Understanding Fatigue: Causes, Symptoms, and Management

Cancer-related fatigue is more than just feeling tired - it's a deep, persistent exhaustion that can impact daily life. Whether you're undergoing treatment or in recovery, understanding the causes and best ways to manage fatigue can help you regain energy and improve well-being.

What you'll learn by reading this page:

What is cancer-related fatigue
Learning how cancer-related fatigue can affect you
Effective ways to manage fatigue during cancer treatment
How diet, probiotics, and supplements can help with cancer fatigue

What is cancer-related fatigue?

Cancer-related fatigue (CRF) is one of the most common cancer symptoms, affecting more than half of cancer patients.

Many people with cancer experience fatigue, a profound sense of tiredness, low energy, and exhaustion. This can occur before, during, and after treatment, with several reports of fatigue persisting for weeks, months, or even years after completing cancer therapy. Cancer-related fatigue (CRF) is a combination of physical, emotional, and mental exhaustion that does not improve with rest or sleep. It is typically more severe and difficult to manage than the fatigue experienced by those without cancer and can affect individuals regardless of whether they are undergoing cancer treatment.

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"You have a wonderful way of fostering community - letting us know that you feel that connection with us and see it among us. Thank you so much for that."

Cancer Survivor,
Member of The After Cancer

Cancer treatments and cancer-related fatigue

Chemotherapy: Many patients notice fatigue setting in a few days after a chemotherapy session. For some, it lingers until the next treatment, while others feel drained from the very first session onward. The body works hard to recover between treatments, which can leave patients feeling exhausted, but it generally improves before the next treatment.

Radiation Therapy: Unlike chemotherapy, fatigue from radiation therapy tends to build up gradually over weeks, peaking near the end of treatment. While energy levels may start improving after radiation ends, it can take weeks or even months to fully recover.

Immunotherapy: With immunotherapy, fatigue can be unpredictable, sometimes appearing early in treatment, other times weeks or months later. The immune system is working overtime to fight cancer, which can lead to extreme tiredness as a side effect.

Post - Surgery: It’s no surprise that surgery takes a toll on the body. The immediate aftermath is often the most exhausting, but as the body heals, energy levels gradually improve. Recovery time varies depending on the type and extent of surgery.

Anemia: Cancer treatments like chemotherapy, radiation, and surgery can reduce red blood cell levels, leading to anemia, a major cause of fatigue. Since red blood cells carry oxygen throughout the body, a low count can leave patients feeling weak, dizzy, and drained.

“When I think of Cancer Related Fatigue, I recall a conversation that I had with my brother who had been diagnosed with non-hodgkins lymphoma. He had endured many harsh treatments and ultimately needed a stem-cell transplant. He was talking to me about his extreme level of exhaustion and described it like this: He said, “It’s like you see a pencil across the room, and you know you need that pencil, but you just don’t have the strength to stand up and get it. You may look at it for a long time, trying to muster up the energy to get there. Whether or not you do just depends on the day.” Perhaps this is an extreme example, but anyone experiencing CRF can certainly relate.”

Marie Theriault

Instructor of Tai Chi, Qigong and Yoga at The After Cancer

What else makes cancer-related fatigue worse?

While cancer treatments like chemotherapy, radiation, surgery, and immunotherapy are major causes of cancer-related fatigue (CRF), they are not the only factors at play. Many other physical, emotional, and lifestyle-related issues can make fatigue worse or prolong it, even after treatment ends.

Pain and fatigue: A draining cycle

Why it matters: Chronic pain is exhausting, both physically and mentally. The body is constantly in distress, which drains energy levels.

Pain medications can also contribute → Some drugs used for pain management cause drowsiness and weakness, further worsening fatigue.

Emotional distress, anxiety & depression

Why it matters: Mental health plays a huge role in energy levels. Cancer-related stress, anxiety, and depression can lead to chronic exhaustion, loss of motivation, and poor sleep.

Fatigue and mental health are connected → Feeling constantly tired can make depression and anxiety worse, creating a vicious cycle.

Lack of physical activity

Why it matters: While too much exertion can worsen fatigue, too little movement can also have negative effects. Prolonged inactivity leads to muscle weakness, reduced stamina, and even more exhaustion.

