Severe tiredness (fatigue) in people with cancer
What can patients do themselves?
Dear patient,
you are experiencing very severe tiredness (fatigue) because of your cancer. Clinicians call this kind of tiredness ‚fatigue‘. Each person experiences fatigue differently, and there are different ways to cope with it. On this website, we describe options that you can try on your own. Many people with fatigue first want to try something they can use directly in everyday life. The health information on this website is meant to help you understand what fatigue is and what you can do for yourself.
Other measures, such as medication, need a prescription. Some people find it difficult to get appointments or to apply for services. If you would like one of these options, please speak with your care team.
Important to know:
- This health information is not a substitute for a conversation with your care team.
- Please speak with your care team if your tiredness suddenly gets much worse or if you have new symptoms (for example severe pain, shortness of breath, fever, or feeling very low).
- If you are unsure what is right for you, please ask your care team before you start anything new.
The information was developed using methods of evidence-based medicine, drawing on the best studies currently available.
Numbers often look very exact, but they can actually be uncertain. Results from scientific studies are always estimates. How exact those estimates are depends, for example, on how many people took part. The numbers also describe probabilities, so they cannot say anything definite about an individual person.
Some people in the studies used for this health information had a different type of illness or other health problems different from yours. The results may therefore not always apply directly to your own situation. If you are unsure, please talk to your care team about it.
This website and its contents were developed as part of the DivO-Inform project. The project was funded by Deutsche Krebshilfe (German Cancer Aid; reference numbers 70115271, 70115542). |
Authors
Prof. Anke Steckelberg, Julia Lauberger
Institute of Health, Midwifery and Nursing Science, Faculty of Medicine, University Medicine Halle, Martin Luther University Halle-Wittenberg
Prof. Birte Berger-Höger, Lia Schilling
Department Evaluation and Implementation Research in Nursing Science, Institute of Public Health and Nursing Research, Faculty of Human and Health Sciences, University of Bremen
Prof. Julia Lühnen
Institute of Clinical Nursing Science, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
Cooperation partners
Landesnetzwerk Migrantenorganisationen Sachsen-Anhalt (LAMSA) e. V. (State Network of Migrant Organisations, Saxony-Anhalt)
Last updated: 27 February 2026
Next update planned: xx
What is cancer-related severe tiredness (fatigue)?
Some people become very tired and weak during or after cancer treatment. This severe tiredness and weakness is called fatigue. It is one of the most common symptoms during this time.
Fatigue is more than normal tiredness:
- You feel very tired, as if you had no energy. The feeling stays even after you rest.
- • Everyday things become harder — for example, shopping, climbing stairs, working, or meeting other people.
- You may find it harder to concentrate or to remember things.
Fatigue can happen during treatment and after treatment. Sometimes it lasts for a long time.
Fatigue can have many causes.
For example:
- the cancer treatment itself (surgery, chemotherapy, immunotherapy, or radiotherapy)
- anaemia, hormone changes, or other physical causes
- worries, fears, sleep problems, or low mood and depression
Often, more than one cause is involved at the same time.
Deutsche Fatigue Gesellschaft (2024): What is fatigue? – Deutsche Fatigue Gesellschaft. Available online at https://deutsche-fatigue-gesellschaft.de/fatigue/was-ist-fatigue/, last updated on 19 March 2024, last reviewed on 10 February 2026.
Deutsche Krebshilfe (2026): Fatigue (Chronic tiredness in cancer). Available online at https://www.krebshilfe.de/informieren/ueber-krebs/mit-krebs-leben/fatigue-chronische-muedigkeit-bei-krebs/, last updated on 10 February 2026, last reviewed on 10 February 2026.
Cancer Information Service, German Cancer Research Center (2026): Persistent tiredness and exhaustion in cancer. Available online at https://www.krebsinformationsdienst.de/nebenwirkungen-bei-krebs/fatigue, last updated on 10 February 2026, last reviewed on 10 February 2026
I have fatigue — what can I do for myself?
In this health information we want to introduce you to options you can try on your own. They are well suited to everyday life and easy to put into practice. You decide for yourself whether and when you want to try something. You can also first take some time to notice how you are managing fatigue in everyday life. The options in this health information have been examined in scientific studies. Researchers looked at whether they helped people feel less tired. Tiredness was measured using different questionnaires.
How can I find out what suits me?
Not every option suits everyone equally well. It can help to try several things to see what works for you.
Possible steps:
- Observe — pay attention for a few days to when your tiredness is especially strong and when it eases.
- Keep a diary — note briefly:
- what you did (for example yoga or endurance training);
- how tired you felt before and after;
- whether something did you good or was too much.
- Adjust — change your plans based on what you notice. Do more of what helps; do less of what is too tiring.
You don’t have to change everything at once. Even small steps can make a difference.
Deutsche Fatigue Gesellschaft (2017): Tips for everyday life. Available online at https://deutsche-fatigue-gesellschaft.de/damit-leben/tipps-fuer-den-alltag/, last updated 4 December 2017, last accessed 10 February 2026
Krebsinformationsdienst, Deutsches Krebsforschungszentrum (2026): Persistent tiredness and exhaustion in cancer. Available online at https://www.krebsinformationsdienst.de/nebenwirkungen-bei-krebs/fatigue, last updated 10 February 2026, last accessed 10 February 2026.
