How to Manage Fatigue

A guide for people with cancer.

What is fatigue?

Fatigue is extreme tiredness and lack of energy that does not get better with rest or sleep. It is the most common symptom for people with cancer. Fatigue can also make you feel:

Weak, heavy or slow
Like you cannot think or remember things
Like you cannot do your usual activities or spend time with your loved ones

Fatigue can come and go over time. It is usually worse when you are getting cancer treatments.

What causes fatigue when you have cancer?

Your fatigue may have many causes, such as:

Cancer treatments, such as surgery, chemotherapy or radiation therapy
Medications, such as opioids, antihistamines and antidepressants
Pain
Depression, anxiety or emotional distress
Anemia (low red blood cell count)
Sleep problems
Dehydration (not enough fluids in your body)

When to talk to a health-care provider about fatigue

Talk to your health-care team at your next appointment if fatigue is causing you distress or getting in the way of your daily life.

Contact your health-care team right away if you suddenly feel:

Dizzy, like you are losing your balance or about to fall
Short of breath or notice your heart beating fast
Confused or have more difficulty thinking clearly or concentrating

There is no medication that is recommended for cancer fatigue. Your health-care team can help you create a plan to manage your fatigue using other strategies.

How to manage your fatigue

Start with small changes and set easy, realistic goals. If you have advanced cancer, speak with your health-care provider about managing fatigue. Some of the advice in this guide may not be useful for people with advanced cancer.

Exercise during and after your cancer treatments

Regular movement or exercise is one of the best ways to help with fatigue from cancer. Resting too much when you have fatigue can make the fatigue worse. Regular exercise or movement can:

Give you more energy
Improve your mood
Strengthen your muscles and balance

If you had an exercise routine before your cancer treatments, check with your health-care team to make sure it is safe to continue.

If you are just starting to move your body more often, try to:

Start slowly with something like walking at a mall or walking your dog
Start with five to 10 minutes of movement and repeat it throughout the day
Over time, move for longer and make your activities a bit more challenging
Aim for about 30 minutes of movement a day, five times a week
Keep track of your progress with a journal or a step tracker

If you struggle with standing or balance, try:

Seated yoga or Pilates
Using an indoor exercise bike
Using an arm cycle or resistance bands
Swimming or water aerobics

Be safe

Stop and rest if you ever feel sore, stiff or short of breath. Talk to your health-care team if you have metastatic cancer in your bones.

Save your energy when you can

The following strategies can help you save energy so you can get the most out of your day.

Plan your activities

Make a daily list of activities, including fun things and tasks you need to do
Put the activities that are most important to you at the top of your list and do them first
Rearrange or get rid of tasks as needed
Listen to your body and stop if you get too tired

Pace your activities based on your energy level

Break your activities down into smaller tasks instead of doing them all at once
Alternate activity with rest, for example, 10 minutes of activity followed by 10 minutes of rest
Do your most important tasks when you have the most energy
Plan rest days after a day when you have a lot of activities or outings

Use supports or devices to make activities easier

Use walking aids, such as handrails, grab bars, a cane or walker
Use reachers for grabbing items and rolling carts for moving things around
Keep the household items you use every day in easy-to-reach places

Eat and drink to keep up your strength

Focus on protein and get as many nutrients as you can. Eat small meals and snacks throughout the day. Choose more protein-rich foods like chicken, fish, nuts and beans to help with muscle strength.

Stay hydrated. Drink six to eight glasses of water or unsweetened, clear drinks each day, unless you have been told to drink less.

Ask to speak with a dietitian if you need help with eating and drinking.

Make preparing food as easy as you can:

Cook when you have the most energy
Make extra food to keep in the freezer
Buy healthy but convenient foods, such as pre-cut fruits and vegetables
Ask family and friends to bring you meals or do your shopping — people are often looking for ways to help

Improve your sleep

Getting good sleep is important when you have fatigue. Talk to your health-care provider if you are having trouble sleeping. For more information, review our sleep guide for tips.

Where to get more information

The Canadian Cancer Society is a trusted source of information. Visit cancer.ca or call 1-888-939-3333.

For more information on this symptom, or for guides to help manage other symptoms, visit Managing Symptoms, Side Effects & Well-Being.

If you need this information in an accessible format, contact 1-877-280-8538, TTY: 1-800-855-0511, or [email protected].

About this guide

Ontario Health’s patient guides provide Information on managing health-related symptoms (“Information”). The patient guides are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, treatment, or care. The information does not establish a physician-patient relationship between you and Ontario Health. Always seek the advice of a qualified health-care provider.

The patient guides may be amended, reproduced, and distributed without prior permission of Ontario Health for limited use in healthcare settings where patients may benefit from the information. Ontario Health must be cited as the source only when the patient guides are reproduced in their original form. Ontario Health is not responsible for any copyright reproduction of materials.