Gentle movement can help → Light activities like walking, stretching, or yoga can boost energy without overexertion.

“I can remember feeling too tired to even watch television during chemotherapy treatment. It's not uncommon for individuals undergoing cancer treatment, such as chemotherapy and radiation therapy, to experience profound fatigue that significantly impacts daily life. For me, the journey of recovery included exercise and nutrition”

Dr Chasse Bailey Dorton

Breast cancer survivor & Medical Director of The After Cancer

cancer survivor meditating with daughter

Sleep problems and fatigue

Why it matters: Many cancer patients struggle with insomnia, restless sleep, or frequent nighttime waking, which prevents full recovery overnight.
Common sleep disruptors include Insomnia (difficulty falling or staying asleep), Sleep apnea (breathing interruptions during sleep), Restless leg syndrome (uncontrollable urge to move legs at night).

Poor sleep = Increased fatigue → When the body doesn’t rest properly, energy levels crash during the day.

Poor nutrition and dehydration

Why it matters: Food and water are the body's fuel sources. Without proper nutrition, the body can’t produce enough energy.
Common eating challenges include loss of appetite, nausea from treatments, difficulty swallowing and changes in taste or smell

Hydration is key → Even mild dehydration can make fatigue worse. Cancer patients should focus on nutrient-dense meals and plenty of fluids to maintain energy levels.

Other health conditions that worsen fatigue

Why it matters: Many cancer patients also have pre-existing health conditions that can make fatigue worse.

Common contributors include heart disease, respiratory conditions, or hormonal imbalances

Cancer-related fatigue isn’t just about treatment, it’s influenced by pain, mental health, sleep quality, nutrition, activity levels, and overall health. By identifying and addressing these factors, patients can take proactive steps to improve energy levels and overall well-being.

Schedule a FREE call to explore how The After Cancer can help you manage fatigue, restore energy, and support your mental well-being after treatment.

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Effective ways to manage fatigue during cancer treatment

Cancer-related fatigue (CRF) is one of the most common and challenging side effects of cancer and its treatments. Unlike everyday tiredness, CRF is a deep, persistent exhaustion that doesn’t fully go away with rest. It can affect physical energy, emotional well-being, and cognitive function, making daily activities feel overwhelming.

While there’s no single medication specifically approved to treat cancer fatigue, research has shown that a combination of lifestyle changes, medical support, and holistic approaches can help patients regain energy, improve quality of life, and better cope with their treatment journey. From nutrition and exercise to sleep therapy and stress management, there are many proven strategies that can help manage fatigue effectively.

This article explores the best ways to reduce cancer-related fatigue, including medical options, lifestyle adjustments, and alternative therapies to support your recovery and overall well-being.

Medical Treatments

There is currently no approved drug specifically for the management of Cancer-Related Fatigue (CRF). Numerous randomized, double-blind, placebo-controlled phase II-III clinical trials have evaluated various drugs and nutraceutical interventions for CRF in oncological patients across all stages of the disease. However, none of these drugs have gained sufficient scientific consensus to warrant a formal recommendation.

Your cancer care team may prescribe medications to help you feel more alert and awake. Always consult your care team before taking any new medicines or supplements, as some may interact with your cancer treatment.

What does this mean for you?

Right now, there’s no single "magic pill" to completely relieve cancer-related fatigue, but doctors are actively researching ways to help. While some medications might be used off-label to boost energy levels, their effectiveness varies from person to person. This is why it’s crucial to work closely with your medical team to find the best way to manage fatigue safely, whether through medications, lifestyle changes, or other supportive treatments.

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"Try replacing one negative thought with three positive ones. For example, Sandy might say “I don’t think I can do this. I am depleted.” She chooses to replace that with “I have the tools to get stronger. I can start small. I survived cancer. I can do this.” The three-to-one ratio can rewire our brains by shifting from the negative to the positive. "

Katie Estridge,

Physical therapist at The After Cancer

Lifestyle Changes

Counseling and Stress Management

Emotional distress and mental health issues can worsen fatigue. Counseling, stress management techniques, and relaxation exercises can help you cope with and reduce the fatigue you feel.

