By Erin Dummert RD, CD

Cancer-treatment fatigue is more than just being tired. It is an overwhelming sense of tiredness that is not always relieved by rest. It can be mild, causing a person to have less energy to do the things he or she wants to do; or it can be severe, affecting many areas of a person’s life and resulting in the inability to do basic activities.

How fatigue affects nutrition
Fatigue can significantly affect one’s desire to eat and energy to prepare basic meals and snacks. Suddenly, even walking to the kitchen for a snack is like running a marathon. This lack of energy is often overwhelming, causing patients to go many hours or even full days with only a few bites of food. This pattern leads to malnutrition and dehydration, both of which cause more fatigue.

Eating for energy
Many patients are in search of foods that will give them energy. Unfortunately, there are no such foods. Even caffeine can reduce long-term energy levels and impair sleep, thus leading to more fatigue. Foods that claim to be a good source of energy simply provide calories (energy for the metabolism), but don’t provide a cancer patient with the type of energy he or she seeks.

Some cancer patients turn to herbal supplements such as Guarana, Ma Huang, or Ginseng for a boost in energy. These are known stimulants, but the stimulation provided by these supplements has not been proven safe or effective in cancer-treatment fatigue. In addition they have known side effects and may interact with medications, therefore they are not recommended during cancer treatment.

Eating despite fatigue
The best advice for people with cancer-treatment fatigue is to eat a balanced diet that includes protein foods such as meat, eggs, cheese, peas and beans, and drink 8-10 glasses of fluids a day. Preventing malnutrition and dehydration can help keep baseline energy levels up and provide the body with the fuel it needs to maintain basic activities. However, this can be easier said than done. Here are some tips to make meeting your nutritional needs easier during this difficult time:

• Ask for help. Friends and family members are usually happy to prepare meals or go to the grocery store.
• Set a timer for 60 minutes intervals. Eat a few bites and drink some fluids every time the timer goes off.
• Eat a few bites every time a commercial comes on TV.
• Keep a cooler or mini refrigerator in the room where you rest, or next to your chair or bed. Keep it stocked with yogurt, pudding, cheese, milk, juice or nutritional supplement drinks.
• Keep non-perishable food items such as nuts, dried fruit, juice boxes, crackers and peanut butter next to your chair or bed and nibble often.
• Eat high calorie, high protein foods to maximize your nutritional intake.

Conclusion
Fatigue is one of the most common side effects of cancer treatment. It can impact many areas of normal living including one’s desire to eat and drink. Left unchecked it can lead to severe consequences such as malnutrition and dehydration, which contribute to additional fatigue, thus creating a dangerous cycle. If you feel your fatigue is interfering with your ability to eat and drink, please discuss this with your healthcare team.