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Cancer-related fatigue Q&A

By Georden Jones 

Because fatigue is a predominant symptom of cancer, CBCN reached out to Georden Jones for advice on managing this symptom. Georden is a doctoral student in clinical psychology at the University of Ottawa. Her thesis focuses on cancer-related fatigue, in particular on the patient's experience with this symptom and how to implement assessment and interventions programs for cancer-related fatigue. Her thesis project is ongoing and is estimated to end by 2019. If you have any questions concerning her work, please do not hesitate to contact her by email: gjone046@uottawa.ca

What is cancer-related fatigue? 

Cancer-related fatigue (CRF) is a common difficulty that patients, including those in palliative care and cancer survivors, may experience. CRF is a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer and cancer treatment. It can significantly impact personal, social, and/or work roles and it can have a negative impact on overall quality of life. 

How is it different from regular fatigue?  

CRF is a fatigue that can present physical, emotional and psychological symptoms. It is not proportional to recent activity, such as exercise, and it can interfere with usual functioning. 

What aspects of cancer or cancer treatments cause cancer-related fatigue?  

The causes of CRF remain unclear. Some cases of CRF begin at the time of diagnosis, others during treatments, or after treatments. Therefore, it is thought to be caused by the cancer itself as well as by its treatment.  

What are some treatments for cancer-related fatigue?  

Before taking part in treatments for CRF, it is important to eliminate physical causes of CRF, such as anemia, nutritional deficits, or dehydration. Treatments that have demonstrated effectiveness for CRF are physical activity including yoga, Cognitive-Behavioural Therapy, and educational programs on CRF management. (Before engaging in physical activity, it is important to talk to your healthcare provider about your physical activity program.) 

What are some tips that patients can follow to help themselves?  

Tips for managing CRF at home include: 

  • monitoring your levels of CRF 

  • engaging in energy conservation strategies such as:

    • setting your priorities for the tasks you can realistically accomplish in the day

    • pacing yourself while performing activities by taking breaks

    • delegating tasks

    • scheduling activities at your peak energy level

    • postponing non-essential activities 
       

  • limiting naps to less than one hour per day to reduce interference with nighttime sleep 

  • having a structured daily routine 

  • using distraction 

  • engaging in meaningful activities 

For more information on cancer-related fatigue, click here.  

References 

Howell, D., Keller–Olaman, S., Oliver, T. K., Hack, T. F., Broadfield, L., Biggs, K., … Olson, K. (2013). A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue. Current Oncology, 20(3), e233–e246. https://doi.org/10.3747/co.20.1302 

National Comprehensive Cancer Network. (2013). NCCN Clinical Practice Guidelines in Oncology: Cancer-Related Fatigue (version 1.2013). Retrieved August 28, 2015, from http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive