
  • Perceived problems with short-term memory.
  • Feeling unwell for several hours after activity.

Fatigue is a very subjective experience, which means that only you really know how it feels and you may find it difficult to describe your fatigue to others. You can complete the fatigue assessment (74kb pdf) to help you communicate with your family, friends and health care providers about fatigue.

What may help

Talk to your Doctor

Write down what you want to tell you doctor:
  • When did the tiredness begin?
  • How long have you been experiencing tiredness?
  • What have you done to try to manage tiredness? Was this helpful?
  • What seems to make you more fatigued?
  • Are there particular periods in the day where you feel more fatigue?

Tell your doctor how the fatigue is affecting your daily life.

Write down what you want to ask your doctor:

  • What may be causing your fatigue?
  • When is fatigue expected to peak after treatment?
  • Will it get better after that?
  • What might relieve it?
  • Who can help?

Many people think nothing can treat tiredness so they don’t mention it. In fact, your doctor may have some suggestions or medicines that may help you.

He or she may look at how other things – such as medications, eating or sleeping, other symptoms or separate medical conditions – could be affecting you.

Naps

Small naps during the day will not take away the tiredness but they may boost your energy and help you sleep better at night. Try not to nap in the late afternoon or evening if you aim to get a good night’s sleep.

Also try to make the most of your rest at night by going to bed and waking up at a similar time each day and avoid stimulants such as caffeine before bed.



Life, Hope & Reality was developed and written by Afaf Girgis, Claire Johnson, and Sylvie Lambert with funding from the NHMRC and Cancer Council NSW.

Last updated 30 August 2015

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