Fatigue is a feeling of extreme tiredness and weakness that isn’t improved after rest or sleep. It is not like normal tiredness, and it can have a big impact on your quality of life. You may get fatigue because of your lymphoma or as a side-effect of treatment. To complicate things, many people with cancer also experience changes to their sleep cycle and can have trouble getting to sleep, or staying asleep for a full nights rest.
For many people, fatigue lasts for months or even a couple of years after treatment ends so it is important to learn new habits that help protect your energy, while still being able to continue with your life.
Fatigue is the most common symptom of cancer, and side-effect of its treatments.
Causes of fatigue
There is no one cause of fatigue. When you have cancer, and have treatment for cancer, you will have many different risk factors for fatigue. These can include:
- The lymphoma using your bodies energy stores to grow.
- Normal emotional responses to having lymphoma and the way your life has changed.
- Pain, which may be related to where the lymphoma is growing, procedures such as central line insertion or biopsies, surgery or radiation treatment.
- Infections.
- Low red blood cells or haemoglobin (anaemia).
- Changes in your hormone levels and proteins that regulate inflammatory processes.
- Side-effects of some medicines such as monoclonal antibodies, radiation therapy and chemotherapy.
- Your body using extra energy to replace good cells at a faster rate than normal, because of damage caused by your treatment.
How an Occupational therapist can help with fatigue
You do not have to ‘put up with fatigue’, and it does not need to be something you cope with alone.
Occupational therapists (OT) are university trained health professionals. They are part of the allied health team and can help you manage your fatigue and improve your quality of life.
They are able to assess how you are going and what supports you may need. They can also help you with strategies and equipment to help make things easier. Watch the video to find out more about how an occupation therapist can help you.
Talk to your local doctor (GP)
Your GP can refer you to an OT as part of chronic disease health management plan (also called a GP management plan). The hospital you have treatment at may also be able to refer you to an OT.
When you get a GP management plan, you can access up to 5 allied health appointments which is covered by Medicare, meaning you should not have to pay, or only pay very little. Allied health visits can include seeing an occupational therapist, an exercise physiologist and more. To see what is covered under allied health click here.
How to cope with fatigue?
Firstly, you need to go easy on yourself. Having lymphoma puts extra strain on your body as the lymphoma uses up some of your energy stores to keep growing.
Then treatments put extra pressure on your body again and your body needs to work harder to clear the lymphoma, and repair or replace your good cells damaged by the treatments.
Protect your energy!
When you’re fatigued and not sleeping well, small changes in your routine can make a big difference. The Royal College of Occupational Therapists recommend protecting or conserving your energy using the 3 P’s – Pace, Plan and Prioritise. Click on the headings below to learn more.
Other tips that may help
Eating healthy foods
Your body needs extra energy to fight the lymphoma and recover from treatments. Eating foods high in nutrition is the only way to put extra energy into your body naturally. Think about the foods you eat, and choose foods higher in nutrients and protein. Some easy to prepare foods that are healthy can include:
- eggs
- nuts and seeds
- fruits and vegetables
- red meat
- smoothy with natural yoghurt and fruit
- meal supplements such as sustagen or ensure.
Everybody’s energy needs will be different, and depending on other side-effects you may have, you may have different things to consider when it comes to food.
(Avoid soft cheeses and processed meats if you are neutropenic, and always wash fresh fruit and vegetables).
Keep hydrated!
Being dehydrated will make your fatigue worse and cause other problems such as low blood pressure, dizziness, headaches, and can cause problems for your kidneys.
You need to drink about 2-3 litres of fluids every day. Drinks with caffeine or alcohol are not included in your fluid intake. Alcohol and caffeine can make your dehydration worse.
Fluids that do count toward your fluid intake include:
- water (you can flavour with cordial or fruit if you prefer)
- fruit juice
- watery soups
- jelly
- ice-cream (do not have soft serve ice-creams if you are neutropenic)
- sustagen or ensure.
Who can help?
Most hospitals can refer you to see a dietician. A dietician is a university trained allied healthcare professional. They will look at your energy needs and consider your lymphoma and treatments. They will then work with you to make a healthy diet to meet your body’s needs that is affordable to your and easy for you to prepare.
Your GP can also refer you to a dietician as part of chronic disease health management plan.
Exercise
When you’re feeling fatigued, exercise is probably one of the last things you want to think about. However, research has shown that exercise can help improve symptoms of fatigue.
You can get access to an exercise physiologist through a GP management plan.
To find an exercise physiologist in your area, click here.
Treatment of fatigue
There is no specific treatment for fatigue. Because there are many causes of fatigue, treatment is aimed at improving whatever the underlying cause is. For example if you are:
- anemic, you may be offered a blood transfusion.
- dehydrated, you will be encouraged to increase the fluids you drink or be given fluids through a cannula or central line straight into your blood stream.
- in pain, your doctor will want to manage the pain better for you.
- not sleeping improving your sleep quality will be the goal (more information on this later on this page).
- stressed or anxious, managing these with relaxation or meditations, counselling or psychology may help.
A dietician may also be able to help make sure you get enough calories, nutrients and protein for your body’s needs.
Managing sleep problems and insomnia
There are many factors that can affect your sleep patterns, and quality of sleep. These can include:
- stress, anxiety, depression or fear
- medicines such as steroids given as part of your treatment
- sleeping during the day
- hormone imbalances
- night sweats or infections
- pain
- changes to routine
- noisy hospital wards.
For more information on managing sleep changes, click the link below.
Summary
- Fatigue is the most common symptoms of cancer, and side-effect of cancer treatments.
- It can impact your ability to do even the simplest of tasks.
- Fatigue is not as simple as being tired. It is an extreme type of tiredness not improved with rest or sleep.
- You do not have to put up with fatigue – there are many strategies to improve fatigue and your quality of life.
- The 3 P’s Pace, Plan and Prioritise are a good start o managing your fatigue.
- Keeping hydrated, eating a healthy diet and exercise can help improve symptoms fatigue.
- Treatment will be aimed at improving the underlying cause of your fatigue.
- Allied health professionals are university trained health care staff the can help you manage fatigue. Ask your doctor at the hospital or your local GP to refer you to dietician or occupational therapist. This can be done as part of chronic disease management plan.
- You are not alone, if you would like to chat to a Lymphoma Care Nurse click the Contact us button at the bottom of the screen for contact details.
