According to the National Cancer Institute, fatigue is the most common side effect of cancer and cancer treatment. It’s normal for you to feel tired and weak at times during chemotherapy.

The fatigue associated with chemotherapy usually gets better during the weeks you aren’t receiving chemotherapy. It’s best to plan a light schedule for yourself after your treatments. Give yourself plenty of time to rest and recuperate.

Some people find they can continue work or complete some normal activities during cancer treatment. It’s easier if you have some flexibility in your schedule and can work part-time or can work from home some days. Making time to rest and allowing others to help can make it easier to get through the more difficult days.

If you work outside the home, it’s a good idea to explore your employer’s sick and disability leave policies. Consider ways you might get help with childcare, household tasks, or other obligations.

Taking these steps can help you prepare for periods when you need to take it easy.

What if the fatigue doesn’t go away?

The fatigue related to chemotherapy will slowly subside after treatment. Many people experience low energy levels for months but then start regaining their energy.

Fatigue during chemo may have multiple causes or aggravating factors including:

  • Lack of sleep
  • Low white blood cell count
  • Low red blood cell count, a condition called anemia
  • Pain
  • Depression
  • Anxiety

How can my doctor help with fatigue?

Because there’s no medical test for fatigue, it’s important to talk to your healthcare team if you’re feeling extra tired or weak.  This is especially true if you find exhaustion is keeping you from normal activities.

To assess fatigue, your doctor or oncologist may do a physical exam and run some blood tests. Blood tests can check for signs of anemia or other imbalances. You’ll likely be asked to describe how you’re feeling and to rate your level of tiredness.

Your care providers may also ask about medications you’re taking as well as your sleep, eating and exercise habits. It may help to write down your daily routine, medications, and how you feel.

How can I manage my fatigue?

The best way to manage fatigue related to chemotherapy will depend on the cause. Of course, chemotherapy is the main reason for your fatigue but other factors like neutropenia, anemia, depression, and pain can aggravate or trigger fatigue.

If you’re anemic, a diet high in iron may help. Your oncologist may suggest a blood transfusion or prescribe a drug to boost your red blood cells. If fatigue is related to pain or depression, medications may help with those symptoms too. It’s important to note that these medications are rarely used due to their risk factors.

Sometimes it’s hard to pinpoint and treat a clear cause of fatigue. The following strategies may help with general fatigue:

  • Practice moderate exercise.
  • Maintain a regular routine for rest.
  • Eat a healthy diet.
  • Drink plenty of fluids.
  • Consider ways to avoid or manage anxiety and stress.
  • Prioritize your activities and delegate or let others help you where possible.

Talk therapy or social support groups may also help. In one study, cognitive behavioral group therapy improved fatigue in people with breast cancer after eight weeks.

Can alternative therapies help with my fatigue?

Alternative therapies may help with fatigue and other side effects of cancer and its treatment. Meditation, yoga, and other lifestyle modifications can improve fatigue and other cancer-related symptoms.

While more research is needed, studies suggest that neurofeedback, a non-invasive form of brain training, may also help with side effects including fatigue. In this method, people learn to modify the activity of the brain.

Clinical trials are exploring various alternative approaches for managing breast cancer-related fatigue including:

  • Therapeutic massage
  • Art therapy
  • Tibetan yoga
  • Reflexology
  • Light exposure

These alternative methods may be safe to try along with those recommended by your doctor.

It’s always best to talk with your doctor about alternative therapies you’re planning to pursue. Be especially careful about vitamins and other supplements. Some over-the-counter vitamins and supplements may interfere with cancer treatment.

Should I be worried?

Fatigue during chemotherapy treatment is normal. Your healthcare team may offer strategies to manage those feelings. There will be times when you just need to give yourself a break and let others pitch in.

The Mayo Clinic says to contact your doctor right away if your symptoms get worse. Seek help if you become dizzy, confused, or short of breath. An inability to get up for more than 24 hours may also be cause for concern.