One of the most common side effects of almost any type of chemotherapy is fatigue. And because the effects on the body from chemotherapy are cumulative, the fatigue often builds, worsening as treatment progresses. Fatigue from chemotherapy often happens during that first week or two after receiving the treatment, but as time goes on, the symptom may last longer and longer.

For many people, it can be disabling.

Feeling tired or weak during cancer treatment can be related to several things — sadness or depression, poor nutrition or not eating enough, disrupted sleep or not enough sleep, pain medications (especially narcotic medications), or anemia (decreased hemoglobin, which is carried by red blood cells). If any of these are occurring, it’s important to take care of these issues first to see if the fatigue improves. Sometimes the fatigue is related to the cancer or the treatment itself, however. That kind of fatigue is harder for us, as oncologists, to help with.

The one big thing that patients can do that can help? Stay active.

People undergoing cancer treatments are usually concerned about whether it’s okay for them to exercise, to go to the gym, to continue playing tennis or going for their morning runs. If there are no other health reasons — like a recent surgery — that would prohibit exercise, my advice is always to continue staying active during chemotherapy.

Here are all of my tips to combat fatigue during chemotherapy, once any treatable conditions have been dealt with appropriately:

1. Get moving. Whether it’s walking or swimming or going to the gym, do something on a daily basis if possible. Not only will the exercise help with fatigue, but it helps to improve appetite and quality of life.
2. Take time to relax. Schedule some rest in your day so that you conserve energy when it’s not needed.
3. Eat well. Keeping up with your nutrition is important on so many levels. Even if you can’t eat three big meals a day, snacking or grazing throughout the day on healthy snacks can keep things going in the right direction.
4. Practice good sleep habits. Taking simple steps, such as limiting naps to short periods of time (maybe 45 minutes to 1 hour), turning off the television or computer during the hour before bedtime, and avoiding caffeine in the afternoon, will help nighttime sleep be more restful. With better rest at night, you might feel more energized for more physical activity the next day.

photo credit: Caitlin Regan, 2008