This week we held the fourth and final Coping Series webinar of 2017, addressing one of the most common symptoms and side effects experienced by lung cancer patients and survivors: fatigue. Over 90% of cancer patients experience fatigue during treatment and around 35% continue to experience fatigue up to five years post-treatment.

We were joined by leading experts Boris Krivitsky, DO and Niki Koesel ANP, ACHPN, FPCN, Director of Palliative Care from Carolinas HealthCare System, Levine Cancer Institute, as well as lung cancer survivor, Shelly Engfer-Triebenbach, to discuss recognizing and managing fatigue during your cancer journey.

What is Fatigue?
Fatigue is a tired feeling that is not relieved with sleep and lasts over time. The difference between fatigue caused by cancer and general fatigue is that the latter can be improved with rest and recovery. In cancer, fatigue can be the result of treatment or from the cancer. For people with lung cancer, even long-term survivors, fatigue may also be linked to other issues such as shortness of breath and/or anxiety.

What Causes Fatigue?
Understanding the root cause of your fatigue is critical to treating it. Here are possible causes:

  • Hormone Levels are altered by the cancer, as well as treatment, which increases the body’s inflammatory processes.
  • Energy is being spent on cleaning up cell waste as the treatment kills the cancer cells.
  • Toxic Substances created from treatment can change your bodies normal processes.
  • Blood cell count is altered during treatment.
  • Sleep disturbance.
  • Pain, anxiety and depression during cancer and treatment are often accompanied by fatigue.
  • Lack of exercise.
  • Anemia (low red blood cell count resulting in low oxygen levels to the body)
  • Medications you are on for other side effects like, pain, sleep, nausea, etc. can cause fatigue.
  • Poor nutrition and hydration.

Techniques for Managing Fatigue

  • Monitor your fatigue levels. What time of day do you experience fatigue? Do certain activities trigger it? Try keeping a daily journal.
  • Establish a Routine. Be intentional with your daily activities.
  • Use Energy Conservation Techniques. Conserve your energy by deciding what daily activities must get done (e.g. pick up the kids) and what can wait.
  • Attend to Nutrition and Hydration. Prioritize food and liquid intake. Caloric intake is critical to maintain basic functions.
  • Manage Pain. Keep your medical team informed so you can best address and manage your pain..
  • Get some Sleep. Be proactive about getting a good night’s sleep by incorporating some or all of the following:
    • Follow a nighttime routine
    • Reduce stress
    • Write in a journal
    • Avoid screen (TV/computer/phone) time 2 hours before sleep
    • Limit naps during the day
    • Use the bedroom for sleep only (avoid working or exercising in your bedroom)
    • Adopt meditation techniques
    • Avoid alcohol, tobacco and caffeine
  • Stay Active. This can be tough during treatment but it’s incredibly helpful to prevent fatigue. Consider:
    • Yoga
    • Physical therapy
    • A structured exercise program
    • Therapeutic massage
    • Acupuncture
  • Emotional State: If you are facing cancer, it is likely you are experiencing some form of anxiety, depression or emotional distress, all of which can result in fatigue. Be aware of these feelings and consider talking with a therapist to address them.
  • Medications: Know what medications you are on and the side effects they carry with them. Most medications for depression, anxiety and insomnia are sedatives/depressants and can affect sleep patterns. If you have tried all these techniques and still don’t see a difference, your doctor may have additional recommendations.

Shelly’s Story
Shelly is a music teacher who lives in Minnesota with her husband and two children. In 2013, she was diagnosed with stage 4 lung cancer at the age of 40. Shelly have been on a number of treatments including chemotherapy and targeted therapy. She is currently on a clinical trial that is working well and her recent scans have shown no evidence of disease.

Here are Shelly’s first-hand tips for managing fatigue:

  • Stay hydrated and nourished. Shelly tries to drink a gallon of water each day and, during treatment, ate even when she didn’t feel like eating.
  • Rest when tired. Sounds easy, but when you are in the middle of something it can be tough.
  • Schedule events depending on your treatment schedule (when you are feeling good). Plan things to look forward to!

Click here to view the full webinar video.

For questions about fatigue and other side effects during your lung cancer journey, contact us at or call 1-800-298-2436.

Lung Cancer Alliance’s Coping Webinar Series is a program to help you manage the side effects and symptoms of lung cancer and its treatment. Click here to learn more.