Dealing with feeling fatigued
Some cancer survivors say that even after treatment has finished, they still feel very tired and worn out.
Fatigue is one of the most common issues for survivors during the first year of recovery.
The type of fatigue that you may have is not the kind that can be treated with naps and sleep. Doctors are not
even sure of its exact causes, and they may be different for different people. Your body is fighting hard, and
it’s normal to feel a bit exhausted, but there is help to manage this.
Getting help for fatigue
Your doctor or nurse can talk to you about what might be causing your fatigue and what can be done about it.
Ask about:
- Whether the medication you’re taking, or any other medical problems you have might be affecting your
energy levels
- Ways that you can control your pain, if pain is a problem for you.
- Any physical exercise programs that might help, such as walking
- Meditation and relaxation exercises
- Changing the way you eat or drinking more fluids
- Medicines or other nutritional supplements that can help
- Specialists like physical therapists, occupational therapists, nutritionists, or mental health care
providers
coping with fatigue
- Plan your day out without giving yourself too much to do
Plan to be active at the times of day when you feel at your most alert and energetic.
- Change how you do things to better conserve your energy
Small changes like sitting on a stool while you cook or iron can make a difference.
- Take short rest breaks or naps between activities
- Try to maintain a regular sleep pattern; go to sleep and wake up at the same time every
day.
- Keep doing the things you enjoy, but do less of them.
Focus on the interests that don’t tire you out so much. Reading something brief or listening to an
audiobook or music is an example.
- Let other people help you
Maybe they can cook a meal, do the laundry or do your grocery shopping. If no one offers to help,
ask for what you need. Your loved ones might be willing to help you, but they may not know what to
do.
- Choose how to focus your energy
As far as possible, let go of the things that don’t matter as much. Free up that mental energy.
- Consider joining a support group
Talking about your fatigue with others who truly understand might help you find new ways to cope
with what you are experiencing.
coping with fatigue
- Plan your day out without giving yourself too much to do
Plan to be active at the times of day when you feel at your most alert and energetic.
- Change how you do things to better conserve your energy
Small changes like sitting on a stool while you cook or iron can make a difference.
- Take short rest breaks or naps between activities
- Try to maintain a regular sleep pattern; go to sleep and wake up at the same time every
day
- Keep doing the things you enjoy, but do less of them
Focus on the interests that don’t tire you out so much. Reading something brief or listening to an
audiobook or music is an example.
- Let other people help you
Maybe they can cook a meal, do the laundry or do your grocery shopping. If no one offers to help,
ask for what you need. Your loved ones might be willing to help you, but they may not know what to
do.
- Choose how to focus your energy
As far as possible, let go of the things that don’t matter as much. Free up that mental energy.
- Consider joining a support group
Talking about your fatigue with others who truly understand might help you find new ways to cope
with what you are experiencing.
Memory and concentration changes
According to the research, one in four people with cancer report that the experience memory and attention
problems after chemotherapy. You might hear this referred to as “chemobrain”, a kind of brain fog that survivors
experience which can lead to problems with focusing and paying attention, remembering new information, or being
able to find the right word when you need it.
These memory and concentration issues can begin shortly after treatment ends, but they may not appear until
later on. These issues don’t always go away, and if a patient is older, it can be difficult to tell whether they
are a result of treatment, or of the aging process. Either way, some survivors report that they just can’t focus
the way they did before their treatment.
Getting help
Your doctor can help. You should talk with him or her if:
- You still have memory and thinking problems that concern you
You can ask about seeing a specialist (a neuropsychologist).
- You’re concerned the medication you’re taking may be causing or adding to the problem
- You think you might be suffering from depression or anxiety
These can also affect your attention, memory, and concentration.
- You’re going through menopause
Memory and concentration problems can sometimes be related to menopause.
Improving memory and concentration
Other cancer survivors that have experienced these issues have found many ways to help improve their
memory and thinking. Some of these ideas might work for you:
- Write it down
Plan your whole day, all the little things you want or need to do. Keep it really simple, and be
realistic about how much you’ll be able to do in a day.
- Set reminders
Put small signs around the house, or use your phone to remind you of things you need to do, like
taking out the trash or locking the door.
- To help your memory, group longer numbers into chunks
For example, the phone number 814-3296 can be repeated as “eight-fourteen, thirty-two, ninety-six.”
- Talk to yourself!
When you’re doing a task that has a number of steps such as cooking or working on a computer,
whispering each step to yourself can help you make sure you get it done properly.
- Manage your stress
Managing your stress better can improve both your memory and attention. Learning how to fully relax
can help you stay calm even in more stressful moments.
- Practice what you plan to say
If you’re going to an event or function, go over any names, dates, and key points you might want to
make so that you feel prepared.
- Repeat the things you want to remember
Saying these things a couple of times can help your mind retain the information.
Improving memory and concentration
Other cancer survivors that have experienced these issues have found many ways to help improve their memory
and thinking. Some of these ideas might work for you:
- Write it down
Plan your whole day, all the little things you want or need to do. Keep it really simple, and be
realistic about how much you’ll be able to do in a day.
- Set reminders
Put small signs around the house, or use your phone to remind you of things you need to do, like taking
out the trash or locking the door.
- To help your memory, group longer numbers into chunks
For example, the phone number 814-3296 can be repeated as “eight-fourteen, thirty-two, ninety-six.”
- Talk to yourself!
When you’re doing a task that has a number of steps such as cooking or working on a computer, whispering
each step to yourself can help you make sure you get it done properly.
- Manage your stress
Managing your stress better can improve both your memory and attention. Learning how to fully relax can
help you stay calm even in more stressful moments.
- Practice what you plan to say
If you’re going to an event or function, go over any names, dates, and key points you might want to make
so that you feel prepared.
- Repeat the things you want to remember
Saying these things a couple of times can help your mind retain the information.
Pain post-treatment
Some people find they have a lot of pain after their treatment, while others report having less.
Every individual is different; what matters is you do what you can to manage your pain.
Types of pain
- Pain or numbness in both the hands and feet due to injured nerves
Chemo and surgery can both damage nerves, which can result in severe pain.
- Painful scars from surgery
These can take time to heal fully.
- Pain in a missing limb or breast
Doctors don’t know exactly why this pain occurs, but ‘phantom pains’ are very real, and not “in
your mind.”
Getting help for pain
Pain can make your recovery more difficult, but your doctor and/or nurse can assess your level of
pain with you, and recommend some of the following approaches:
- Pain-relief medication
Doctors will usually try the mildest medicines first, then work up to stronger meds if they are
needed. The key to relieving pain with medication is to take your medications exactly as your
doctor prescribes.
- Antidepressants
Sometimes, antidepressants can be prescribed to reduce pain or numbness from injured nerves.
- Physical therapy
Attending physical therapy can help relieve pain. Your therapist may use cold, heat, massage,
pressure, and/or stretches and exercises to help with your pain.
- Braces
These are used to limit the movement of a painful limb or joint.
- Acupuncture.
A proven method that uses needles at different pressure points to reduce your pain.
- Hypnosis, meditation, or yoga
A trained specialist can teach you these approaches, and all can be effective for pain.
- Relaxation skills
Many survivors have found that practicing deep relaxation techniques help to relieve pain and
reduce their stress.
- Nerve blocks, or surgery
If the other suggested methods aren’t working got you, you may want to talk to your doctor.
Nerve blocks or surgery can help if you are suffering from persistent pain that affects how you
live your life. These are big decisions and may put you at risk for other problems, or require
you to stay in the hospital, but you can talk this through with your doctor.
The correct dose of medicine with regular doctor visits could be helpful for pain.
Pain post-treatment
Some people find they have a lot of pain after their treatment, while others report having less. Every
individual is different; what matters is you do what you can to manage your pain.
Types of pain
- Pain or numbness in both the hands and feet due to injured nerves
Chemo and surgery can both damage nerves, which can result in severe pain.
- Painful scars from surgery
These can take time to heal fully.
- Pain in a missing limb or breast
Doctors don’t know exactly why this pain occurs, but ‘phantom pains’ are very real, and not “in your
mind.”
