What is cancer-related fatigue?
Cancer-related fatigue is a very strong feeling of tiredness.
It can happen because of:
- The cancer itself
- Treatment or medicines
- Stress or worry
- Pain
This tiredness can change from day to day.
Sometimes it does not get better with rest.
Fatigue can affect:
- Physical activities (like walking or climbing stairs)
- Everyday tasks (like reading or seeing friends)
Any activity that uses energy can feel harder.
Fatigue can happen at any point, before, during or after treatment.
Small changes can help
Making small changes to your day can help you manage fatigue.
You can use your energy in a way that works better for you.
Keeping a fatigue diary can help you:
- Spot patterns
- Plan your day
- Save energy for the things that matter most
Watch this video from Macmillan for more support:
Coping with fatigue – Macmillan Cancer Support
https://www.youtube.com/watch?v=JMApRzwXFEc
Things to avoid
Some things can make fatigue worse.
Try to avoid:
- Drinking alcohol
- Drinking caffeine
- Long naps (more than 15 minutes)
- Napping after 3pm
These can all make you feel more tired later.
The 5 Ps: ways to save your energy
You can manage fatigue by remembering the 5 Ps.
1. Pacing
- Balance activity with rest
- Take breaks often
- Work slowly and steadily
- It is better to finish something with energy left
than rush and feel worn out later
2. Planning
- Spread your activities across the week
- Don’t try to do everything in one day
- Think about when you have the most energy
- Check your energy before and after tasks
using a scale from 0 (no energy) to 10 (full energy) - Try to reduce extra hard tasks, like going up and down stairs many times
3. Prioritise
- Focus on the things that matter most
- Choose activities that bring you joy — they can give you energy
- Try to cut back on things that aren’t important
4. Permission
- Give yourself permission not to do everything
- It is okay to rest
- Ask others to help with tasks when you need it
5. Posture
- Avoid bending or twisting too much
- Change your position often
- Sit down for tasks when you can (like chopping food or ironing)
Sitting can save up to 25% of your energy
When to ask for help
If fatigue makes daily tasks difficult, speak to your cancer team.
They can support you or refer you to an Occupational Therapist.
An Occupational Therapist can:
- Help you plan your day
- Give advice on saving energy
- Suggest equipment that may help you
If you experience a new/worsening pain whilst doing an activity, we encourage you to rest, monitor pain and if gets worse to contact your cancer team.
Helpful resources
- Fatigue Management Toolkit
(Newcastle Hospitals)
https://intranet.newcastle-hospitals.nhs.uk/wp-content/themes/karabiner/dl-file.php?file=2024/09/Fatigue-management-toolkit.pdf - Fatigue Activity Rating Diary
https://intranet.newcastle-hospitals.nhs.uk/wp-content/themes/karabiner/dl-file.php?file=2024/09/Fatigue-management-Activity-Rating-Diary.pdf
Sleep
Sleep and cancer
When you are unwell, sleep can become harder.
You might:
- Struggle to fall asleep
- Wake up a lot in the night
- Have bad dreams or very realistic dreams
- Feel tired or worn out during the day
Some medicines can also change how you sleep.
Good sleep is important for:
- Your health (healing and recovery)
- Your feelings (mood and stress levels)
Finding ways to improve your sleep can help your body and mind feel better.
Tips to help you sleep better
Here are some simple things that may help you sleep:
Keep a routine
Try to go to bed and wake up at the same time each day.
Relax before bed
Do something calming, like reading, listening to soft music, or gentle breathing.
Make your room comfortable
Keep your bedroom dark, quiet, and cool if you can.
Limit screens
Try not to use your phone, tablet, or TV for at least 1 hour before bed.
Avoid long naps
Short naps are okay, but try not to nap for more than 15 minutes, and not after 3pm.
Be kind to yourself
Sleep can change during illness — this is normal.
Small steps can still help
