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Focus on side effects: Fatigue

written by

Leukaemia Care, Charity

What is fatigue?

Fatigue is one of the most common side effects reported by patients diagnosed with a blood cancer. Managing cancer-related fatigue is a large part of everyday life, and, unlike ‘normal’ tiredness, it is not relieved by rest so even the most simple of daily tasks can become challenging.

Fatigue is a very common condition for many people with a blood cancer. However, many people do not report any changes in their tiredness levels as it’s assumed that it is a natural consequence of living with a blood cancer.

Fatigue is often referred to as exhaustion, tiredness or lethargy and it might be experienced physically or psychologically, so it can affect your ability to do everyday tasks, as well as your mental ability. Fatigue can affect concentration levels, memory and even libido.

What causes fatigue?

There are a variety of reasons why you may experience fatigue during your cancer journey:

Chemotherapy and Radiotherapy

If you have been through, or are having, chemotherapy treatment, fatigue may be a side effect of this process. Some of the medication you may have been prescribed can sometimes cause drowsiness, which may increase feelings of fatigue.


A poor diet or loss of appetite can lead to spells of fatigue. It is important that your body obtains the nutrients it needs in order to be able to maintain healthy energy levels.

Other medication

Some medication you may be given as part of your treatment such as painkillers and anti-sickness medicines can cause drowsiness.


If you are anaemic, or have low levels of haemoglobin, this can affect your energy levels. The red blood cells that carry oxygen around your body are often reduced by leukaemia cells and chemotherapy. Blood tests will be able to establish whether you have anaemia and inform your medical team on the appropriate action to take.

Depression and Anxiety

Anxiety and depression can contribute to fatigue. It is common for you to suffer with anxiety and depression after you’ve been diagnosed. These feelings do generally get better and easier to deal with. If you feel that your mood has been low for some time, you should speak to your medical team who will advise you on how to cope and manage your depression. Our Step-by-Step booklet on the emotional impact of a blood or lymphatic cancer will provide you with more information.

Managing your fatigue

There are a number of things that you can do to adapt to the changes in energy levels your body may go through. It’s important that you speak to your doctor and nurses about your fatigue as they will be able to help work out a management plan for you.

Fatigue Diary

Some people find it useful to use a fatigue diary where they record their daily energy levels. This is a simple way to identify changes and any particular triggers as you can note the days and times when the fatigue is better or worse.

Diet and Nutrition

Diet and nutrition are important to all people, but are even more important when you are experiencing fatigue. A well-balanced diet, high in protein with carbohydrates and lots of fresh fruit and vegetables can help sustain your body’s energy. You should try and aim to drink between 6-8 glasses of water a day, to make sure you are well hydrated and keep any toxins flushed through your kidneys.


Research has shown that exercise is one of the best interventions for improving fatigue during and post-treatment. Exercise helps to build your stamina and increase your strength, which in turn increases your overall energy levels and sense of well-being. If you find that you are in and out of hospital a lot, you can contact one of the physiotherapy team or ask your medical team about a structured exercise programme and advice about gentle, regular exercise.

Complementary therapies

Some people find that complementary therapies such as yoga, meditation and aromatherapy can help with fatigue. These kinds of therapies can help reduce your anxiety levels, which in turn will reduce your fatigue. Other ways of energising yourself are through arts workshops and joining a choir.


Getting the right amount of sleep is very important. If you need to rest or sleep during the day, make sure that you take yourself off to bed rather than dozing on the sofa and try not to sleep for any longer than two hours at the very most. Relaxation techniques such as listening to a relaxation CD or breathing exercises have been found to promote a better nights sleep. You could also try to avoid drinking caffeine or alcohol before bed and opt for malted drinks or warm milk instead.

Managing fatigue is all about pacing yourself. Many patients find that close family and friends could help in doing everyday chores and tasks, such as ironing or cleaning. Accepting help in this way and understanding that you may not be able to do as much as you once could, can help you feel less pressured and help reduce tiredness.

Most importantly, you should listen to your body, and appreciate that your lifestyle may have to change to accommodate fatigue. However, there are ways of managing it, and it should not debilitate you.

All of the tips described are ideas for you to try. Everybody will be different and it is important for you to find what works best for you.

If you are experiencing cancer-related fatigue, you should talk to your medical team who will be able to advise you on how to manage it. Our CARE Line is also available 24/7 on 08088 010 444 if you simply want someone to listen to what you’re going through. 

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