Getting help for pain
Pain can make your recovery more difficult, but your doctor and/or nurse can assess your level of pain with
you, and recommend some of the following approaches:
- Pain-relief medication
Doctors will usually try the mildest medicines first, then work up to stronger meds if they are needed.
The key to relieving pain with medication is to take your medications exactly as your doctor prescribes.
- Antidepressants
Sometimes, antidepressants can be prescribed to reduce pain or numbness from injured nerves.
- Physical therapy
Attending physical therapy can help relieve pain. Your therapist may use cold, heat, massage, pressure,
and/or stretches and exercises to help with your pain.
- Braces
These are used to limit the movement of a painful limb or joint.
- Acupuncture
A proven method that uses needles at different pressure points to reduce your pain.
- Hypnosis, meditation, or yoga
A trained specialist can teach you these approaches, and all can be effective for pain.
- Relaxation skills
Many survivors have found that practicing deep relaxation techniques help to relieve pain and reduce
their stress.
- Nerve blocks, or surgery
If the other suggested methods aren’t working got you, you may want to talk to your doctor. Nerve blocks
or surgery can help if you are suffering from persistent pain that affects how you live your life. These
are big decisions and may put you at risk for other problems, or require you to stay in the hospital,
but you can talk this through with your doctor.
Changes to your nervous system
Cancer treatment can sometimes cause damage to the nervous system. This is something called neuropathy (problems
with nerve function). Sometimes, these symptoms can be made worse by other conditions like diabetes,
malnutrition, alcoholism or kidney problems.
Symptoms might begin when you begin chemotherapy, or could show up after treatment. If they show up, tell your
health care team immediately. Your symptoms can improve over time, however this can be a process that takes
months and sometimes even years to heal.
Getting help for nervous system changes
Treatments can include:
- medication
- topical cream
- pain patches
- physical therapy
- acupuncture
- exercise.
managing nervous system changes
- Be careful
Take care when handling knives, scissors, and any other sharp objects.
- Take care to avoid falling
Walk slowly, always use handrails, and have bath mats in your tub or shower to prevent slippage. Notice
and remove any rugs or cords that you could trip over. If you need to steady yourself when walking, do
so by using a cane or other device.
- Wear soft tennis shoes or other footwear with flexible rubber soles
- Use gloves and thermometers instead of your bare hand when checking water temperature, to avoid
getting burned
If you can, lower the temperature setting on your hot water heater or geyser.
- Allow ample time for rest
Lymphedema or swelling
Lymphedema is a swelling of a part of your body (often the arm, leg, face, or neck) caused by a buildup of lymph
fluids. This can be caused either by cancer or its treatment. There are different types of lymphedema. Some
happen right after surgery and are mild, and short-lived. Others can occur months or even years after cancer
treatment, and can be painful. These types may also occur after an insect bite, a minor injury, or a burn.
Who is at risk of Lymphedema?
Persons diagnosed with or treated for the following cancers may be at higher risk for developing lymphedema.
- Breast cancer
If you had radiation therapy, had your underarm lymph nodes removed, or had radiation in the underarm
area.
- Melanoma of the arms or legs
You may be at risk if you had lymph nodes removed and/or had radiation therapy
- Prostate cancer
If you had surgery or radiation therapy to the whole pelvis you may be at risk.
- Cancers of the reproductive organs
Male or female, if you had surgery to remove lymph nodes or had radiation therapy to the pelvis, you may
be at higher risk.
- Cancers that spread to the lower abdominal area
Pressure from a growing tumor may make it difficult for your body to drain fluid.
Getting help
Your doctor or nurse may be able to help you find ways to prevent and relieve lymphedema. Ask about:
- Skincare
Keep your skin clean, and if advised by your doctor, use a lotion to keep your skin supple. Do not
use products that are perfumed.
- Exercise
There are exercises that can help the body drain lymph fluid, and also exercises you should not do.
Talk to your doctor for advice on this.
- How to treat lymphedema:
- Keep the arm or leg raised, above your chest, for extended periods of time.
