Cancer and Fatigue: in the workplace

When dealing with cancer, fatigue is a common side effect of treatments. It may include physical, emotional or mental tiredness, and is often unpredictable, hitting without warning.

Everyday activities may become overwhelming tasks, and with cancer-related tiredness, sleep doesn’t help.

The fatigue doesn’t stop when the treatment stops either – it may continue for months or years afterwards. Many people report that fatigue is the most distressing side effect of cancer and its treatment.

It’s worth remembering however that not everyone who has cancer suffers from fatigue, and for those who do suffer it may vary from minor to severe. 70% to 90% of people with cancer are reported to suffer from it, however only 20% think something can be done about it so many don’t even mention it to their doctor.

Cancer-related fatigue is sometimes called CRF or simply “cancer fatigue”.

What causes it?

Fatigue in cancer patients may be caused by:

The cancer
Cancer treatments – chemotherapy, radiation therapy, surgery, bone marrow transplants and biological therapy may all result in fatigue, caused by or in addition to other side effects. People being treated with chemotherapy often find that their fatigue is often worse in the first few days and gets better as the treatment goes on.
Anaemia – this may occur if the treatment destroys too many healthy red blood cells, or if the cancer has spread to the bone marrow.
Pain – Chronic pain may cause people to become less active, eat less, sleep less and become depressed, all of which add to fatigue.
Emotions – anxiety, stress or depression may add to fatigue.
Lack of sleep
Poor nutrition
Medications – some medications, including pain relievers, may cause fatigue.
Lack of exercise – people who lead active lives but are forced to slow down may feel fatigued. Try to maintain normal activity levels if possible.
Hormonal changes – these may occur as side-effects of treatments including surgery, radiation therapy or chemotherapy. Changes to the thyroid gland, adrenal glands, testes or ovaries may also cause fatigue.

When to talk to a doctor

Consulting a doctor is important if the person is experiencing:

Dizziness
Confusion
Loss of balance
Inability to get out of bed for more than 24 hours
Severe shortness of breath
Worsening signs and symptoms
Uncontrolled pain
Inability to control side effects such as nausea, vomiting, diarrhoea or loss of appetite
Ongoing depression

Fatigue or Depression?

Some signs of fatigue are similar to depression, and sometimes both fatigue and depression are in play, so the person should talk to their doctor. The doctor may refer the patient to a mental health professional for an opinion.

Management

The most effective ways to manage fatigue include:

Developing good sleeping habits
Engaging in physical activities and exercise
Smart use of time and energy
Appropriate handling of other health factors

What is the right kind of exercise?

Regular moderate exercise can help to decrease feelings of fatigue, even during cancer treatment. Checking with the doctor is a sensible first step.

Effective exercises for people undergoing cancer treatments include:

An exercise plan which starts slowly, allowing the body time to adjust
The exercise is most helpful when regular – preferably every day
The exercise should not leave the person feeling significantly stiff, sore or exhausted
Exercise of moderate intensity is the most successful, such as walking, using an exercise bike, yoga or swimming

Getting support from other people

Those with cancer need help and support. This may mean help from family and friends, as well as medical practitioners, but it may also include support from other people who have been through the same difficulties.

Managing work with fatigue

If patients continue to work while dealing with cancer and suffering from fatigue, they should be encouraged to talk to their employer or human resources. Adjustments may be possible to help them to continue working: