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After treatment and remission

Balancing fatigue and activity

Activity reduces fatigue, but overdoing it can make it worse. This topic explains how to spread your energy through the day and find a balance between activity and rest.

Last updated: ~3 min read
A jar with a limited number of coins of light.
Figure 1.A daily energy budget.

01Short answer

Fatigue after treatment (topics “Why tiredness lingers” and “Chronic fatigue”) can change from day to day. Many people try to do everything on a “good” day and then have no energy at all for several days. This is called the “boom and bust” cycle, and it slows recovery. A better approach is pacing — spreading out your energy. Its main principles: keep an energy diary and learn when in the day you have most energy; think of energy as a “budget” — there is a limited amount each day; choose the most important tasks and put them in your most energetic hours; break big tasks into parts; take short planned breaks before you get tired; alternate heavy and light tasks; ask for help and hand some tasks to others. Physical activity is an important part of this balance: regular light to moderate movement reduces fatigue (topic “Getting active again”). The key is to start at a steady level and build up gradually. Both activity and rest should be planned. Long daytime naps can disturb night-time sleep — a short rest of 20–30 minutes is better. If fatigue seriously limits daily life or is not improving, get the causes checked.

02Simple explanation

Fatigue changes from day to day.

“Boom and bust” slows recovery.

Pacing means spreading out your energy.

Important tasks go in your best hours.

Activity and rest are planned.

03Scientific explanation

Pacing: the ACS and CRUK recommend conserving energy by setting priorities, breaking up tasks, planning rest and asking for help.

Activity: according to the NCI, regular physical activity has the strongest evidence for reducing cancer-related fatigue; overdoing it, however, can increase fatigue.

Rest: ASCO recommends short daytime rests (under 20–30 minutes); long daytime naps disturb night-time sleep.

Diary: the NCI notes that an energy and fatigue diary helps you spot patterns and plan.

04What happens in the body?

What is “boom and bust”?

Doing a lot on a good day, then having no energy for several days. This cycle slows recovery.

Lines with sharp peaks and a steady wave.
Figure 3.Boom-and-bust versus a steady pace.

An energy budget

You have a limited amount of energy each day. Spend it on what matters most and keep some in reserve.

How to pace

An energy diary, priorities, breaking tasks up, alternating heavy and light tasks, and a break before you get tired.

A rhythmic line of light rising and dipping.
Figure 2.Alternating activity and rest.

Activity is part of the balance

Move lightly or moderately every day, but start at a steady level and build up gradually. Even on tired days, a short walk is possible.

Rest and sleep

Take short rests of 20–30 minutes and avoid long daytime naps. Go to bed and get up at the same time every day.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05Energy balance

Steps.

Track — An energy diary.1TrackAn energy diary.
Prioritise — Choose what matters.2PrioritiseChoose what matters.
Split — Break tasks into parts.3SplitBreak tasks into parts.
Rest — Planned short breaks.4RestPlanned short breaks.
EnergyEnergy levels steady.
ActivityMore movement.
RestPlanned rest.

06An example of pacing (simplified)

WhenWhatTip
Your best hourThe most important taskFocus on one thing
After thatA short break10–20 minutes
During the dayA light walkA steady pace
EveningQuiet activitiesLess screen time

* Adapt the plan to your own energy pattern.

07Key terms

Pacing
Spreading energy through the day.
Energy budget
A limited daily amount of energy.
Boom and bust
Doing a lot, then a long slump.
Priority
The most important task.
Energy diary
A record of energy levels.
Delegating
Handing a task to someone else.

08Key points

  • Think of your energy as a budget.
  • Choose what matters.
  • Break tasks into parts.
  • Rest before you get tired.
  • Move a little every day.
  • Stick to the plan on good days too.

09Frequently asked questions

Should I rest completely on a tired day?

Usually not; short, light movement often helps.

Asking for help is hard.

It saves your energy for recovery; loved ones often want to help.

Can I nap in the day?

Briefly, 20–30 minutes; a long nap can spoil the night.

When should I see a doctor?

If fatigue is not improving or seriously limits your daily life.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Should I rest completely on a tired day?

  2. Asking for help is hard.

  3. Can I nap in the day?

  4. When should I see a doctor?

  5. Does this information replace medical advice?

My questions

12Sources

  1. National Cancer Institute. Fatigue (PDQ®)
  2. American Cancer Society. Managing Cancer-related Fatigue
  3. Cancer.Net (ASCO). Fatigue
  4. Cancer Research UK. Fatigue and cancer
  5. World Health Organization. Physical activity
  6. National Cancer Institute (NCI). Follow-Up Medical Care
  7. National Cancer Institute (NCI). Cancer Survivorship
  8. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  9. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
  10. National Cancer Institute. Facing Forward: Life After Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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