What can help with fatigue?

Who can help with fatigue?

It’s important to talk to your medical team about any tiredness or fatigue. You should have a main contact, who is normally a specialist nurse. They can provide expert care and advice about pancreatic cancer, and will be able to answer your questions. They can also provide you with emotional support.

The medical team should regularly check how you are coping with your symptoms, including fatigue. They may assess your fatigue to try to work out what is causing it and how bad it is. If they can find the cause they may be able to treat it. For example, they can look at whether any symptoms or your treatment could be causing the fatigue. Treating the symptoms, or changing the treatment may help.

Your medical team should explain:

• what fatigue is
• what is causing it
• how it can be managed
• what you should expect, including that it might last after your treatment has finished.

For example, if you are having chemotherapy, they should explain how this might cause fatigue and how it might change at different points during the treatment. Your medical team should also explain things that you can do yourself to deal with fatigue.

Understanding more about fatigue may help you feel more prepared to deal with it. Read more about the different causes of fatigue and how they can be managed.

Ask your medical team what support is available to help with your fatigue – you don’t have to cope alone.

Other professionals who can help with fatigue

As well as your usual medical team, there are other health professionals who can help you manage fatigue.

• Occupational therapists (OT) can provide advice on how to manage your fatigue so that you can carry on doing things you want and need to do. They can give you advice on how to change tasks to help you stay independent, and equipment that can save you energy. They can also suggest ways to help you relax and sleep well. And they can provide emotional support to help you deal with the impact fatigue can have on you. Your GP or nurse can refer you to an OT. You can also contact your council – social services also provide occupational therapy.
• Dietitians provide advice about diet and nutrition, which may also help you manage fatigue.
• Physiotherapists can give you exercises and advice to help you keep active, which can help with fatigue. Your doctor or nurse can refer you to a physiotherapist.
• Psychologists can help with the emotional effects of pancreatic cancer and fatigue, such as anxiety, stress and depression. Your GP or nurse can refer you to a psychologist.

Planning your time

Planning your time so that you do activities when you have more energy and rest when you need to can help you deal with fatigue. It can help you do more of the things you want or need to do. But pace yourself. Don’t try to do too much, and plan time to rest between activities.

Spread activities that require more energy over a few days. Don’t try to do everything on a good day, as it might make you more tired the next few days. You could try setting yourself small, realistic goals.

Work out which activities are important and which can wait – and focus on doing the important things. Important activities should include things you enjoy – these can help you deal with stress and improve your mood. It’s fine to put off doing something that’s not important. You might find it helpful to plan your time with a relative or friend. They can help you prioritise activities, and you could also ask family or friends to help with things like household chores.

Planning is important but remember that things don’t always go to plan, so don’t give yourself a hard time if your plan doesn’t always work out.

An occupational therapist can help you plan your time to make the most of the energy you have. They can also recommend ways to save energy, including equipment to make tasks easier.

You might find it helpful to keep a diary of your fatigue. Write down when you have fatigue, how bad it is, and anything that makes it better or worse. A diary can help you see when you have more energy and help you plan your time. You could write down a plan for the day based on this. A diary can also help you describe your fatigue to your medical team and show how any treatment you are having affects it. If you feel too tired to keep a diary, you could ask a family member to fill it out for you.

Physical activity

There is good evidence that physical activity can help with fatigue and increase your energy levels. Physical activity is unlikely to make your fatigue worse. It can also:

• help you feel better generally
• increase your appetite
• improve your strength and fitness
• help with stress and anxiety
• and help you cope better with treatment.

Speak to your medical team before starting any kind of exercise plan. They can advise you on what type of activities are best for you, and any safety issues to be aware of. For physical activity to help, you will need to do it regularly. Read more about physical activity.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy is a type of talking therapy that can help you deal with problems by changing how you think and feel about problems and worries. There is some evidence that CBT can help people with cancer deal with fatigue and problems sleeping. It can also help with anxiety and depression.

CBT is available on the NHS. You can access it yourself – find out more on the NHS website. Your GP can also refer you, or you can pay for it privately. The British Association for Behavioural and Cognitive Psychotherapies has a database of therapists on its website.

