Overcoming Cancer-Related Fatigue: Practical Strategies to Regain Strength
From exercise to psychological intervention, helping Hong Kong cancer patients overcome fatigue and rebuild their quality of life.
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Cancer-related fatigue (CRF) is very different from everyday fatigue. It cannot be relieved simply by sleep, and is often accompanied by prolonged, profound physical and psychological exhaustion. CRF reduces participation in daily life and impacts treatment outcomes.
Research shows that 59%–100% of patients undergoing treatment experience CRF, with 30%–60% reporting moderate to severe fatigue (jiaap.in; Semantic Scholar). Even among long-term survivors, when using strict diagnostic criteria, around 20% continue to suffer from persistent fatigue (Wikipedia).
The Core Issue: This Is Not Ordinary Tiredness
Understanding the Causes of CRF
CRF is typically the result of multiple interacting factors:
- Physiological inflammation pathways – Tumors and treatments trigger inflammatory cytokines (IL-1, IL-6, TNF-α) that act through the central nervous system and endocrine pathways, altering fatigue perception and circadian rhythm regulation (Herald Sun; UCLA Semel Institute; Nature).
- Psychological and lifestyle factors – Anxiety, depression, insomnia, and nutritional deficiencies can create a vicious cycle that worsens fatigue (Wikipedia).
- Functional decline – Reduced physical fitness, lack of exercise, and chronic pain are also frequent contributing factors.
Action Plan: Integrated Intervention Strategies
- Exercise — the strongest non-pharmacological approach
Systematic reviews confirm that aerobic exercise (e.g., brisk walking, swimming), strength training, yoga, and tai chiall help reduce CRF, both during and after treatment (Semantic Scholar; SpringerLink; Health). Recent studies also show that structured exercise programs improve fatigue and quality of life even in advanced cancer patients (Health). - Cognitive Behavioral Therapy (CBT) and Psychoeducation
CBT has been shown to significantly reduce fatigue scores (standardized mean difference ≈ −2.50) (Frontiers). Other psychological interventions—including mindfulness, psychoeducation, and CBT—also demonstrate improvements, though the strength of evidence varies (BioMed Central). - Mindfulness Interventions
Mindfulness-based stress reduction (MBSR) and related practices are effective in improving CRF, reducing psychological stress, and enhancing sleep quality. These approaches are particularly beneficial for survivors of lung and breast cancer (Wikipedia). - Multicomponent Rehabilitative Therapy
Combining exercise, psychoeducation, and physical therapy into a multidisciplinary rehabilitative program has been shown to effectively alleviate CRF and related symptoms such as cognitive decline, anxiety, and insomnia (Oncology Nursing Society).
Practical Recommendations for Patients in Hong Kong
- Build a “move daily” habit
- Aim for 150 minutes of physical activity per week, such as brisk walking, stretching, beginner’s yoga, or light weight training.
- Light evening exercise can also support better sleep.
- Don’t neglect psychological tools
- Explore acceptance-based psychoeducation and community or online mindfulness programs.
- Explore acceptance-based psychoeducation and community or online mindfulness programs.
- Consider CBT to restore mental energy
- If fatigue significantly impacts quality of life, professional psychological support is strongly recommended.
- If fatigue significantly impacts quality of life, professional psychological support is strongly recommended.
- Leverage a multi-professional support system
- Oncologists, physiotherapists, and psycho-oncology social workers can collaborate to create a personalized CRF management plan.
- Oncologists, physiotherapists, and psycho-oncology social workers can collaborate to create a personalized CRF management plan.
- Monitor and adjust continuously
- Use fatigue self-assessment tools (such as FACT-F) and review progress regularly to refine interventions as needed.
Conclusion: Rebuilding Strength
Cancer-related fatigue should not be accepted as an unavoidable condition—it is a challenge that can be reversed. Through an integrated approach that combines exercise, CBT, mindfulness, and rehabilitative care, patients in Hong Kong can not only regain their energy but also rebuild their quality of life.
The real key lies in taking action: one exercise session, one mindfulness practice, one conversation with a counselor—each step helps patients gradually emerge from the shadow of fatigue.
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References
- Hilfiker, R., Meichtry, A., Eicher, M., Balfe, L. N., Knols, R.H., Verra, M.L. & Taeymans, J. (2018). Exercise and other non‑pharmaceutical interventions for cancer‑related fatigue. British Journal of Sports Medicine, 52(10), 651–658. British Journal of Sports Medicine
- Jongnés, M. (2024). Effect of cognitive‑behavioral therapy on fatigue in cancer patients: a systematic review and meta-analysis. Psycho‑Oncology. Frontiers
- (2022). Lifestyle and integrative oncology interventions for cancer-related fatigue. Elsevier.ScienceDirect
- Springer Link. (2022). Management of Fatigue in Patients with Advanced Cancer. SpringerLink+2Annals of Oncology+2
- Wikipedia Contributors. (2025). Cancer‑related fatigue. Wikipedia. Wikipedia+1
- Semel Immunology Institute. (2014). Cancer‑related fatigue mechanisms, risk factors, and treatments.semel.ucla.edu
- Annals of Oncology. (1999). Impact of Cancer‑Related Fatigue on the Lives of Patients. ScienceDirect+15Oxford Academic+15ScienceDirect+15
- (2025). Multicomponent rehabilitative intervention. Oncology Nursing Society. Oncology Nursing Society
- Wikipedia Contributors. (2025). Mindfulness‑based stress reduction. Wikipedia. Wikipedia+2Wikipedia+2
- Wikipedia Contributors. (2025). Mindfulness‑based cognitive therapy. Wikipedia. Wikipedia
- The Guardian. (2025). Exercise can counter side-effects of cancer treatment. com
- com. (2023). Cardio, strength training may benefit stage IV breast cancer patients. Health