Search
Close this search box.

About Lymphoma

Fatigue

Fatigue is a feeling of extreme tiredness and weakness that isn’t improved after rest or sleep. It is not like normal tiredness, and it can have a big impact on your quality of life. You may get fatigue because of your lymphoma or as a side-effect of treatment. To complicate things, many people with cancer also experience changes to their sleep cycle and can have trouble getting to sleep, or staying asleep for a full nights rest.

For many people, fatigue lasts for months or even a couple of years after treatment ends so it is important to learn new habits that help protect your energy, while still being able to continue with your life.

On this page:
"Coping with fatigue has been one of the worst side effects. But I am kind to myself when I need rest and found exercise helped."
Jan

Causes of fatigue

There is no one cause of fatigue. When you have cancer, and have treatment for cancer, you will have many different risk factors for fatigue. These can include: 

  • The lymphoma using your bodies energy stores to grow.
  • Normal emotional responses to having lymphoma and the way your life has changed.
  • Pain, which may be related to where the lymphoma is growing, procedures such as central line insertion or biopsies, surgery or radiation treatment. 
  • Infections.
  • Low red blood cells or haemoglobin (anaemia).
  • Changes in your hormone levels and proteins that regulate inflammatory processes.
  • Side-effects of some medicines such as monoclonal antibodies, radiation therapy and chemotherapy.
  • Your body using extra energy to replace good cells at a faster rate than normal, because of damage caused by your treatment.

There are many different symptoms that fatigue. You may: 

  • Find simple chores seem overwhelming. 
  • Feel as if you have no energy and could spend whole day in bed.
  • Wake up tired after a full night’s sleep.
  • Feel sluggish, slow or weak.
  • Have trouble thinking, making decisions or concentrating.
  • Feel irritable or short-tempered.
  • Be more forgetful than usual and feel like you have a mental fog.
  • Become breathless after only light activity.
  • Lose your sex drive.
  • Feel sad, frustrated, or upset.
  • Feel isolated because you don’t have the energy to socialise or keep in touch with people.
  • Be too tired for work, social life, or daily routines.

Fatigue related to your lymphoma or its treatments may be mild or severe. Everybody responds differently, but most people will experience some level of fatigue.

Things people have said about their cancer related fatigue: 

  • I felt completely drained of energy.
  • Sitting up was sometimes too much of an effort.
  • I couldn’t even get out of bed today.
  • Standing just took too much out of me.
  • The fatigue was extreme, but improved a couple of weeks after radiation treatment.
  • If I pushed myself to go for a short walk in the morning, I felt better on those days, the fatigue wasn’t so bad.

How an Occupational therapist can help with fatigue

You do not have to ‘put up with fatigue’, and it does not need to be something you cope with alone.

Occupational therapists (OT) are university trained health professionals. They are part of the allied health team and can help you manage your fatigue and improve your quality of life.

They are able to assess how you are going and what supports you may need. They can also help you with strategies and equipment to help make things easier. Watch the video to find out more about how an occupation therapist can help you.


Talk to your local doctor (GP)

Your GP can refer you to an OT as part of chronic disease health management plan (also called a GP management plan). The hospital you have treatment at may also be able to refer you to an OT.

When you get a GP management plan, you can access up to 5 allied health appointments which is covered by Medicare, meaning you should not have to pay, or only pay very little. Allied health visits can include seeing an occupational therapist, an exercise physiologist and more. To see what is covered under allied health click here.

How to cope with fatigue?

Firstly, you need to go easy on yourself. Having lymphoma puts extra strain on your body as the lymphoma uses up some of your energy stores to keep growing. 

Then treatments put extra pressure on your body again and your body needs to work harder to clear the lymphoma, and repair or replace your good cells damaged by the treatments.

Protect your energy!

When you’re fatigued and not sleeping well, small changes in your routine can make a big difference. The Royal College of Occupational Therapists recommend protecting or conserving your energy using the 3 P’s – Pace, Plan and Prioritise. Click on the headings below to learn more.

Give yourself permission to take your time. Rushing and trying to get things done quickly will make you feel more tired in the short-term, and possibly make you feel more fatigue and pain the following day.

  • Break your task into smaller chunks with regular rest periods – (e.g., you don’t need to vacuum the whole room in one go, and you can have a rest half way up a flight of stairs).
  • Rest in between activities. Sit or lay down for 30-40 minutes before moving on to a new task.
  • Sit instead of stand where possible.
  • Spread activities across the day or week.
  • BREATHE – anxiety, fear, concentration or busyness can cause us to subconsciously hold our breath. But breathing helps get the oxygen around our body that we need for energy. Remember to breathe – Do not hold your breath.

Plan – Take time to think about the task you need to do, and plan how to do it.

