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Survivorship Series: Cancer Related Fatigue

annekatzby Anne Katz, PhD, RN 

This Monthly Survivorship Series, written by CKN Survivorship Editor, Anne Katz, is provided by CKN with permission from ONS.  We hope this series will become a useful resource that will help to facilitate dialogue between cancer patients, their loved ones and their physicians with a view towards improving the quality of life for cancer survivors.  

Most of us can relate to what it feels like to be tired … some of us are nurses, others physicians and many of us work (or have worked) the night shift. Some of us are female and have been preg­nant and remem­ber the exhaus­tion of that first trimester fol­lowed 36 weeks later by the weeks and months of car­ing for a new baby.

Can­cer sur­vivors know the over­whelm­ing fatigue — phys­i­cal and men­tal — that accom­pa­nies treat­ment and that may per­sist long after treat­ment is over. Radi­a­tion is the num­ber one cul­prit that causes fatigue and the lin­ger­ing of this side effect often comes as a sur­prise; peo­ple often assume that once treat­ment is over, the side effects just disappear.

Some strate­gies that have been shown to improve sleep are: avoid­ing late after­noon or long naps; lim­it­ing time in bed to actual sleep­ing and not watch­ing TV in bed before sleep; going to bed only when sleepy; set­ting a con­sis­tent time for going to sleep and wak­ing up; avoid­ing caf­feine, sodas and other stim­u­lants in the evening; and estab­lish­ing a pre-​​sleep rou­tine that is used con­sis­tently. This is com­monly called sleep hygiene and is a way to avoid sleep med­ica­tion that can be addictive.

Exer­cise has been empir­i­cally shown to help with cancer-​​related fatigue and while there is less evi­dence for inter­ven­tions such as mas­sage, ther­a­peu­tic touch and relax­ation exer­cises, these may be help­ful as well. While it sounds counter-​​intuitive to exer­cise when you are exhausted, reg­u­lar mod­er­ate exer­cise has been shown to increase energy lev­els and improve over­all well being.

How do you pre­pare your patients for the inevitable fatigue from radi­a­tion ther­apy? What sug­ges­tions do you make to help them with this side effect of treat­ment? Please share your prac­tice expe­ri­ence with read­ers of this blog so that we can all improve the care of our patients.

Exercise and Physical Activity as Treatment for Cancer Related Fatigue

Cancer Related Fatigue


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