Cancer Related Fatigue

Between 80-100% of ppl with cancer report having fatigue, and may report feeling very weak, listless, drained, or “washed out” that may decrease for a while but then come back (American Cancer Society, 2020). Compared to normal fatigue, cancer related fatigue (CRF) is more severe & is an exhaustion that can't be overcome with only rest or a good night's sleep. Related symptoms to CRF include muscle weakness & difficulty with concentrating (Leukemia & Lymphoma Society, n.d.).

Below is an educational video which provides an introduction to what cancer related fatigue is & provides tips on how to manage it.

Tracking your energy

Keeping an energy diary can be a helpful way to understand when you have energy to do certain activities. Not only can you rank and track when you have the most energy during the day, but you can also keep tabs of which activities may be more energy consuming than others. For example, if you have more energy in the morning when you get up it may be beneficial to choose one of your more energy consuming tasks (like doing the laundry) to start with, take a break, and then move on to lighter tasks later in the day.

This activity can help with thinking about and practicing energy conservation as well. The goal of energy conservation is learning how to balance rest & activity during times of fatigue so important activities & goals can still be maintained.

The 4 P's include:

Plan = define your goal for an activity. You can prepare by gathering supplies & equipment needed beforehand to avoid additional trips or steps.
Prioritize = decide what needs to be done first & what can be done later. For activities which may be too taxing, consider delegating tasks to friends and loved ones by asking for their help if they are able to provide it.
Pace = slow & steady and never try to rush. Take time to rest when you feel tired & even before you feel tired.
Position = avoid bending & reaching too much, maintain good posture, & sit vs. stand when you can.

Communicating support with friends and loved ones in stressful times

Below is a psychosocial exercise to not only help boost support for yourself but also for others in your life. Remember to do this for both yourself as well as for the person you are talking with. 😉

1. What I need you to do when I am feeling (stressed, fearful, overwhelmed, exhausted, irritated, etc.) is... (finish the sentence).

2. What I need you NOT to do when I am feeling (stressed, fearful, overwhelmed, exhausted, irritated, etc.) is... (finish the sentence).

References

American Cancer Society. (2020). What Is Cancer-Related Fatigue? American Cancer Society. Retrieved June 19, 2023, from https://www.cancer.org/cancer/managing-cancer/side-effects/fatigue/what-is-cancer-related-fatigue.html

American Cancer Society. (2023). Understanding psychosocial support services. Retrieved from https://www.cancer.org/cancer/survivorship/coping/understanding-psychosocial-support-services.html

AllofMeIowa. (2020). Cancer-Related Fatigue [PDF document]. Retrieved from https://allofmeiowa.org/wp-content/uploads/2020/09/Cancer-Related-Fatigue.pdf

Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., Zucker, D. S., Matthews, C. E., Ligibel, J. A., Gerber, L. H., Morris, G. S., Patel, A. V., Hue, T. F., Perna, F. M., & Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise, 51(11), 2375-2390. doi:10.1249/MSS.0000000000002116

Cancer Research UK. (n.d.). What Is Cancer Fatigue? Cancer Research UK. Retrieved June 19, 2023, from https://www.cancerresearchuk.org/about-cancer/coping/physically/fatigue/what-is-cancer-fatigue

FACIT.org. (n.d.). FACIT Fatigue Scale (Version 4). Retrieved from https://www.facit.org/measures/FACIT-Fatigue

Johnson, L. (2019, October 2). The 4 P's of Energy Conservation. Retrieved from https://www.advancedptsm.com/blog/2019/10/2/the-4-ps-of-energy-conservation https://www.stjoes.ca/patients-visitors/patient-education/a-e/PD%208278%20Energy%20Conservation.pdf

Leapers. (n.d.). Energy diary. Leapers. Retrieved from https://www.leapers.co/resources/technique/energy-diary

Leukemia & Lymphoma Society. (n.d.). Cancer-related fatigue. Leukemia & Lymphoma Society. Retrieved June 19, 2023, from https://www.lls.org/treatment/managing-side-effects/cancer-relate

Living Strength Care. (n.d.). Energy conservation. Retrieved from https://livingstrengthcare.com.au/occupational-therapy/energy-conservation/

MD Anderson Cancer Center. (2016). Build a healthy plate. Retrieved from https://www.mdanderson.org/publications/focused-on-health/build-a-healthy-plate.h29Z1590624.html

Mayo Clinic. (n.d.). Cancer fatigue. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-fatigue/art-20047709

NHS Inform. (2022). Cancer-related fatigue. Retrieved from https://www.nhsinform.scot/illnesses-and-conditions/cancer/side-effects/cancer-related-

fatigue#:~:text=Cancer%2Drelated%20fatigue%20(CRF),continues%20for%20months%20or%20years.

Sadeghi, E., Gozali, N., & Moghaddam Tabrizi, F. (2016). Effects of Energy Conservation Strategies on Cancer Related Fatigue and Health Promotion Lifestyle in Breast Cancer Survivors: A Randomized Control Trial. Asian Pacific Journal of Cancer Prevention: APJCP, 17(10), 4783–4790. https://doi.org/10.22034/apjcp.2016.17.10.4783

Smith-Gabai, H. & Holm, S. (2019). OT in Acute Care (2nd ed., pp. 688-689). American Occupational Therapy Association. Retrieved from https://library.aota.org/OT_in_Acute_Care_2e

Studer, Q. (2022). The well-being tool kit. Studer Community Institute.

Yale Medicine. (n.d.). Cancer-related fatigue. Retrieved from https://www.yalemedicine.org/conditions/cancer-related-fatigue

Yost, K. J., & Eton, D. T. (2015). The Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F): a systematic review of its development, measurement properties, and current recommendations. Quality of Life Research, 24(10), 2479-2493. https://doi.org/10.1007/s11136-015-1009-2