  • Collect everything you need before you start so you don’t need to go back and forth.
  • When you have items to carry, use a basket on wheels.
  • If you need to drive several places, plan the order so you drive the least distance.
  • Avoid planning tasks around the time you need to be somewhere.
  • Have a seat in the bathroom or at the sink so you can sit while you shower, brush your teeth, do the dishes.
  • Use special equipment to make the task easier – An occupational therapist can help you with this (ask your GP for a referral).
  • Have someone rearrange furniture and equipment to make the task easier.
  • Ask for help and prepare a list for family and friends.
  • Keep a diary to note down what times of days your energy is at its highest and lowest. Plan your activities for when your energy is higher.

There are many things we do that do not have to be done. Other things, may need to be done, but are not urgent. Consider what is most important and aim to do those.

  • Plan to do the most important or high energy tasks first, or at a time of day your energy is at its highest.
  • Delegate – who can help and do some of the work for you? Ask them to help.
  • Put off non-urgent tasks for another time.
  • Get comfortable saying “No”. This can be difficult but it is an important part of your self-care while having treatment for, or recovering from lymphoma.

Other tips that may help

Eating healthy foods

Your body needs extra energy to fight the lymphoma and recover from treatments. Eating foods high in nutrition is the only way to put extra energy into your body naturally. Think about the foods you eat, and choose foods higher in nutrients and protein. Some easy to prepare foods that are healthy can include:Pie chart showing healthy food choices from the 5 food groups.

  • eggs
  • nuts and seeds
  • fruits and vegetables
  • red meat
  • smoothy with natural yoghurt and fruit
  • meal supplements such as sustagen or ensure.

Everybody’s energy needs will be different, and depending on other side-effects you may have, you may have different things to consider when it comes to food.

(Avoid soft cheeses and processed meats if you are neutropenic, and always wash fresh fruit and vegetables).

Keep hydrated!

Being dehydrated will make your fatigue worse and cause other problems such as low blood pressure, dizziness, headaches, and can cause problems for your kidneys.

You need to drink about 2-3 litres of fluids every day. Drinks with caffeine or alcohol are not included in your fluid intake. Alcohol and caffeine can make your dehydration worse.

Fluids that do count toward your fluid intake include:

  • water (you can flavour with cordial or fruit if you prefer)
  • fruit juice
  • watery soups
  • jelly
  • ice-cream (do not have soft serve ice-creams if you are neutropenic)
  • sustagen or ensure.
Who can help?

Most hospitals can refer you to see a dietician. A dietician is a university trained allied healthcare professional. They will look at your energy needs and consider your lymphoma and treatments. They will then work with you to make a healthy diet to meet your body’s needs that is affordable to your and easy for you to prepare.

Your GP can also refer you to a dietician as part of chronic disease health management plan.

Exercise

When you’re feeling fatigued,  exercise is probably one of the last things you want to think about. However, research has shown that exercise can help improve symptoms of fatigue. 

You can get access to an exercise physiologist through a GP management plan.

To find an exercise physiologist in your area, click here.

Treatment of fatigue

There is no specific treatment for fatigue. Because there are many causes of fatigue, treatment is aimed at improving whatever the underlying cause is. For example if you are:

  • anemic, you may be offered a blood transfusion.
  • dehydrated, you will be encouraged to increase the fluids you drink or be given fluids through a cannula or central line straight into your blood stream.
  • in pain, your doctor will want to manage the pain better for you.
  • not sleeping improving your sleep quality will be the goal (more information on this later on this page).
  • stressed or anxious, managing these with relaxation or meditations, counselling or psychology may help.

A dietician may also be able to help make sure you get enough calories, nutrients and protein for your body’s needs.

Managing sleep problems and insomnia

There are many factors that can affect your sleep patterns, and quality of sleep. These can include:

  • stress, anxiety, depression or fear
  • medicines such as steroids given as part of your treatment
  • sleeping during the day
  • hormone imbalances
  • night sweats or infections
  • pain
  • changes to routine
  • noisy hospital wards.

For more information on managing sleep changes, click the link below.

For more info see
Sleep issues

Summary

  • Fatigue is the most common symptoms of cancer, and side-effect of cancer treatments.
  • It can impact your ability to do even the simplest of tasks.
  • Fatigue is not as simple as being tired. It is an extreme type of tiredness not improved with rest or sleep.
  • You do not have to put up with fatigue – there are many strategies to improve fatigue and your quality of life.
  • The 3 P’s Pace, Plan and Prioritise are a good start o managing your fatigue.
  • Keeping hydrated, eating a healthy diet and exercise can help improve symptoms fatigue.
  • Treatment will be aimed at improving the underlying cause of your fatigue.
  • Allied health professionals are university trained health care staff the can help you manage fatigue. Ask your doctor at the hospital or your local GP to refer you to dietician or occupational therapist. This can be done as part of chronic disease management plan.
  • You are not alone, if you would like to chat to a Lymphoma Care Nurse click the Contact us button at the bottom of the screen for contact details.

Support and information

Sign up to newsletter

Share This

Newsletter Sign Up

Contact Lymphoma Australia Today!

Please note: Lymphoma Australia staff are only able to reply to emails sent in English language.

For people living in Australia, we can offer a phone translation service. Have your nurse or English speaking relative call us to arrange this.