Fatigue

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Fatigue in the cancer patient is one of the most common complaints physicians and nurses hear. We define fatigue as an overwhelming lack of energy that has an impact on your daily life activities. You may find that you are unable to do as much during the day as you used to. You may be short of breath, even after light activity. Some people find it difficult to pay attention during conversation, or may have a desire to sleep all the time. For many, this change in energy level can be profoundly depressing.

Fatigue related to cancer can, be caused by many things, including chemotherapy, recovery from surgery, anemia, infection, side effects of medications, radiation therapy, and anxiety. The majority of cancer patients experience fatigue at some point in the course of their disease and its treatment. However, with patience and planning, you can learn ways to conserve your energy and to cope with this common symptom.

Here are some suggestions you may find helpful

Plan and prioritize

• Do the most important tasks of the day first, while your energy is highest.

• Set reasonable goals for a day. If you normally accomplish four things, plan to finish two. Anything extra you get done will be a bonus.

• Accept help from friends and family, and learn to ask for help when you need it.

• Establish good sleep habits. Don't drink caffeine in the evening, and try to limit naps in the daytime to short periods if you can. Try to establish a routine for bedtime that enables you to relax and rest comfortably. If you need to, take pain medicine before sleep to avoid waking up during the night in discomfort.

Meal preparation

• Assemble ingredients and utensils before you start, and sit while you cook. Prepare enough so that you'll have leftovers, and freeze half the meal for later. Use cookware you can serve from, and serve at the counter instead of at the table.

• Store frequently used items within easy reach to avoid bending and stretching.

• Use tools that make tasks easier, like a rubber jar opener, electric can opener, and lightweight utensils. Let dishes soak instead of scrubbing, and air-dry them.

• Consider mixes or prepackaged food as an energy saving option. Order food from a restaurant to be delivered a few days a week.

• Sign up for a meal delivery service. In San Francisco, Meals on Wheels (920-1111), Meals that Heal (4404325) and Kimochi Nutrition (931-2287) provide meals to seniors at little or no cost.

Housekeeping

• Ask for help with the most difficult tasks.

• Do a little each day, and spread chores throughout the week.

• Organize before you start. Carry dust cloths and sprays in a bucket and complete work in one room at a time. Use mops, brooms and dustpans with long handles to avoid bending.

• Sit to fold laundry.

• Wear clothing that does not require ironing, or sit to iron.

Remember, prioritize: The dirt will still be there when your energy is higher

Bathing and dressing

• Use a shower stool. These are available in most large drugstores.

• Install a grab rail.

• Avoid extra hot water, which may leave you feeling drained.

• Sit to dry off, or use a terrycloth robe.

• Consider an elevated toilet seat.

• Lay out clothes in advance, and avoid rushing to dress.

• Wear loose fitting clothes that fasten in the front.

• Avoid bending over to put on shoes and socks. Slip on shoes may be easier to put on than lace ups.

In addition to the above suggestions, remember that managing stress and continuing to participate in activities that make you happy will improve your overall quality of life.

A special note about fatigue related to anemia

Anemia is the medical term used to refer to having fewer than normal red blood cells. People with cancer often experience anemia for multiple reasons. Your body may be producing fewer red blood cells than normal as a side effect of chemotherapy. You may have lost blood as a result surgery. In some cases, anemia is due to the underlying disease.

When anemia is severe, your physician may recommend a blood transfusion to rapidly raise your red blood cell level. If you are less severely anemic, she or he may prescribe a medication called Procrit, which is given as a weekly injection under the skin. In either case, your physician will discuss the benefits of either treatment option with you. Remember that there are measures you can take to help deal with fatigue so that it interferes as little as possible with your life.