Cancer fatigue is the most common complaint I hear daily in practice. It is estimated that at least eighty percent of people in cancer remission experience fatigue. Some cancer survivors even struggle with fatigue for the rest of their lives. Physical and mental exhaustion, or a combination of both, can disrupt daily activities, prevent us from doing regular physical activity, and can impact our ability to participate fully in our lives. This situation reduces the quality of life for survivors and their families.
An important thing to remember is that fatigue is a symptom of many other underlying issues. In cancer recovery, fatigue is generally a result of how cancer and its treatment have affected the body. These issues will be unique to each person, just as the cancer journey is.
To overcome cancer-related fatigue, the first step is to determine the causes of fatigue and determine what is in the way of restoring the body to its normal, natural, energetic state. I call these “roadblocks”. The causes of cancer-related fatigue are often associated with the physical body, but roadblocks can include mental or even spiritual complications.
The physical body and recovery fatigue
When trying to overcome cancer-related fatigue, there is a tendency to presume that low energy levels are merely the result of lack of sleep or the stress of going through treatment. While that is certainly true, guessing why someone may be fatigued is ineffective. It can lead to poor care and make the survivor feel like they are doing something wrong when they follow directions and get no results. This can lead to overwhelm and frustrated, which only further zaps energy. For example, while there is data to show that exercising thirty minutes per day can reduce cancer-related fatigue by thirty percent, if a survivor has nutrient deficiencies that undermine energy production in the body, then trying to force themselves to exercise will merely perpetuate the vicious circle (1). Instead, properly evaluating the areas that may be most impacted for that individual at that specific time in their journey will be much more effective. This can be done by using the Eight Pillars of RecoveryTM questionnaire (backlink: https://cancerremissionmission.com/resources/) I created after working with hundreds of patients. It helps break down where an individual is most impacted by the disease and treatments and guides where to begin the journey to recovery.
Fran was a forty-eight-year-old mother of two young children when we met. She’d been previously diagnosed with stage four colon cancer and had completed surgery, chemotherapy, and radiation treatments. Her oncologist had newly diagnosed her in remission because her cancer had been labeled stable for many months. Despite the odds, the possibility of remission seemed close at hand. The biggest problem, though, was that she could no longer care for her children. She struggled to get out of bed due to crippling fatigue, joint pain, and brain fog. She couldn’t play with her children because of the intensity of the pain she was experiencing in her joints. Most important to her, though, was that she could no longer walk her kids to school.
During her first visit, we investigated the Eight Pillars of HealthTM (backlink: https://cancerremissionmission.com/resources/ ) and discovered that her cellular function and immune health needed deeper investigation. On further discussion, we discovered that her vitamin D levels had not been checked since her diagnosis. I explained that this inexpensive blood test could give us more insight into what contributed to her physical limitations because vitamin D deficiency is linked to chemotherapy treatment (2), and the symptoms can include cognitive impairment, joint and body pains, fatigue, and mood changes. With the return of the blood work, she was diagnosed with extreme vitamin D deficiency. Upon prescribing and diligently taking an adequate amount of vitamin D, she reported vast improvements in her cognitive ability, and she was overjoyed to report she could walk almost two kilometers each day to take her kids to school.
The Impact on Mental & Spiritual Health
The cancer journey impacts more than just the physical body. A cancer diagnosis, and the journey itself, are full of twists and turns that profoundly impact one’s mental and spiritual health. The nature of this can range from a simple change in perspective on life and a desire to find one’s purpose to complex post-traumatic stress disorder because of prolonged emotional distress. Many people will have intrusive thoughts, like fear of cancer returning or anxiety about the fact that they’re not recovering as quickly as they think they should.
When our mental health is not addressed, concerns like anxiety and depression can also deplete us. In addition, insomnia and poor sleep are often a part of the anxiety and depression picture, only perpetuating extreme tiredness. Getting support for mental health is imperative to full recovery from cancer-related fatigue. Although many cancer survivors or their caregivers are unsure if they are suffering, a large five-year study from 2017 showed that survivors, and their family members, are three to four times more likely to have anxiety and depression (3) than the general population and they are less likely to be diagnosed.
Addressing any mental health challenges is just as unique as addressing the physical impacts. Finding a course of treatment that works for you requires curiosity and openness. Therapies such as cognitive behavioral therapy, talk therapy, medication, EMDR (Eye Movement Desensitization and Reprocessing), acupuncture, or Havening® have clinically shown the ability to support the transformation of a cancer survivor. If you’re unsure where to access these kinds of therapies, check out our online community (backlink – https://www.instagram.com/cancerremissionmission/) or the professional associations of these therapies.
Angela was a single, twenty-nine-year-old survivor of rectal cancer. She met me during her recovery when she was pronounced to be in remission. Her major concern was fatigue. We began by assessing and addressing all the areas of concern discovered in her Eight Pillars of HealthTM assessment. After 6 months of support, the fatigue was no longer crippling, however, she confessed to still struggling and complained that she could not motivate herself. She used to joke with me that she woke up after cancer in a sixty-year-old’s body. Upon deeper investigation, we discovered that she was still struggling with the idea of being so young when she was diagnosed with cancer, and she had a lot of anger about missed opportunities in her youth. Many of her friends had been married, had kids, and finished their degrees. She felt she was stuck in a dead-end job and starting from scratch at an older age. I proposed to her that she was likely suffering from depression and anxiety. She resisted this, stating that she wasn’t sad or suicidal and, according to her family doctor, didn’t fit the criteria for depression, but rather she experienced extreme irritability, frustration, injustice, and anger about everything that had happened to her. I explained that according to most recent studies, approximately thirty percent of cancer survivors suffer from undiagnosed depression, and many do not meet the typical criteria of such a diagnosis. I think the emotional trauma and situation were fueling the lingering fatigue. We discussed options, and she felt hypnosis and talk therapy were most in-line with her goals. Upon meeting three therapists, she was able to find one that fit her needs. She began the process of healing the trauma of her diagnosis and treatment. Angela used hypnosis to help deal with her triggers and, within three months, reported a full recovery of her energy. Today, Angela has two adopted children and a devoted partner. She has created a beautiful life, discovered her opportunity from cancer, and is the true definition of thriving.
Finding the reason, or root cause, of a survivor’s cancer-related fatigue is the imperative first step in correcting the problem. Only then can a truly strong recovery and transformation occur. Full healing begins when we can assess where we are in our journey to thriving and develop the roadmap to keep navigating the journey. To develop your own roadmap to move from survivor the thriver, and kick cancer-related fatigue to the curb, check out my book The Opportunity in Cancer – How to Radically Transform Your Cancer Recovery Journey. (backlink: https://theopportunityincancer.com/book/)