University College Hospital
Coping with fatigue and tiredness
Radiotherapy Department
Patient information series
№16
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Contents
What is fatigue?
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What causes fatigue?
5
Coping with fatigue
6
Helping yourself at home
7
Eat well
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Get good quality rest
8
Useful contact numbers
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What is fatigue?
Fatigue is the medical word for feeling tired most or all of the time.
Patients describe it in a variety of ways, using terms such as weak,
exhausted, weary, worn-out, emotionally and mentally drained. This
level of tiredness will vary between individuals. Although many people
are able to carry on with their normal routine, others may find it difficult
to cope. Fatigue is very common during treatment, and it can be just
as distressing as other treatment side effects. Fatigue can influence
a person’s sense of wellbeing, their daily performance, the activities
of daily living, relationships with family and friends, and compliance
with treatment. This booklet is intended to give you help with coping
with fatigue during your treatment.
What causes fatigue?
There is no single cause of fatigue. It is thought that many different
factors may contribute to, or add to, feelings of fatigue. These include:
•Radiotherapy, chemotherapy and surgery can be very taxing on the
human body. Your body needs more energy to cope with these
treatments.
•Feeling sick, vomiting and diarrhoea may cause you to “go off” your
food. This will mean that you have less energy in reserve.
•Pain and other symptoms such as breathlessness may cause fatigue.
•The emotional responses to the cancer and its treatment such as
anxiety, fear, confusion, stress and depression may also generate
feelings of lethargy and fatigue.
•Sleep problems or lack of sleep may make you feel exhausted.
•Relationship problems or arguments can cause frustrationand
weariness.
•Anaemia (a low red blood cell count which causes a low haemoglobin)
will cause fatigue. The doctors will be able to treat this.
•Other factors such as travelling to and from hospital, lack of family
support, dependants, age, lifestyle, occupational and financial
status can all contribute to feelings of fatigue.
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Coping with fatigue
There are many things that can be done to make the problem of
fatigue more bearable. Here are some suggestions to help you cope.
Some of the suggestions will be more effective for some people than
others. Do not feel that you have to suffer on your own.Share your
feelings with your family and friends. They will understand if you are
not able to do all the things that you usually do.
•Plan activities. Do the important activities first. Most people have more
energy for the things they enjoy and feel best doing.
•Pace yourself. Aim to do what you know you can realistically achieve.
•Do not feel guilty if you are not able to achieve everything you
intended. Accept that you are not fully fit at the moment.
•Keep a daily diary of your symptoms. This will be helpful both for
yourself and the medical team to identify a personal pattern. Then
you can plan activity and rest periods and feel more in control.
•Maintain your social life. A natural reaction in response to fatigue is to
reduce activity. Try to maintain those activities that make you happy in
your daily life.
• Regular light exercise has been shown to decrease fatigue. If you are
used to regular exercise try to continue with this if you feel able. Even
taking short walks in the fresh air may help to boost your energy levels.
Before undertaking any gentle exercise please consult with your doctor.
•Do not be embarrassed to discuss your problems with the hospital
staff. We are here for you.
•Consider having some complementary therapies such as
aromatherapy or reflexology. The radiotherapy department
provides reiki, aromatherapy and massage for patients during their
treatment. Please ask a member of staff for further details.
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•Some local cancer charities will provide complementary therapies
free to patients. If you wish to consider these therapies please
discuss them with your radiotherapy doctor.
•Talk to your doctor. In a small number of cases some people need
medication or a blood transfusion.
Helping yourself at home
There are a number of ways in which you can make life easier for
yourself. Here are some suggestions:
•If others offer to help, accept.
•Spread chores out over the week and do a little at a time.
•Prioritise your tasks so that the most important ones are done first.
•When doing chores, sit down wherever possible.
•Get help with the shopping. Larger supermarkets will often provide
you with in-store help if you go to customer services. If you have
access to a computer, make full use of delivery and internet services.
Eat well
Eating a healthy balanced diet is important in the management of fatigue.
Try to eat a good mixture of high protein foods (meat, milk, cheese),
carbohydrates (bread, potatoes, rice) and fresh fruit and vegetables.
•Use ready prepared meals and snacks where possible.
•Pre-prepare food when you have the energy and freeze it for later.
•Take advantage of the times when your appetite is best.
•Drink plenty of fluids. Try to drink at least eight glasses of water/
squash per day. This will keep you hydrated and cleanse your body
of any toxins.
•Please ask for a copy of the booklet “Eating hints for patients”.
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Get good quality rest
Getting the right amount of sleep at night is important. Short periods
of rest are better than long ones. However, only take afternoon naps if
they do not interfere with your night-time sleep. Here are some
suggestions to help you get a good night’s sleep.
•Try to go to bed and wake up at the same time each day.
•Make sure that your bedroom is not too hot or cold.
•If you are disturbed by noise try wearing earplugs. Sometimes a
background noise such as gentle music can be relaxing.
•Avoid drinking tea, coffee and alcohol during the evening. Have malted
drinks instead.
•Have a light snack before going to bed. This will stop you waking in
the night because you are hungry.
•If you cannot fall asleep, avoid lying in bed tossing and turning. Try
reading a book or watching television. Audible tapes with stories
may also be helpful.
•If you still have problems consider asking your GP for some sleeping
pills. They can be very useful to help restore a poor sleep pattern.
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We hope that you found this booklet useful and that some of the advice
given will help you cope with fatigue during and after your treatment. If
you experience fatigue and tiredness because of your treatment, it may
take some time to resolve. Fatigue can continue to be a major issue for
patients who are no longer on treatment. This post-treatment fatigue
can last, with varying degrees, from several weeks to several years. If
you have any worries please speak to your doctor, the radiographers or
your nurse specialist/key worker.
If you are still having problems or feel that you cannot cope, please
speak about the fatigue with a member of your medical team.
Remember that fatigue is a common side effect. You are not alone.
Your body is giving you some very important messages, “listen”
to it and seek advice. We are here for you and your needs.
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Useful contact numbers
Local
Macmillan Information and Support Radiographer
Mark Williams
Direct telephone:
020 3447 3711
Main switchboard:
0845 155 5000
ext 73711
bleep 1458
Alternative switchboard: 020 3456 7890
ext 73711
bleep 1458
Email: [email protected]
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National
Health Talk Online
Website:www.healthtalkonline.org
Cancer Research UK
Website:www.cancerresearchuk.org
Carers UK
Freephone:
0808 808 7777
Wednesday to Thursday
Email:[email protected]
Website:www.carersuk.org
Macmillan Cancer Support
Cancer Line freephone:
0808 808 0000
Monday to Friday, 09:00 to 21:00
Textphone:
0808 808 0121
Monday to Friday, 09:00 to 18:00
Email:[email protected]
Website:www.macmillan.org.uk
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NHS Direct
Telephone:0845 4647
Available 24 hours
Website:www.nhsdirect.nhs.uk
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Telephone:08454 242424
Website:www.nhs24.com
NHS Choices
Website:www.nhs.uk
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First published: July 2003
Last review date:
June 2013
Next review date: June 2015
Leaflet code:
UCLH/S&C/CD/RT/FATIGUE/2
© University College London Hospitals NHS Foundation Trust
Created by Medical Illustration RNTNEH 020 3456 5103 Unique Code: 28890