Fatigue nears the top of the list of concerns for people undergoing cancer treatments. Chemotherapy, radiation, biological treatments, and pain medications may all make you feel tired, weak, or worn out. I know from my own experience with prostate cancer that the worst side effects of my treatment were debilitating fatigue and depression.

Every person is different in the amount of fatigue they experience and what helps them to feel more energized, and you should talk to your healthcare provider about steps you can take to boost your energy.

In the meantime, here are a few of the strategies I’ve found to combat fatigue over the years.

Keep moving

I’ve never been a gym guy. And exercise was the last thing on my mind when I first began cancer treatments. All I really wanted to do was sit on the sofa. I’m lucky that my partner wasn’t about to let that happen.

She made me take short walks. These walks became longer. She saved me.

Exercise is a must. It’s amazing how just a little movement and fresh air can combat fatigue. The trick is to set a realistic goal for yourself and stick to it. Start slow and eventually aim to get to three to five hours of moderate activity, like walking, per week.

Some men tell me they struggle to walk even short distances. My reply is always the same: Walk a short distance. Walk a little farther tomorrow.

My first strolls with my wife were only a quarter of a mile. We did this daily for two weeks before adding distance and small hills. She bought me a bicycle and a kayak. Eventually we started riding bicycles.

I hated exercise at first. But I started to look forward to our walks and rides as they became longer and harder. I also started to have more energy and felt better.

My wife and I will now bike 15 miles a day during the warm months of the year. We’re avid hikers. The Mt. St. Helens Volcanic Monument offers us an abundance of trails. To this day, I feel the fatigue set in if I’m not physically active on a regular basis.

Eat to fight fatigue

What you eat can help fight treatment-induced fatigue.

Many cancer patients experience anemia due to radiation, chemotherapy, low iron levels in the blood, or cancer itself. Anemia is a lower than normal level of hemoglobin, or the part of red blood cells that carry oxygen. A common symptom is fatigue.

Your care team will monitor your complete blood count during treatment. But talk to your doctor if you suspect you’re becoming anemic. One important way to ward off anemia is by eating iron-rich foods including green leafy vegetables, beans, sweet potatoes, fish, and meat.

I was raised in the mountains of southwest Washington and grew up eating wild game and fish. I introduced my vegetarian wife to elk steak and she was hooked. I find that wild game is lean, and it isn’t raised with growth hormones or antibiotics. It also just tastes better!

We supplement a small serving of animal protein with a lot of fresh organic fruit and vegetables. This diet helps me to fight fatigue.

I know cancer patients who swear by a vegan diet as well to fight fatigue. Talk to your doctor and possibly a nutritionist to figure out a diet that works for you.

Talk to your doctor about supplements

The person who first said “stick it where the sun don’t shine” was talking about where I live. We’re a couple hours south of Seattle, Washington. Sometimes it seems like the sun will never come out.

Our bodies produce vitamin D with sunlight. Not getting enough exposure to the sun can lead to vitamin D deficiency, may cause symptoms of depression and fatigue.

Not everyone needs to worry about vitamin D deficiency. Talk to your doctor if you think vitamin D deficiency might be a problem for you.

I’m not a fan of supplements. But I take a couple under the watchful eye of my oncologist to help with fatigue. I take vitamin D and sometimes a natural multi-vitamin when fresh organic produce isn’t readily available in winter.

Some research is also looking into whether L-carnitine and ginseng supplements can help fight fatigue associated with cancer. Be sure to always talk to your healthcare provider before taking any supplement.

Sleep to fight fatigue

Sleep has not come easy for me. Falling asleep was difficult as a cancer patient. Staying asleep was harder.

Getting enough sleep is essential for combatting fatigue. Sleep helps your body to repair and balance hormones. It helps your brain to work properly so you can learn and remember new information. Sleep improves decision-making and problem-solving ability. Without it, our brain loses the ability to think clearly. Lack of sleep has even been linked to depression.

I started using over-the-counter sleep aids early in my diagnosis on my doctor’s advice. I later started taking melatonin about an hour before bedtime each night. I’ve found it to be helpful. But be sure to talk with your doctor before taking any supplements.

Prostate cancer patients may also find that frequent urination leads to nighttime bathroom trips that disrupt sleep. Avoid drinking fluids right before bed to minimize sleep interruption. Empty your bladder completely before retiring for the night. And refrain from drinking coffee or alcohol in the evening. (These tips can work for anyone who wakes up in the middle of the night to use the restroom!)

Lastly, there is no substitute for a quality mattress. I fall asleep easier, sleep better, and wake feeling rested since we bought our new mattress.

Ask for help treating depression and anxiety

Anxiety and depression are more common in people with cancer than the average population. A cancer diagnosis can be scary. The stress of treatments and physical symptoms like pain, nausea, and fatigue may contribute to depression.

Depression, in turn, can make you feel tired. You may have trouble sleeping and be uninterested in things that used to energize you.

Speak to your doctor if you’re feeling anxious or overwhelmed due to your diagnosis or treatment. There is help, including psychotherapy, medication, and support groups.

I believe a holistic approach is the best way to fight fatigue. Feed your mind, body, and spirit and exercise as much as your condition will allow. These strategies worked for me.

I’ve been fighting stage 4 prostate cancer for over 13 years. Today I feel good. I hope to feel good tomorrow. I’ll do everything in order for that to happen.

For more information on how to manage your cancer journey reach out to your doctor or healthcare team.