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Cancer Fatigue: What It Is & 9 Powerful Lessons

Cancer Fatigue: What It Is & 9 Powerful Lessons

Cancer can put you in a lethargic space, debilitated and feeling hopeless and in despair. Lena Dunham described fatigue well “…I was too tired to crumple my face when I cried.”

But there are positives to it and I’m writing this article to help others find relief, to lend perspectives that you could accept as your new truth. I also write this to remind myself of things I can forget when I’m right in the thick of a tired spell.

First, let me explain the difference between normal fatigue and cancer fatigue. Normal tired is when you go through a day and by the end, you’ve slowed down. After a full day of work and the commute, you’re pretty tired.

Cancer fatigue is caused by reasons related to cancer:

  1. Having cancer can result in weakened muscles, organ damage, hormonal changes or proteins being released called cytokines which cause fatigue.

  2. Physical pain from tumor(s)

  3. Treatment for cancer: surgery, chemotherapy, radiation

  4. Side effects of cancer treatment such as anemia, nausea, vomiting, mood changes

  5. Emotional distress such as depression, anxiety, worry

  6. Inadequate sleep from treatment side effects and/or emotional distress

  7. Poor nutrition from a lack of appetite

Cancer fatigue gets set off easily, especially if you’re not watching how hard you push yourself or how long you going without rest but it can also happen as a mystery, seemingly without a particular cause. Cancer fatigue is getting worn out after maybe a few hours of getting up, eating breakfast, making some phone calls and working your way out the door.

In some cases, after just waking up around 6am, I’ve found myself needing rest as early as 9, 10 or 11am and I might need rest again in the late afternoon. Sometimes resting helps, sometimes it doesn’t and it could take me hours to get out of the daze I woke up from.

I could sleep a solid 8 hours or more and still feel it. Caffeine only helps part of the time.

Low energy is something that I deal with regularly and it gets me depressed at times. It can be extremely frustrating and I struggle with being okay with it. I am trying to learn to be OK with it more often. These are some things I’ve learned and continue to review when fatigue hits me. I’ve divided the tips up by which ones to focus on DURING one of these tired spells or BEFORE/AFTER it hits. It helps me manage my energy with better planning.


A lesson of priorities
Because my energy is more limited than most people, I need to focus on what needs to get done. I’ve become someone who over-plans and it’s to make sure I separate what should be tackled first and handle the rest later. If it’s getting to the doctor’s office or posting an article on a certain day because it would be relevant to current events, I can focus on those things instead of getting attached to finishing everything I had planned to do.

Belleruth Naparstek has many guided meditation CDs; one titled “A Meditation to Help You Fight Cancer.” One of the affirmations is, “I tell this cancer these things: Thank you for teaching me to stop and listening. Thank you for reminding me of what is truly important. You can go now.”  I would get very emotional while listening to this and when I felt I had the time and a safe space, I would sit and cry.

Now I ask myself every day, “What is important?” It’s a question that is open-ended, gives clear direction and only I can answer it. It helps me plan my day, everything else is placed around the important tasks.

A lesson on rhythm
When I have a lot to do, I tend to rush through my tasks and end up burning out. It’s like my body is telling me it’s time to slow down. And there’s no need to be on GO mode all the time. I know it’s terrible for my health, it’s just hard to stop when I’m wound up.

In the book, French Women Don’t Get Fat by Mireille Guiliano, “American women seem to have two modes: sitting or spinning.” It helps to name it something that is simple and visual. When I start to rush about, it’s easier to become more aware of whether I am going back to the old habit of toggling between these two states throughout the day.

A Lesson On Time Management
Ever notice that when you have so many choices or so much time to spare that it’s hard to make a decision? After deciding on what is important, the next thing to consider is when to do it. If I’m trying to handle a difficult project and wait until the afternoon when my energy is more likely to dip, I’m setting myself up for failure.

Now I schedule those important, left-brain tasks for when I am at my peak. For me, it’s in the morning. But if I’m writing, I need the creativity of the alpha state during the late afternoon or a few hours before bed. It’s also helpful to draft a to-do list in the afternoon for the following day, then review it in the morning.

A lesson on creative energy

When fatigue sets in, it’s easier to get into the alpha state. This is where creativity flows, so it is ideal to work on art projects, like drawing, painting and writing. I can start handwriting and get my thoughts all out on paper. I’ll write a page of continual thoughts in cursive, (the concept of Morning Pages by Julia Cameron).

Creativity also helps problem solving. I notice ideas and small epiphanies come to me during the alpha state that usually happens right after waking up, right before bed or when you’re a little tired. It can be helpful to work through problems when I am tired to see what my uninhibited, fuzzy mind can do.

A lesson on perfectionism
Sometimes being tired means not even having enough energy to even be angry about it. Being tired quiets the grumpy and can mellow you out like having a glass of wine. It can put out the perfectionism that creates anxiety instead of taking your level of work to a higher level of quality.

A lesson on acceptance

Never get angry at a fact. It is easier to accept the fact that energy has run out. If you’re already tired, it’ll take even more energy out of you to be upset and fight fatigue.

Accepting change can be incredibly difficult, especially accepting that this is the new normal, at least for now. Fatigue is a very common complaint of cancer patients, it affects our quality of life. I find it helpful to remember “I’m tired now and that’s OK.” It doesn’t mean I am giving up and it doesn’t mean I am affirming something negative. It means I am in acceptance.

A lesson of adaptability
Having chronic fatigue means I’ve to learn how to let go of what I had planned. There is a tendency to get attached to a something I had in mind, to get something done or to go somewhere. When the fatigue sets in, none of it really matters; it happens anyway. It is teaching me to let go and detach, if I allow it.

A lesson of empowerment
The other approach is to power through the fatigue. Sometimes it is better to muscle through it with exercise because you can actually get reenergized. The important thing to remember here is that you do have a choice in how you handle it. You can allow our body to rest or choose to strengthen it with movement.

After taking a 45-minute walk, I can get a second wind and feel accomplished that I got exercise in for the day. Or not.

A lesson on limitations
When I’m at home, I have a list of things to do, many lists, maybe too many. I can be indecisive about what to do and that can send me in circles, not accomplishing much except browsing the web or rearranging my day.                                           

“There is no more miserable human being than one in whom nothing is habitual but indecision.”
— William James

But when I’m tired, my choices are much more limited. My energy can be so drained that all I can do is lie in bed with my eyes closed, not able to sleep and not even able to read. That leaves me 2 choices: to meditate or daydream. I can practice breath work that calms me down in a matter of minutes. Or I can daydream and think to myself, “Wouldn’t it be so, so nice if….” and fill in rest, working out the details and how I feel in that moment. When I’m done with either, I am calm, rested and re-energized.

The silver lining is that I end up being limited to doing things that are challenging for me to actually sit and “do” but are important to staying centered.

Some days, I have more stamina and those are great days. But when I have fatigue, I turn back to these reminders. I hope you found it helpful and I welcome comments and feedback.

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