The Manual: Helping you control fatigue, so it doesn’t control you

Here our Specialist Nurse John, who is an expert in dealing with fatigue, answers your questions.

I feel tired a lot, do I have fatigue?

Everyone feels tired sometimes, and everyone has different levels of energy. Some people feel more tired as they get older, but fatigue is more than tiredness.

Everyone’s experience of fatigue is unique to them, so it’s a difficult thing to define. Some compare it to the kind of exhaustion you feel if you’re recovering from the flu, it leaves you completely drained. For some it can be hard just to get out of bed.

Fatigue can have an impact on your daily life – your hobbies, your work, and your relationships. This can be very frustrating to live with, and can affect the way you see yourself.

Whether your fatigue is mild, and affects you from time to time, or whether it has a bigger impact on your life, there are ways to improve it.

Why do men with prostate cancer get fatigue?

Fatigue is a very normal part of living with any type of cancer, not just prostate cancer. It can be the result of the cancer itself, or your treatment. Just the experience of a cancer diagnosis or going through treatment can be stressful and worrying, and this can leave you feeling exhausted.

Feeling fatigued doesn’t mean your cancer is getting worse and it doesn’t mean your treatment isn’t working.

Whether you get fatigue, and how it affects you, depends on a number of things, for example how fit and well you are, the stage of your cancer, and the type of treatment you have.

Men who’ve had surgery (radical prostatectomy) for example tend to feel fatigued for a while afterwards. Whereas men on hormone therapy and radiotherapy may notice their fatigue gets worse throughout their treatment. For some it will improve again when treatment finishes, but for others it can linger on.

What can I do about it?

Don’t beat yourself up if you’re feeling tired and not like yourself. It’s not a sign of weakness, and it’s important to give yourself time to recover. When you feel up to it, there are things you can try which can make a real difference.

The first thing to do is talk to your GP or someone in your medical team. They can find out what’s causing your tiredness – if it’s the prostate cancer or its treatment, or something else such as low blood count (anaemia) – and suggest ways to treat it.

Organise your day so that you can do the things that are most important to you in the times you feel most active. Read more below.

Try and stay active with some gentle exercise – even if it is just going for a walk around the block. Getting some light exercise can lift your mood, and help you to feel more energised and awake. Always talk to someone in your medical team before starting a new exercise plan.

Try and eat a healthy diet – choosing healthy foods can help you feel more energetic throughout the day.

Feeling worried or down can make you feel more tired, and feeling tired can make you feel more worried or down. It can be a vicious circle. If you are feeling down, it’s a good thing to get some support and unload what’s going on in your head. Here are some things that might help.

I’m finding it hard to get motivated, what can help?

Try setting some goals for yourself. It helps to have a reason or purpose to take control of your fatigue – like getting back to work, or spending more time with the kids or grandkids. And keep up the things that you enjoy doing, as this will spur you on too.

When I’m feeling tired, should I rest or should I try and carry on regardless?

It’s all about balance. It’s good to have some periods of rest, but not doing anything all day can make you feel more tired and less motivated. So it’s important to have some periods of activity in your day as well, even if you don’t really feel like it.

Some treatments such as hormone therapy can make you feel tired, and cause you to lose some muscle strength. Resting completely throughout treatment can make this worse. Getting some exercise can help keep your muscles strong and keep you feeling more awake. Speak to your doctor before you make any changes to the way you exercise, they can make sure any new activity is safe and suitable for you.

It helps to get a good night’s sleep too. If you find it difficult, you could try some relaxation techniques, and dealing with any worries that are keeping you awake. You can also speak to your GP who might be able to suggest medications. There’s more in our booklet, Living with and after prostate cancer.

I’ve got responsibilities and activities I need to keep up, how can I do this?

By planning your days around when you feel most active and when you need to rest, you can try and do the things that are most important to you. Keeping a diary can help you spot patterns of when you have more energy.

Make a list of the things you want to do and decide what’s most important, what can wait, and what you can get help with. Then plan to do the most important things when you know you’ll have more energy. Remember to give yourself time to relax, as well as stay active.

You can also change the way you do certain things, so you don’t have to give up things you enjoy. For example you could still play golf, but play every week or two, not every day, and play 9 holes instead of 18.

If fatigue is making it hard to concentrate at work, or you can’t do as much as you used to, you can speak to your employer about flexible working – where you change your hours or duties so you can carry on working. You may be able to take extra breaks or work shorter days for example. Read more about work and prostate cancer.

Who can help me deal with my fatigue?

It’s really important to have support. This might be from someone close to you, or it could be from a health professional who’s trained to listen. You could join a local support group or our online community, so you can swap stories and ideas with other people who’ve been there.

We also have a fatigue support service called Get back on track. It’s a ten-week telephone service led by our Specialist Nurses who are experts in fatigue. They can help you get motivated and make positive changes to your lifestyle so that you can manage your fatigue, and do the things you want to do. To see if this service might be suitable for you, you can call our Specialist Nurses or fill out our simple online form.