To live with cancer – Increase intensity to decrease fatigue

16 February 2020 | By Sara Ivarsson

Cancer related fatigue is one of the most common side effects cancer patients suffer from. An overwhelming exhaustion that affects all aspects of life. But new research shows that there's one action that has proven very effective to alleviate and reduce fatigue. Learn more here! 

This is the third blog post in a series on living with cancer that I'll be writing the coming months. The introduction and links to the first blog posts, can be found in the first one; To live with, after and next to cancer.

The key to reduce fatigue & nausea

The legs feel like lead. No, that’s a lie. The whole body feels like lead. You can’t think and you struggle to follow the conversation you’re in. The brain feels as heavy as the body.

Cancer related fatigue has entered. Uninvited it ignored knocking on your front door. It just stomped right into your house and made itself comfortable on your favorite couch. And in your bed. And in the kitchen. It accompanies you at work, and it won’t even leave you alone when you hang out with your friends or enjoy time with your family. It puts a heavy dark cloud on the activities you love but now can’t find the energy to appreciate, or even do, anymore.

That's the thing with fatigue – it affects all aspects of your life.

Cancer related fatigue is one of the most common side effects cancer patients suffer from. Fatigue is something else than just feeling very tired. You can’t make it go away by resting more and you feel as drained in the morning as you did before going to sleep the evening before. It is a persistent and overwhelming exhaustion that decreases capacity for both physical and mental work.

Although the level of fatigue, and how long it lasts, differs from person to person, a lot of patients rate fatigue as one of the hardest side effects to deal with due to its severity and impact on quality of life. Once considered a side effect that “comes with cancer” there are now many things that can help with managing the paralyzing feeling of exhaustion.

This blog post introduces one action that has proven very effective to alleviate and reduce fatigue. One way to show fatigue that it’s not welcome, is to do exactly the opposite of what it wants you to do. Fatigue wants you to join it resting on the couch, taking an extra nap, sleep more in the morning. While all those things are good and important for recovery, they should not be all you succumb to.

Introducing: Physical activity!

Exercise is the key
Before it was said to cancer patients to rest to restore energy levels. Now more and more research show that being physically active is not only safe and well-tolerated by cancer patients but also a key factor to reduce symptoms such as fatigue and nausea. The thought of exercising may be overwhelming when you are already feeling depleted. But exercise can increase energy levels and help you to build stamina to do more of your usual activities.

In Helsingborg exercise has become a part of the treatment in cancer care. During the fall of 2019 a project started at Cancerrehabiliteringsmottagningen at Helsingborgs Lasarett. Every patient about to undergo chemotherapy is scheduled to meet a physiotherapist to come up with an individualized exercise plan.

“It’s not a study to see the effects physical activity has on our patients. We already know from many studies that cancer patients benefit from exercise when it comes to counteracting both short- and long-term side effects, especially fatigue. This is a project to evaluate how we can implement exercise as standard care for cancer patients”, says Patrik Göransson, psychologist and leader of the patient process at the Cancerrehabliteringsmottagningen in Helsingborg.

Photo cred: Jonna Jansdotter Svensson

Prevention and treatment
In collaboration with Friskis & Svettis, the hospital offers patients two training sessions each week. The sessions focus on circuit training that includes both strength work and getting the heart rate up, as the combinations of those seem to give “the most bang for the buck”. For those who decide to exercise outside of the hospital-organized sessions the physiotherapist takes extra time to create a plan for them to follow on their own.

“We see physical activity and exercise as prevention and treatment, with the aim to improve the patients’ physical and mental health. We use the same terminology as with medicine, talking about training sessions as doses. It should be natural for doctors, nurses, and patients to see exercise as a part of treatment. With the right support we want to create a behavior pattern where physical activity is a natural part of everyday life.”

Apart from showing fatigue the door, exercise encourage better treatment results. As chemotherapy takes its toll on the entire body, physical activity is important for patients to keep, and even gain, strength and aerobic fitness during treatment. Being in good physical shape seem to improve resilience in a way that lead to less need of care due to treatment related side effects. It also increases the capability to endure the medicinal treatment plan.

Patrik also addresses the positive psychological impact exercise and the feeling of participating have.

“It gives a different perspective from just fighting against cancer”, Patrik says. “You fight FOR something. You fight for wellbeing, for more strength, for better energy in everyday life. It is a positive direction of intention and energy”.

Women in the Swedish study OptiTrain said that the exercise made them experience health, even if battling side effects. Participants often reported to be tired and affected when they arrived for training. Afterwards they expressed feeling better and healthier.

Managing fatigue with exercise
Being physically active is good, but it is always a good idea to talk to your doctor or physiotherapist before starting an exercise program. You can get advice about the best routines for you and discuss if there are any contraindications or limitations that can affect how you tolerate exercise.

Some tips for managing fatigue with exercise:

  • Combine aerobic exercise with strength training = Do something that gets your heart rate up, like walking, running, cycling, dancing, swimming + lift, push and pull something heavy, like your own body, weights, resistance bands, furniture, a child.
  • Base the activity on your own level.
  • Find a regular, daily if possible, routine of being physically active. Some days that will mean high intensity training, other days that will mean a short walk. Doing something active will often make you feel better and more energized after.
  • Be mindful and pace yourself. Allow for rest if necessary.
  • Try breaking up exercise in into smaller amount of time. 3x15 minutes during a day might be better than 1 longer block of time.
  • Exercise with friends and family or ask if there is an exercise program for cancer patients at your hospital. Having a support network both makes exercise more fun and manageable.

Exercise at home

Sometimes it feels better, and easier, to exercise at home and not having to go to a gym. Then online classes come in handy. Below you'll find video recommendations to inspire you to get started. 

Get your muscles working with these nice whole-body sessions. 

20 min

Move with

Sweat party: Quick and effective workout for your entire body.

10 min

Move with

Full body strength – develop your body awareness to get the most out of your training.

20 min

Move with

Stärk upp kroppen genom en blandning av stående och liggande positioner med flexband.

30 min

Move with

En skön genomkörare för hela kroppen med enklare rörelser anpassade för dig som nybörjare.

Include some cardio and get the heart pumping.

30 min

Move with

SOMA MOVE: Get yourself moving and sweating with this challenging flow with Linus Johansson.

10 min

Move with

A circular training with exercises for your cardio strength an exploration of your movements.

10 min

Move with

Sweat Party: Heart-pounding intervals and focus on balance.

45 min

Move with

Utmana din styrka och puls på dina villkor, allt du behöver är ett par hantlar och lite untz untz.

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War on cancer

The physical challenge is huge for a cancer patient. The mental and emotional challenge is at least as great. War On Cancer is a social media-app, a social network and community, where everyone affected by cancer have the opportunity to share their cancer experience and get in contact with others who actually understand. War On Cancer's mission is to put focus on, and radically improve, the mental health of everyone affected by cancer. The first step is the digital social network that creates belonging and community in a time of isolation and uncertainty. You are reminded that you are never alone. We'll fight cancer together.

Learn more about War On Cancer and download their app at
Share your story, it will make a difference.

Learn more

  • Ongoing studies – In Sweden there are ongoing studies to find out which type of exercise is most effective for cancer patients, both with positive and interesting results.
    • Phys-Can
      In a collaboration between the university hospitals in Uppsala, Linköping, and Malmö/Lund, cancer patients are participating in a study called Phys-Can which is comparing the effects of aerobic- and strength training at a high intensity with training on lower intensity.
    • OptiTrain
      At Karolinska Institute and Karolinska University hospital OptiTrain is a study looking at which physical exercise is best for women with breast cancer diagnosis undergoing chemotherapy: aerobic training, or combination training with both aerobic- and strength training.

Sara Ivarsson

Sara is a yoga teacher previously focusing on yoga for athletes but now working more therapeutic with focus on cancer patients, cancer survivors and their families.

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