Overcoming cancer-related fatigue

Gabriella Kourie elaborates on how to overcome cancer-related fatigue.

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Cancer-related fatigue is broadly used to describe a multi-factorial symptom of cancer. Fatigue is described as a feeling of being tired or weak and in severe cases exhausted. There are different types and levels of fatigue especially during cancer treatment. There is physical fatigue, but undoubtedly so emotional and psychosocial fatigue is attached to the healing process.

If you have undergone treatment yourself or if you have watched a loved one undergo treatment; you will know that fatigue can occur before and long after treatment is completed. It’s important to understand the various causes of fatigues so that you can better understand what to do and how to combat it.

Fatigue differs from person to person and the key concept here is that it isn’t one element that triggers the fatigue but rather numerous elements.

Let’s start at the core

The cancer: Cancer causes changes in your body that can lead to fatigue. This occurs on a more complex level of changes in your protein and hormone levels. After receiving a diagnosis, many patients have said “Oh, maybe that is why I’ve been feeling so tired.” The cancer itself may be drawing nutrients and energy from the body causing the feeling of fatigue. 

The treatment: All oncology treatments can result in fatigue as a side effect. In all of the systemic treatments, there is damage to your healthy cells as well as the malignant ones. Fatigue may occur as your body works hard to repair and replace the damaged cells caused by treatment. 

The outer layers of fatigue

There are a variety of side effects that can occur with your treatments. Symptoms such as anaemia; loss of appetite and nausea; pain; insomnia; decreased physical activity; mood changes; and time spent on the treatment (travelling to appointments or giving up large time periods to achieve health), can all contribute to fatigue lingering long after active treatment is finished.


Starting your chemotherapy cycles with a blood test isn’t for fun. Your oncologist is mainly looking at your white blood cell count to see if your immune system is strong enough to fight the next round. However, a decreased red blood cell count is also common in the cancer community. You can be anaemic before starting treatment or develop it as the treatment starts to periodically destroy healthy red blood cells. It’s important to raise feelings of fatigue with your oncologist at check-ups as there may be an underlying anaemia contributing to the fatigue.

Nausea, vomiting or loss of appetite

A dysfunctional digestive system or loss of appetite can be more dangerous than it seems. Food is energy and when you don’t eat, you don’t have the fuel your body needs to carry out basic functions.

Vomiting and diarrhoea don’t help either; the amount of nutrients being absorbed is diminished leading to fatigue and lack of drive and energy. Speak to your doctor about weight- and appetite loss and bowel dysfunction. A referral to a dietitian goes beyond wanting to control weight and is a vital role in maintaining a healthy diet during and after cancer treatments.


Chronic pain is unfortunately common. It may be from muscle wasting, early symptoms of menopause or even a metastases site. Pain makes you inclined to be less active, which in turn leads to a decreased appetite, more time sleeping or resting and can go as far as depressing your mood. All of these factors lead to fatigue and can easily become a vicious cycle.

Mood and emotions

A diagnosis comes with many valid emotions from anxiety, stress and even depression which can all lead to experiencing emotional fatigue.


The word cancer is enough to give you sleepless nights and if you are experiencing disturbed sleep or sleeping less at night (either due to treatment, feelings of anxiety or day sleeping) you can experience fatigue.

Lack of exercise

Being idle or moving less is unquestionably a cause of cancer-related fatigue. Exercising carefully and safely during chemotherapy treatments is highly encouraged. By doing meaningful and purposeful tasks during the day not only boosts your mood but requires small bursts of physical exertion which lead to you feeling tired at the end of the day and not fatigued. Guided and prescribed exercises help with poor sleep, low mood, pain and, most importantly, fatigue.

Fatigue is part of the cancer experience, however, please don’t take it as a new factor you now have to live with. Speak to your oncologist first and foremost and then safely reach out to an oncology dietitian and rehabilitation specialist.

Gabriella Kourie is a qualified occupational therapist. She further trained and qualified 
as a PORi oncology and breast cancer rehabilitation therapist and is currently qualifying in Lymphoedema Assessment 
and Treatment.

MEET THE EXPERT – Gabriella Kourie

Gabriella Kourie is a qualified occupational therapist. She further trained and qualified as a PORi oncology and breast cancer rehabilitation therapist and is currently qualifying in Lymphoedema Assessment and Treatment.

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