Incorporating practices such as yoga, Qigong, meditation, and mindfulness into daily routines can significantly reduce stress levels, which is particularly beneficial for those experiencing cancer-related fatigue. These activities not only promote relaxation and mental clarity but also help manage the physical and emotional exhaustion that comes with cancer fatigue. By calming the mind, soothing the body, and reducing stress, they can alleviate some of the overwhelming fatigue associated with cancer, leading to improved energy levels and a greater sense of well-being.

Sleep therapy

If you're experiencing sleep disturbances, such as difficulty falling asleep, frequent awakenings during the night, or sleeping excessively due to cancer-related fatigue, your cancer care team may recommend sleep therapy. Sleep therapy is a structured approach designed to address these issues by improving the quality and consistency of your sleep. This therapy can involve various techniques, such as cognitive-behavioral therapy for insomnia (CBT-I), which focuses on changing negative thoughts and behaviors around sleep. Additionally, it may include sleep hygiene practices, like maintaining a regular sleep schedule, creating a restful sleep environment, and limiting naps during the day.

In some cases, sleep therapy may also involve relaxation techniques, such as mindfulness or progressive muscle relaxation, which can help reduce stress and anxiety that may be contributing to sleep problems. By incorporating these strategies, sleep therapy aims to not only improve your sleep but also enhance your overall energy levels and mood, making it easier to manage the daily challenges of cancer treatment. Improved sleep can lead to better physical and emotional resilience, supporting your recovery and quality of life throughout your cancer journey.

Physical activity

Physical exercise is the most effective intervention for managing Cancer-Related Fatigue (CRF). There is robust evidence that regular physical activity can reduce systemic inflammation, improve energy levels, and help counteract fatigue. Exercise enables patients to perform daily activities more easily and enhances their overall quality of life.

For cancer patients, both during and after treatment, prolonged inactivity can cause a loss of skeletal muscle mass and strength, making it harder to climb stairs, maintain balance, or carry out routine tasks. This physical decline, known as deconditioning, can lead to:

Reduced muscle strength and cardiovascular fitness
Increased physical discomfort and mobility issues
Lower self-esteem and confidence in daily activities
A higher risk of anxiety and depression

What does this mean for you?

Even though fatigue makes exercise feel impossible, staying as active as possible, even with gentle movement like walking, stretching, or yoga, can actually help improve energy levels over time. Movement helps keep muscles strong, supports mental well-being, and can even reduce inflammation, which contributes to CRF. The key is to start small and listen to your body, gradually incorporating safe, tailored exercises based on your abilities and treatment stage. Always check with your healthcare team before beginning any new exercise routine.

"Second, try to get regular exercise with an activity that you love to increase your metabolism and burn more calories. Try walking, biking, yoga or other strength building exercises. Just pick something you would look forward to even if you are tired and not feeling 100%.

Cheryl Hoover

breast cancer survivor and a nutrition coach at The After Cancer

Nutrition

Cancer patients frequently face challenges in maintaining a diet that provides adequate nutrients, which can significantly impact their overall health and contribute to cancer-related fatigue. To address this, your cancer care team may monitor your vitamin and mineral levels to ensure your body receives the essential nutrients needed to support energy levels and reduce fatigue. If you're struggling with eating, consulting a nutrition specialist can offer personalized guidance and support, helping you manage your diet more effectively during treatment and potentially alleviating some of the exhaustion associated with cancer.

Top tips for managing fatigue:

Stay Physically Active
Reduce Stress
Improve Sleep Quality
Eat a Balanced Diet

Schedule a FREE call to explore how The After Cancer can help you manage fatigue, restore energy, and support your mental well-being after treatment.

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How does cancer fatigue affect you - more than just feeling tired

Cancer-related fatigue (CRF) is not just ordinary tiredness. It’s a deep, overwhelming exhaustion that affects the body, mind, and emotions. Unlike normal fatigue, it doesn’t go away with rest, and it can impact every aspect of daily life. Here’s how it may affect you physically, emotionally, and mentally.

“During treatment, I was annoyed, achy and fatigued 90% of the time, elated or confident 9% of the time and “fine” 1% of the time."

Diane M. Simard

Breast cancer survivor

Physical Symptoms

Cancer fatigue can make even simple activities feel like a challenge. Everyday tasks like walking, cooking, or even getting out of bed may feel draining and difficult.

Persistent tiredness

Feeling exhausted all the time, no matter how much you rest or sleep.

Weakness

A noticeable decrease in strength, making it difficult to perform everyday activities.

Shortness of breath

Feeling winded or out of breath with minimal effort.

Sleep problems

Difficulty falling asleep, staying asleep, or experiencing restful sleep, leading to even more fatigue.

Reduced physical activity

A noticeable decline in physical activity due to lack of energy or stamina.

General discomfort

Experiencing aches, pains, or a sense of physical unease that adds to the sense of fatigue.

Difficulty in recovering from physical activity

Taking longer than usual to recover from even mild physical activities.

“I have always been an active person, and it bothered me a lot whenever my body would take longer to recover after doing any kind of exercise post-treatment. I was honestly scared that it would be like that for the rest of my life. But little by little, one exercise at a time, I am regaining the physical capacity I had before chemo.”

Beatriz Costeira

Hodgkins Lymphoma survivor

Emotional and Cognitive Symptoms

Fatigue doesn’t just affect the body. It also impacts mental clarity, mood, and emotions, making it harder to concentrate, stay positive, or feel engaged in life.

Brain fog or difficulty concentrating

Struggling to focus on tasks or maintain attention for long periods of time.

Memory issues

Experiencing issues with short-term memory, such as forgetting appointments or losing track of conversations.

Irritability: Becoming easily frustrated, angry, or upset, often due to the overwhelming sense of exhaustion.

Depression and anxiety

Feelings of sadness, hopelessness, or anxiety that may be exacerbated by the physical toll of fatigue.

Lack of motivation

Losing interest in engaging in activities, like hobbies, or pursuing goals.

Emotional numbness

Feeling detached or indifferent, possibly as a coping mechanism for chronic fatigue.

Overwhelm

Becoming easily overwhelmed by routine tasks or daily responsibilities due to the constant sense of fatigue.

Cancer-related fatigue is more than feeling tired. It's a full-body experience that affects physical strength, mental focus, and emotional well-being. Recognizing these symptoms can help patients and caregivers find better ways to manage fatigue, improve quality of life, and seek the right support.

Schedule a FREE call to explore how The After Cancer can help you manage fatigue, restore energy, and support your mental well-being after treatment.

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Can nutrition and supplements help with cancer-related fatigue?

Cancer-related fatigue (CRF) is one of the most common and distressing side effects of cancer and its treatment. It’s not just about feeling tired after a long day, it is a deep and constant feeling of tiredness that is not fully relieved by rest or sleep. It can affect your physical, emotional, and mental well-being.

But here’s the hopeful part: nutrition can play an important role in managing fatigue. Research shows that eating well can support energy levels, help your body recover from treatment, and improve overall quality of life.

A 2019 review of studies published in Nutrition and Cancer found that nutritional interventions can reduce fatigue in cancer patients, especially when they focus on personalized, high-protein diets and anti-inflammatory foods.

Let’s explore how food can help, and what simple steps you can take.

Disclaimer:

The information in this article is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your doctor, oncology team, or a registered healthcare professional before starting any new supplements, probiotics, or major dietary changes, especially during or after cancer treatment. Some supplements may interact with medications or affect your treatment outcomes. Your healthcare team can provide personalized guidance based on your unique medical needs.

"The kitchen is a place that is so underrated as a space for healing, but I learned in pharmacy school that the first medicines were actually plants and many of todays manufactured medications are created to mimic what foods, herbs and spices do to help us heal and be healthy."

Cheryl Hoover

Breast cancer survivor and a nutrition coach at The After Cancer

1. Eat small, frequent meals throughout the day

Many people with cancer feel too tired to eat large meals, or lose their appetite entirely. But skipping meals or going too long without eating can make fatigue worse. That’s because your body needs a steady supply of fuel to keep going.Try eating small meals or snacks every 3-4 hours, even if you’re not very hungry. This helps stabilize your blood sugar and gives your body the nutrients it needs to recover.

Examples of energy-boosting snacks

Half a turkey sandwich with whole grain bread
Greek yogurt with granola and fruit
Oatmeal with peanut butter and banana
Cottage cheese with sliced peaches
A smoothie with milk, fruit, and a scoop of protein powder

If preparing meals feels overwhelming, consider batch cooking on low-energy days, using frozen healthy meals, or asking friends and family for help.

2. Prioritize nutrient-dense foods

Not all calories are created equal. When you’re dealing with fatigue, every bite matters, so aim to fill your meals with nutrient-dense foods that support energy, healing, and the immune system.

Try to build each meal with a combination of carbohydrates + protein + healthy fat to keep your energy steady.

Focus on these food groups

Whole grains like oats, brown rice, quinoa, and whole wheat bread provide long-lasting energy and fiber.

Lean proteins such as fish, poultry, eggs, tofu, and legumes support muscle repair and immune health.

Fruits and vegetables are packed with antioxidants and anti-inflammatory compounds that help your body recover.

Healthy fats from olive oil, avocado, nuts, and seeds help regulate hormones and keep you full longer.

3. Stay well hydrated

Did you know that even mild dehydration can make you feel more tired? Cancer treatment can cause side effects like vomiting, diarrhea, or sweating that increase your risk of fluid loss.

Signs of dehydration include

Dry mouth

Dizziness or headaches

Fatigue

Dark-colored urine

Sip throughout the day, don’t wait until you’re thirsty. Aim to drink 6-8 cups of water or other fluids each day. If you find plain water unappealing, try herbal teas, broth-based soups, or water infused with lemon, berries, or cucumber.

4. Protein is your friend

One of the most important nutrients during cancer treatment and recovery is protein. Protein helps maintain lean body mass, supports your immune system, and helps tissues heal.

According to research, cancer patients with higher protein intake may experience less fatigue, especially when facing muscle loss or weight changes due to treatment.

Protein-rich foods to include

Eggs or egg whites
Dairy (milk, yogurt, cheese)
Chicken, fish, lean beef or pork
Beans, lentils, chickpeas
Protein powders or nutritional drinks if appetite is low

A simple tip: Include a source of protein in every meal and snack.

5. Be smart about sugars and processed food

When you’re exhausted, reaching for sweets, chips, or soda is tempting. But processed foods and sugary snacks can cause a rapid spike and crash in blood sugar, making your fatigue worse over time.

Instead, choose whole foods with fiber, protein, and healthy fats to help stabilize energy levels.

Instead of this

Candy bar
Pastries
Soda

Try this

Apple slices with peanut butter
Hummus with whole-grain crackers
Trail mix with nuts and dried fruit

Remember: There’s no need to cut out treats entirely, but try to enjoy them in moderation alongside more nourishing foods.

By focusing on a well-rounded diet, proper hydration, and medical supervision, you can take proactive steps toward managing fatigue and improving overall well-being.

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⭐⭐⭐⭐⭐

"Learning new techniques and virtually being able to attend the class was great. I was able to attend no matter where I was. I really enjoyed these sessions. Learned several ways to live life after cancer."

Cancer survivor,

Member of The After Cancer

Common supplements: what science says

In what concerns vitamins and supplements, these and nutraceuticals have been studied for their potential benefits, but scientific evidence remains mixed, and no supplement is currently approved as a standard treatment for CRF.That said, some natural compounds and dietary changes may offer support by boosting energy, improving gut health, and reducing inflammation. Here’s what the research says about common supplements and dietary considerations for managing CRF.

American ginseng root powder

Some research suggests that American ginseng might help alleviate cancer-related fatigue, though more studies are needed to confirm its effectiveness. A systematic review of clinical trials found it to be safe and potentially beneficial, but due to limited research quality, it is not yet recommended as a standard treatment.

L-carnitine, Coenzyme Q10, Astragalus, Guarana

These nutraceuticals have been explored for CRF, but current research does not show strong clinical benefits.

Leading cancer organizations, including ASCO (American Society of Clinical Oncology) and ESMO (European Society for Medical Oncology), do not recommend these supplements for managing CRF.

What does this mean for you?

While some supplements show promise, they are not a guaranteed solution. If you’re considering adding supplements to your routine, it’s essential to consult with your cancer care team to ensure they are safe and won’t interfere with your treatment.

Probiotics and gut health

Probiotics may support digestive health and strengthen the immune system, potentially reducing the severity and frequency of diarrhea caused by antibiotics or chemotherapy. Emerging research also suggests that gut bacteria could influence fatigue and cognitive issues, commonly known as "chemo-brain," which are side effects of chemotherapy.

Since it can be challenging to get enough probiotics solely through diet, patients might consider adding probiotic-rich foods like kefir, Greek yogurt, kimchi, miso, and other fermented foods to their meals. Additionally, a high-fiber diet, rich in fruits, vegetables, legumes, and whole grains, may improve the diversity of gut bacteria.

Patients should consult with their healthcare team and seek nutritional guidance before starting probiotic supplements.

What does this mean for you?

Instead of relying on supplements, focusing on a balanced diet with probiotic-rich and fiber-packed foods may be a more effective and safer way to support energy and overall health during cancer treatment.

While some supplements show potential for managing cancer-related fatigue, there is no universal solution, and research remains inconclusive. The best approach is a combination of nutrient-dense foods, gut health support, and medical guidance.

Before taking any vitamins, supplements, or probiotics, it’s crucial to consult your healthcare provider to ensure they are safe and appropriate for your specific cancer treatment plan.

"People with cancer are bombarded with false information on the internet, someone always trying to sell them something, and friends/family telling them what they should or shouldn’t do to treat their cancer. They need credible sources of information and empowered to become an integral part of their care and recovery."

cancer survivor suffering from cancer related fatigue

Dr Chasse Bailey Dorton

Breast cancer survivor & Medical Director of The After Cancer

Final Words: Small Steps Matter

Cancer-related fatigue can feel overwhelming, but you are not powerless. By making small, thoughtful changes to the way you eat and drink, you can support your body’s recovery and regain some control over your energy.

Eating well doesn’t mean perfection, it means doing the best you can, with what you have, on any given day.

Start with one or two changes that feel manageable. Maybe it’s adding a high-protein snack each afternoon. Or drinking a bit more water. Or asking a loved one to help prep meals on weekends.

These small efforts can have a big impact over time.

Schedule a FREE call to explore how The After Cancer can help you manage fatigue, improve your eating habits, and support your well-being after treatment.

Book a FREE Call

Fatigue - by Dr. Chasse Bailey-Dorton, MD

Fatigue is a common symptom experienced by cancer patients during and after treatment. In this blog, Dr. Chasse Bailey-Dorton explains more.

Dr Chasse Bailey-Dorton, MD

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Chemotherapy late side effects

Chemotherapy's side effects can be short-term or long-term and can have a significant impact on a patient's quality of life.

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Understanding Fatigue: Causes, Symptoms, and Management

Cancer-related fatigue is more than just feeling tired - it's a deep, persistent exhaustion that can impact daily life. Whether you're undergoing treatment or in recovery, understanding the causes and best ways to manage fatigue can help you regain energy and improve well-being.

What you'll learn by reading this page:

What is cancer-related fatigue Learning how cancer-related fatigue can affect you Effective ways to manage fatigue during cancer treatment How diet, probiotics, and supplements can help with cancer fatigue

What is cancer-related fatigue?

Are you feeling tired and lacking energy?

Cancer treatments and cancer-related fatigue

What else makes cancer-related fatigue worse?

Pain and fatigue: A draining cycle

Emotional distress, anxiety & depression

​Lack of physical activity

​Sleep problems and fatigue

Poor nutrition and dehydration

Other health conditions that worsen fatigue

Cancer-related fatigue isn’t just about treatment, it’s influenced by pain, mental health, sleep quality, nutrition, activity levels, and overall health. By identifying and addressing these factors, patients can take proactive steps to improve energy levels and overall well-being.

Schedule a FREE call to explore how The After Cancer can help you manage fatigue, restore energy, and support your mental well-being after treatment.

Read more about Cancer Fatigue on our blogs...

Fatigue - by Dr. Chasse Bailey-Dorton, MD

Radiotherapy late side effects

Chemotherapy late side effects

What is cancer-related fatigue
Learning how cancer-related fatigue can affect you
Effective ways to manage fatigue during cancer treatment
How diet, probiotics, and supplements can help with cancer fatigue

Lack of physical activity

Sleep problems and fatigue