8 Ways to Fight the Fatigue of Chemotherapy Treatment

Cancer is debilitating, but so is chemotherapy treatment. You might be nauseated and sore, but the most common of chemo side effects is unrelenting fatigue. Still, you don’t have to just lie there and give in to tiredness. We talked to experts to find 8 ways to improve your strength and stamina while receiving cancer treatment... If you’re going through chemotherapy treatment, you probably feel as if you’ve gone a few rounds in the boxing ring: beat-up and just plain beat. “Fatigue is probably the main side effect of chemotherapy,” says naturopathic oncologist Leanna Standish, N.D., medical director of the Bastyr University Integrative Oncology Research Center in Seattle. Patients undergoing chemotherapy are in a triple bind. First, cancer itself is tiring. Second, 50%-90% of all cancer patients suffer from fatigue, according to a 2011 Brazilian study. Plus, anti-cancer drugs may sap your strength. But you can fight fatigue, say cancer experts. Simple changes in diet and lifestyle can keep your body fortified while you battle the effects of chemotherapy and cancer. Read on for tips on staying strong… 1. Get enough calories. This isn’t the time to start a diet — even if you’re overweight. “Some people say, ‘I have a few pounds to lose anyway.’ But you can lose a lot of muscle mass during chemotherapy,” warns Michelle Szafranski, a registered dietician for the American Cancer Society and a co-author of What To Eat During Cancer Treatment: 100 Great-Tasting, Family-Friendly Recipes to Help You Cope (American Cancer Society). Eating enough might be more important than eating healthy during chemotherapy treatment, she says. Your body needs plenty of nourishment to help maintain strength and stamina. Check with your primary physician and oncologist, or ask to be referred to a registered dietitian, to find out how many calories you should be eating every day during treatment. Some patients may have to nibble all through chemotherapy treatment to keep their stomachs settled — or they might find themselves able to eat just one food, such as pudding. “Some people have mouth sores from chemotherapy, and all they can eat is mashed potatoes,” Szafranski explains. “If you can tolerate only one food, eat [it] — just make sure you get enough calories," she says. Do whatever you have to to get through the chemotherapy, she says. “We’ll have time after chemo to get back to a better diet,” Szafranski says. 2. Fortify with supplements. Poor nutrition can contribute to fatigue. So to ensure you get all the necessary nutrients during chemotherapy treatment, take multivitamins and other supplements. “It’s especially important for women to take calcium,” says Judith Smith, director of pharmacology at the University of Texas MD Anderson Cancer Center in Houston. Aim for 600 mg of calcium, 2-3 times a day, she advises. “Take one of the newer supplements that have vitamin D and magnesium for better absorption,” says Smith, who also recommends omega-3 [fatty acids] – “generally a 2-gram dose, 2-3 times a day,” she says. Both calcium and vitamin D supplements were shown to increase muscle mass in a 2010 study in India. And a 2011 Washington University study found that omega-3s boosted muscle growth in older patients. But first check with your oncologist about taking vitamins and supplements – some may interact with your other medications. If chemotherapy has left you too exhausted to eat at all, ask your doctor about intravenous nutrients. 3. Control nausea. Feeling nauseated during chemotherapy treatment? Tell doctors right away and ask for a medication adjustment. “There are so many options for treating nausea, so many combinations of medications that can be tailored to the patient,” Smith says. But new anti-nausea pharmaceuticals have a nutritional drawback, Szafranski says. “The tricky thing is, those {anti-nausea] drugs slow down digestion,” she says. “That can lead to constipation and food staying in the stomach longer than usual.," Szafransky says. If that happens, tell your doctor, who can recommend a laxative that’s safe to use with your other medications. 4. Fortify your blood. “Fatigue can often be attributed to anemia,” Smith says. Anemia is a condition in which the blood doesn’t contain enough red blood cells to transport all the oxygen the body needs. Chemotherapy drugs can cause anemia by affecting the bone marrow, where red blood cells are produced. A multivitamin supplement with iron, one of the building blocks of red blood cells, can help reverse anemia, she says. If blood tests indicate anemia, ask your doctor about supplements with iron or medications that can make your body produce more red blood cells. Standish takes a slightly different approach, recommending daily B-complex vitamins, because they give the body the necessary raw materials to rebuild marrow. “Especially B-12 and folate [a B vitamin that’s also called folic acid] are extremely important nutrients that help bone marrow to recover, and they are safe to take with chemotherapy,” she says. 5. Manage stress. Anxiety was linked to fatigue in chemotherapy patients in a 2008 study published by the American Society of Clinical Oncology. “If you’re under months of stress, your immune system doesn’t function well,” Standish explains. So how can you relieve some of the anxiety of chemotherapy treatments? Try journaling or blogging about your experience a few times a week, she advises. It can help cancer patients change their feelings and thinking about the disease and improve their physical and psychological well-being, according to a 2008 Georgetown University study. 6. Improve your sleep. Worrying about your chemotherapy treatments not only will give you insomnia but will also sap your energy. So ask your doctor about medications or supplements that you can take temporarily to sleep better. Worried about becoming dependent on sleep aids? You probably won’t. A 2011 University of Nebraska study showed 219 breast cancer patients who used prescription or over-the-counter sleep aids during and immediately after chemotherapy didn’t become dependent on them. Standish recommends taking melatonin, a hormone your body makes, at bedtime. “We start at 10 mg and can go up as high as 40 mg,” she says. Melatonin has a side benefit too: It stimulates the body’s own cancer-fighting immune system, she says. 7. Move your body. Take a 45-minute walk every day, rain or shine, Standish advises. “Sunlight and fresh air, moving your body and talking to a friend reduces fatigue,” she says. “Ask one of your closest friends to come to your house every morning to get you to go for a walk, even if you don’t feel like it.” Her advice is backed by a 2010 Netherlands study, which found that breast cancer patients who participated in an 18-week aerobic exercise program were significantly less fatigued than breast cancer patients who did no exercise. Getting exercise not only fights chemo fatigue — it also might help you live longer. Postmenopausal women with breast cancer were more likely to survive if they participated in nine or more hours of physical activity per week—even if they had not been physically active before diagnosis, reports a 2011 study by Cancer Prevention Research. 8. Ask about stimulants Still exhausted after chemotherapy treatments? Ask your doctor if stimulants might help. Ritalin (dexmethylphenidate), commonly prescribed for hyperactivity, may give you more pep after chemotherapy treatment. In 2009, University of Cincinnati researchers found that patients with a variety of cancers reported much less fatigue after taking Ritalin. Provigil (modafinil), a medication for narcolepsy, improved cancer patients’ alertness in a 2010 German study. Guarana (Paullinia cupana), a plant from the Amazon, is an herbal energizer. Brazilian breast cancer patients who took 50 mg of guarana twice a day said it greatly improved their fatigue — without making them anxious or interfering with sleep, according to a 2011 study conducted by researchers from the University of Miami. “Our group reported impressive results with the use of the dry extract of Guarana (Paullinia cupana), with no significant side effects and at low cost, for the treatment of physical and mental cancer-related fatigue,” the researchers said. What Really Causes Cancer? 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