Cancer-related fatigue is quite different to the fatigue a person may feel who is not undergoing cancer treatment. Patients often tire rapidly, with less physical activity than normal and this tiredness is usually not relieved by rest or sleep. The psychological effects of a cancer diagnosis, such as anxiety, stress, tension and disturbed sleep pattern, can result in a patient’s feelings of fatigue (NCI, 2023).
Cancer-related fatigue is a distressing persistent subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.NCCN, 2026
There is a wide range of information available and many research studies have been carried out into cancer-related fatigue. Such research has shown that it may be a result of the body’s response to the accumulation of various metabolites, including those from protein destruction, increased metabolic rate due to malignancy or to the blood count being low (NCCN, 2026). It has been suggested that drugs which cross the blood brain barrier or those with side-effects of neurotoxicity may be implicated in the development of fatigue. Examples of these drugs are Vinca-Alkaloids, Methotrexate, Cytarabine, Ifosfamide and Asparaginase, although there is limited evidence available to support these thoughts (Baehring and Soussain, 2024).
Cancer drugs factsheets (CCLG)
There are different types of fatigue:
| Type of fatigue | Definition |
| Normal | Where there is an identifiable cause |
| Pathological | Where it is caused by disease process |
| Situational | Where it is related to stress |
| Psychological | Where it is related to anxiety |
Practical advice for patients suffering from cancer-related fatigue
Cancer-related fatigue may resolve when treatment is completed. During treatment and for as long as the child or young person (CYP) is experiencing fatigue some practical advice can be offered.
It is important to talk to the CYP about fatigue, so they understand why they are feeling like this and that it is a common side-effect of treatment. Encouraging some gentle exercise can be beneficial, alongside an assessment of sleeping patterns and suggesting rest times as part of the daily routine. Talking to the CYP about their routine to ensure they are not doing too much and advising them to keep a fatigue diary may help to determine the best way to treat it. Encouraging adequate nutrition and hydration can also help with fatigue. Stress and anxiety can be a big contributor, so ensuring that the CYP has someone to talk to and share worries with can also help (Baehring and Soussain, 2024).
Cancer-related fatigue can have an impact on any activity that a CYP may wish to participate in; therefore, it is important to address this from a multi professional perspective. The occupational therapist and physiotherapist within the patient’s team can support them by using a person-centred approach to determine what motivates them, then using this to support the CYP to achieve their goal. Their goal can be achieved by grading an activity that still gives the CYP a sense of achievement.
Further strategies
- Education about fatigue
- Graded activities
- Energy conservation strategies
- Routine and set rest times
- Healthy eating
- Get support
- Relaxation
- Sleepy hygiene promotion
- Exercise
Exercise
Sport and exercise are important because they:
- Can reduce fatigue for some people
- Can increase and maintain levels of fitness
- Help maintain a healthy weight (CYP may gain or lose weight during treatment)
- Improve sense of wellbeing and self-confidence
- Improve sense of belonging, particularly with team sports
(Langworthy et al., 2023)
Benefits of sport and exercise during/after cancer treatment
- Release endorphins – ‘feel good’ hormones
- Decreases pain
- Increases strength
- Enhances sleep
- Increases bone density
- Increases appetite
- Relieves constipation
(Langworthy et al., 2023)
Physiotherapist/OT may help by:
- Individualised exercise programmes
- Goal-setting
- Exercise referral programmes
When recommending exercise, the type of central venous access device a child or young person has in situ and other factors may mean contact sports are not recommended.
Further reading and information
CCLG physical activity and exercise guidelines
These Government factsheets provide general information about physical activity in specific age groups/abilities:
References
Baehring, J.M. and Soussain, C. (2024) Neurological complications of medical therapies in haematological malignancies. Oxford Textbook of Neurohaematology. Oxford University Press, pp. 109–122. doi:10.1093/med/9780198884903.003.0008.
CCLG (2023). Exercise pathways in paediatric oncology, from hospital to school. [online] CCLG - The Children & Young People’s Cancer Association. Available at: https://www.cclg.org.uk/magazine-articles/exercise-pathways-paediatric-oncology-hospital-school. (Accessed 18th February 2026)
Langworthy, E., Gokal, K., Kettle, V.E., Daley, A.J. (2023) Effects of physical activity interventions on physical activity and health outcomes in young people during treatment for cancer: a systematic review and meta-analysis of randomised controlled trials. BMJ Open Sport & Exercise Medicine, 9(1). https://doi.org/10.1136/bmjsem-2022-001466 (Accessed 18th February 2026)
NCI (2023) Psychological stress and cancer. National Cancer Institute. Available at: https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet (Accessed: 16 December 2025).
NCCN (2025). Cancer-Related Fatigue. [online] National Comprehensive Cancer Network. Available at: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1424. (Accessed: 16 December 2025).
Last reviewed: February 2026