Scripps Cancer Center

Cancer-Related Fatigue

Medical Nutrition Therapy

About

Cancer-related fatigue is described as feeling tired, weak, exhausted, or lacking energy and is the most common side effect of cancer and its treatment. Fatigue can be caused by many things including inadequate nutrition, decreased physical activity, and emotions including depression and anxiety. Cancer treatments and their side effects such as pain, decreased sleep, anemia, nausea, and vomiting are also major contributors.

Cancer-related fatigue is different than any other fatigue. It can be improved through lifestyle changes, including diet, physical activity, and/or medical interventions. It is important to manage this symptom to maintain strength and support quality of life.

 Lifestyle Tips

• Nutrition

  • Eat 4-6 small meals a day to provide constant energy and fuel

    • Choose foods that are easy to chew

    • Have protein with every meal and snack

      • Examples: eggs, milk, Greek yogurt, cottage cheese, beans, nuts/seeds, nut butter, soy, meat, poultry, and seafood

  • Choose iron rich foods

    • Plant sources: whole grain breads, fortified cereals, beans, lentils, soy products, and dark green leafy vegetables such as spinach, brussels sprouts, and broccoli

      • Combine an iron-rich food from a plant source with a food rich in Vitamin C to improve iron absorption

        • Examples: 

          • Orange juice or strawberries + oatmeal or cold cereal

          • Lemon, lime and/or tomatoes + beans or lentils

          • Stir fry peppers, broccoli + tofu

    • Animal sources: beef, sardines, shrimp, clams

  • Stay hydrated - dehydration can cause or worsen fatigue

    • Aim for a minimum of 8 cups (64 oz) of water a day

    • Include foods that contain fluid or those that melt at room temperature

      • Examples: soup, gelatin, ice cream, frozen yogurt, and frozen popsicles/ices

  • Meal preparation

    • Buy foods that are easy to prepare or cook

      • Examples: frozen fruits and vegetables, canned beans or soups, and already prepared fresh or frozen foods and meals

    • Have easy to grab foods that require minimal preparation on hand

      • Examples: yogurt, cottage cheese, trail mix, bars, nut butter, cheese sticks, dried fruit, nutrition drinks

    • Use the microwave to cook or re-heat foods

    • Use curbside or home delivery for groceries and meals to go

    • When feeling well, make extra food to save or freeze and eat later

    • Allow friends, family, and caregivers to cook or help prepare meals and snacks

• Physical Activity

  • The best way to reduce cancer-related fatigue: exercise!

    • Try going for a 10-minute walk, swim, cycle, practice yoga, or strength train if it is safe for you

    • This will improve physical strength, boost mood, and improve sleep

  • Stay active and engaged in regular activities such as socializing with friends and family, enjoying hobbies, gardening, volunteering, etc.

• Sleep and Rest

  • Aim for 7-8 hours of sleep each night

  • Avoid screen time 1-2 hours before bed - take a bath, listen to music, or read a book instead

  • Keep a routine of when to sleep and when to wake up

  • If you cannot sleep, go to another room and do something relaxing until you feel tired

  • Avoid alcohol, caffeine, and nicotine in the evening

  • Plan the day to include time for rest and short naps (30 minutes or less) in the late morning or early afternoon, when/if needed

  • Evaluate your room

    • Identify the bedroom with sleeping - watch television, read, and work in a different room

    • Keep it cool, between 60-67ºF, and consider using a fan

    • Reduce light - use black out curtains and/or an eye mask

    • Sleep on a comfortable mattress and pillow

    • Drown out noises that may startle you awake through use of a fan, white noise machine, or ear plugs

• Keep an Activity Log

  • Track activities performed during the day and your level of fatigue

  • You may start to see patterns. For example, maybe you notice you feel more tired after chemotherapy or in the mornings

    • This insight will help your healthcare team better support you with an individualized approach

• Get Help and Support

  • If some offers you help, accept it

  • Ask family, friends, and other support systems to perform tasks such as cleaning, cooking, gardening, grocery shopping and running errands

  • Provide specific requests so others can best support you

  • Talk to those close to you and consider joining a support group with others who understand what you're going through

  • If you are feeling anxious or depressed, tell your healthcare team and they will help connect you with someone who can help

Contact the healthcare team if:

• Fatigue worsens

• Feeling too tired to get out of bed for 24 hrs

• Experiencing confusion, dizziness, lose balance easily, or shortness of breath