- Special types of massage can move the lymph fluid from where it has settled.
- Special sleeves and clothing that help encourage lymph fluid to drain.
- Losing weight can make a difference.
- Emotional support from loved ones or professionals, to help you cope.
- Avoid any procedures in the area with lymphedema.
Watch out for signs of swelling or infection, and always communicate with your nurse or doctor.
Who is at risk of Lymphedema?
Persons diagnosed with or treated for the following cancers may be at higher risk for developing lymphedema.
- Breast cancer
If you had radiation therapy, had your underarm lymph nodes removed, or had radiation in the underarm
area.
- Melanoma of the arms or legs
You may be at risk if you had lymph nodes removed and/or had radiation therapy
- Prostate cancer
If you had surgery or radiation therapy to the whole pelvis you may be at risk.
- Cancers of the reproductive organs
Male or female, if you had surgery to remove lymph nodes or had radiation therapy to the pelvis, you may
be at higher risk.
- Cancers that spread to the lower abdominal area
Pressure from a growing tumor may make it difficult for your body to drain fluid.
Getting help
Your doctor or nurse may be able to help you find ways to prevent and relieve lymphedema. Ask about:
- Skincare
Keep your skin clean, and if advised by your doctor, use a lotion to keep your skin supple. Do not use
products that are perfumed.
- Exercise
There are exercises that can help the body drain lymph fluid, and also exercises you should not do. Talk
to your doctor for advice on this.
- How to treat lymphedema:
- Keep the arm or leg raised, above your chest, for extended periods of time.
- Special types of massage can move the lymph fluid from where it has settled.
- Special sleeves and clothing that help encourage lymph fluid to drain.
- Losing weight can make a difference.
- Emotional support from loved ones or professionals, to help you cope.
- Avoid any procedures in the area with lymphedema.
Mouth or teeth problems after treatment
Many survivors develop problems with their mouth or teeth during and after treatment. Some of these issues go
away after treatment, but others can last a long time or may possibly never go away. Problems can also develop
months or even years after treatment has ended.
Radiation or surgery to the head and neck can cause problems with:
- teeth and gums
- the soft, moist lining of your mouth
- glands that make saliva (spit)
- jawbones.
Certain types of chemotherapy can also trigger these problems
Who is at risk of these changes?
- Almost all patients who’ve had radiation therapy around the head and neck
- Most people who’ve undergone a bone marrow transplant
- About 40% of people treated with chemotherapy
Getting help
If your problems persist after your cancer treatment has ended, talk to your doctor about possible causes,
and the different ways you can control mouth pain.
See your dentist as soon as you can after you finish your cancer treatment. Talk to them about how regularly
you need checkups, and you can also ask for advice on how to take care of your mouth and teeth.
Changes in weight and eating habits
Certain types of chemotherapy or medications can cause issues with weight gain. Sometimes, excess weight can
stay on even after treatment ends. Among breast cancer survivors who’ve been treated with certain types of
chemotherapy, there is the possibility of gaining weight in a different way – losing muscle and gaining fat
tissue.
Unfortunately, the methods people usually use try to lose weight might not work the same for this type of weight
gain. Remember to be kind to yourself, and patient with yourself. Take comfort in the positive things that are
within your control, like eating a nourishing and healthy diet that will give your body the best possible fuel
to recover and thrive. Keep in mind that your treatment is over, your body is still recovering and getting
stronger, but this can take time.
Some cancer survivors find themselves with the opposite issue: they feel no desire to eat, and as a result lose
weight.
Regaining Your appetite
There are some things you can try doing to improve your appetite:
- Little and often: start with small meals
You might find having five small meals a day to be less ‘intimidating’ than three larger ones.
- Eat your favorite foods
If the very thought of eating lacks appeal, you can focus on only foods you really liked before treatment.
Make eating as appealing as you can while you try to kick-start your appetite.
- Get active
A walk before a meal might help you feel hungrier, and exercise in general can help your body gain strength
and appetite.
Trouble swallowing
After radiation therapy or chemotherapy, some people find that they have trouble swallowing, which of course can
make it hard to eat. There are some things you can do to make swallowing as easy as possible so that you get as
much nourishment as you can.
help for difficult swallowing
-
Try to eat soft and bland foods that are moist, or moistened with something like gravy or a sauce.
Puddings, soup, bananas, ice cream, and yoghurts are all nourishing and should go down easily.
-
Blend solid foods to make them easier to get down.
-
When eating, tilt your head back or move it forward to see if there is a way that feels better.
-
Take a sip of water every few minutes to help you swallow. Carry a water bottle around with you, so
you’ve always got it on hand. Some cordial in your water may make this a tastier habit to pick up!
Radiation therapy can make it hard to swallow after treatment.
help for difficult swallowing
-
Try to eat soft and bland foods that are moist, or moistened with something like gravy or a sauce.
Puddings, soup, bananas, ice cream, and yoghurts are all nourishing and should go down easily.
-
Blend solid foods to make them easier to get down.
-
When eating, tilt your head back or move it forward to see if there is a way that feels better.
-
Take a sip of water every few minutes to help you swallow. Carry a water bottle around with you, so
you’ve always got it on hand. Some cordial in your water may make this a tastier habit to pick up!
Bladder or bowel control problems
These are among the more distressing problems faced by people when they finish treatment. There can be a lot of
shame associated with these, and it can even cause people to avoid going out in public. It can make returning to
work particularly difficult, and interfere with social life.
A loss of control can happen after treatment for pelvic, bladder, rectal, prostate, ovarian, colon, or other
cancer. Surgery may have left a survivor without a bladder, or without any bowel control at all. Or there may
still be some control, but lots of sudden trips to the bathroom are needed. There may also be the opposite
problem, when constipation occurs as a side-effect to pain medication.
Getting help
It’s important to notify your doctor about changes in bladder or bowel function or habits. Speak to your doctor
or nurse about:
-
Constipation
-
Exercises or medicines that may help with your issue
-
Help in managing and coping with ostomies. An ostomy, or an opening from inside the body to the outside to
pass urine or waste material, is a huge change to your life and it’s very normal to find it difficult
and distressing. Ask about services and support groups that can help you cope with changes.
Menopause symptoms
After chemo, some women stop menstruating regularly, and others stop getting periods altogether. Some treatments
and medications can cause changes in women’s bodies, reducing how much hormones they produce. These changes can
have effects like causing periods to stop, as well as other menopausal symptoms.
After time, some women will start getting their periods again (among younger women this is more likely), but
others will not. Allow yourself the time to grieve for the loss of your fertility as needed and appropriate for
your individual circumstances.
SYMPTOMS of menopause
- Irregular periods
A change in your periods is often one of the first signs of menopause onset. Your periods may become
lighter, less regular, or have only short periods where bleeding is heavy. Periods may also stop all of
a sudden.
- Hot flashes
These are often worse at night, and can negatively affect sleep and cause mood changes.
- Problems with the vagina or bladder
Tissues in these areas can become drier and thinner, and you may be more prone to vaginal infections.
You may also have trouble holding your urine, or other urinary tract problems.
- Lack of interest in sex
Your physical and emotional changes may make it more difficult for you to become sexually aroused.
- Fatigue and sleep problems
You may feel very tired, or have trouble falling asleep or experience sleep disturbances.
- Memory and mood problems, depression
Some may be simply related to growing older, but there may be a link between the changes in your hormone
levels and your emotions.
- Other body changes
You might notice changes like your waist getting bigger, having less muscle and more fat around your
body, or some thinning and loss of elasticity in your skin.
Getting help
Go to see a gynecologist for a check-up every year. Talk to them about
-
Any medicine, supplements, or other approaches that you can avail of to help you manage your
menopause symptoms
-
Any tests you should have (an example might be a bone density test to check whether you are at risk
for osteoporosis)
Getting help
Go to see a gynecologist for a check-up every year. Talk to them about
-
Any medicine, supplements, or other approaches that you can avail of to help you manage your menopause
symptoms
-
Any tests you should have (an example might be a bone density test to check whether you are at risk for
osteoporosis)