Dealing with negative thoughts

You might find that fatigue gets you down and you start to think quite negatively. For example, you might think that you should be able to do more or cope better. You might think you are lazy – or worry that other people think you are lazy or not trying hard enough.

These kinds of negative thoughts are normal, but they can make it harder to deal with fatigue, and make the fatigue worse.

What can help?

If you do start thinking in this way, try to challenge it. For example, try to think about more helpful ways to look at things. If you have pancreatic cancer, it is ok to feel tired – this doesn’t mean you are lazy. Focus on positive things – such as what you can do, rather than what you can’t.

You might find it helpful to write down negative thoughts and check regularly how well you are dealing with them. Cognitive behavioural therapy (CBT) can also help you find ways to deal with negative thoughts.

You might find that trying some of the things in this section is a positive way of dealing with fatigue, and this can help you deal with negative thoughts.

Getting some support

Fatigue can be difficult to deal with and have a big impact on your life. Getting some support can help you cope.

Support from family and friends

Family and friends can be a big support. For example, they can help with household chores and practical things like driving you to hospital for treatment. This can help you save energy for more important things.

You might find it easiest to ask people to do specific tasks. You may find that people like being able to help in this way.

Your medical team

Your medical team can also provide support. You should have a main contact, who is often a specialist nurse. You can talk to them about your fatigue, and how you are feeling more generally. They can help you find ways to manage the fatigue. They can also support you emotionally, and will know of any support available locally.

Support from other organisations

Cancer centres provide information and support. Some run courses or provide services such as counselling or complementary therapies. Examples include Maggie’s Centres and Macmillan information and support centres.

There are also other organisations that can support you. For example, The British Red Cross and Age UK provide a range of support services.

Ask your nurse if there are any local cancer centres or other services that can help you deal with cancer and fatigue.

Support groups

There are cancer support groups around the country where you can meet other people going through similar experiences. There are some groups specifically for pancreatic cancer.

Social care

There may be times when you need extra support at home. You may be eligible for care and support from your local council’s social services department

Complementary therapies

Some people find that complementary therapies help them cope with fatigue. There isn’t much evidence about them, and they don’t work for everyone. But they may help you feel more relaxed, and might help with other symptoms that affect fatigue, such as anxiety or pain. Complementary therapies can also be something pleasant when you are dealing with cancer.

Complementary therapies work alongside your medical treatments – don’t stop any cancer treatments. It’s important to speak to your medical team before trying a complementary therapy, as some may affect your cancer treatment.

These complementary therapies may help with fatigue:

• massage
• reiki
• meditation
• mindfulness
• hypnotherapy
• acupuncture.

Distracting yourself

You may find that it helps to distract yourself from the fatigue. Try to focus on doing things that you enjoy. Some examples include seeing friends and family, hobbies, going for a walk, listening to or playing music, reading or watching television. If you have a pet, you may also find that they help to distract you from fatigue.

Dealing with memory problems

Fatigue can make it hard to remember things and to concentrate. This is normal, but it can be frustrating. An occupational therapist may be able to help you deal with this. Speak to your GP if you are having a lot of memory problems.

There are lots of ways to help you remember things.

• Try using a diary, post-it notes or your mobile phone to remind you of things.
• You could set an alarm on a clock, kitchen timer or mobile phone if you need to remember something at a specific time.
• Pill boxes have compartments for different days and times to help you plan your medicine in advance, so that you don’t forget to take it.
• Write a “to do” list of things you need to do, and cross things off as you do them.
• Keep a list of important numbers by the phone – this could include family, friends, your medical team and GP.
• Make a shopping list and cross things off as you buy them. You could start the list a few days before you go shopping, and note things down as you think of them.

Steroids

Steroids are medicines that can be used to treat some symptoms and side effects, including pain and sickness. They may sometimes help with fatigue in the short term.

If steroids are not taken properly, they can cause problems sleeping and stomach problems, so follow your doctor’s advice. If you have diabetes, steroids can cause your blood sugar level to rise. Your doctor or nurse will need to monitor this.

Reviewed February 2020

To be reviewed February 2022