Options at a glance
Strength training
What is strength training?
Strength training can make the body stronger. It helps build muscle. You train using your own body weight or equipment (for example dumbbells). You do the movements slowly to make sure you do them correctly.
Strength training can be done in different places — for example in gyms or in courses offered by your health insurance provider. There, you get personal instruction and support from trained staff. You can also do strength training on your own. For this you will need, for example, an exercise mat and small dumbbells. There are also strength training videos on the internet — some previous experience is useful, because there is no one to supervise you. Ask your care team or your health insurance provider about what is available.
Strength training compared with no training
Start of training: during cancer treatment
In the short term (up to 12 weeks after starting), strength training can help you feel less tired and more energetic.
How to read the figure below:
An empty battery means severe tiredness and no energy; a full battery means full energy for everyday life. No one has a full battery all the time. In people without fatigue, the average battery level is about 84%.
More energy with strength training
after 12 weeks
People who did regular strength training during cancer treatment reported having more energy than people who did not train. The improvement was large enough for many people to notice it in everyday life.
The results come from 12 studies with a total of 1120 participants. The studies mostly showed similar results. They looked at the first 12 weeks of strength training, which is why this time period is reported here.
.
Medium-term and long-term effects of strength training
Few studies have looked at whether strength training still helps with tiredness after more than 3 months, so nothing certain can be said yet.
Only a few studies show how people are getting on 3 to 6 months or longer after their training. Their results conflict and the studies are too small to allow firm conclusions. At present there is too little reliable evidence to say whether strength training also reduces tiredness in the long term. |
Lighter strength training compared with heavier strength training
The two types of training differ in how heavy the weights are, how often the weights are moved, and how hard the training feels.
There is no evidence that lighter strength training leads to more energy than heavier strength training, or the other way round.
Studies showed that people benefited from strength training whether the training was lighter or more demanding. No type of strength training was clearly better or worse than another. The available studies are too few to show reliable differences between types of strength training.
Ernst, M., Wagner, C., Oeser, A., Messer, S., Wender, A., Cryns, N. et al. (2024). Resistance training for fatigue in people with cancer. Cochrane Database of Systematic Reviews 11, CD015518. https://doi.org/10.1002/14651858.CD015518
Montan, I., Löwe, B., Cella, D., Mehnert, A., & Hinz, A. (2018). General population norms for the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale. Value in Health 21(11) [Epub 16 May 2018]. https://doi.org/10.1016/j.jval.2018.03.013
All figures created with DALL·E.
Endurance training
What is endurance training?
Endurance is about being able to keep going for a long time, for example by running, swimming, or cycling. You can do this fast or slowly. With practice over time, your endurance improves. Endurance training strengthens the heart and lungs.
Endurance training can be done in different ways — for example in gyms, sports clubs, or courses offered by your health insurance provider. There, you get personal instruction and support from trained staff. Endurance training can also be done on your own — for example, you can go jogging, walking, or cycling. There is also a lot of information and many videos on the internet; some experience with training is useful, because there is no trainer with you. Ask your care team or your health insurance provider about what is available.
Endurance training compared with no training
Start of training: during cancer treatment
In the short term (up to 12 weeks after starting), endurance training can help you feel less tired and more energetic.
How to read the figure below:
An empty battery means severe tiredness and no energy; a full battery means full energy for everyday life. No one has a full battery all the time. In people without fatigue, the average battery level is about 84%.
More energy with endurance training
after 12 weeks
People who did regular endurance training during cancer treatment reported having more energy than people who did not train. The improvement was small but noticeable. The results come from 6 studies with a total of 593 participants. The studies mostly showed similar results. They looked at the first 12 weeks of endurance training, which is why this time period is reported here.
Medium-term and long-term effects of endurance training
Few studies have looked at whether endurance training still helps with tiredness after more than 3 months, so nothing certain can be said yet.
Only a few studies have looked at how people are getting on 3 to 6 months or longer after endurance training. These studies are small and show mixed results. At present there is too little information to say whether endurance training also reduces tiredness in the longer term.
Endurance training compared with strength training
Strength training or endurance training – which is better for fatigue?
Both types of training can help. There is no evidence that one is better than the other.
In studies that compared strength training directly with endurance training, tiredness decreased in both groups. You can start with the type of training you prefer or that fits better into your everyday life. The number of studies on this is limited, so it is unclear whether some people benefit more from one type of training than from the other.
Wagner, C., Ernst, M., Cryns, N., Oeser, A., Messer, S., Wender, A. et al. (2025). Cardiovascular training for fatigue in people with cancer. Cochrane Database of Systematic Reviews (2), CD015517. https://doi.org/10.1002/14651858.CD015517
Oeser, A., Messer, S., Wagner, C., Wender, A., Cryns, N., Bröckelmann, P. J. et al. (2024). Cardiovascular training versus resistance training for fatigue in people with cancer. Cochrane Database of Systematic Reviews (9), CD015519. https://doi.org/10.1002/14651858.CD015519.pub2
Montan, I., Löwe, B., Cella, D., Mehnert, A., & Hinz, A. (2018). General population norms for the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale. Value in Health 21(11) [Epub 16 May 2018]. https://doi.org/10.1016/j.jval.2018.03.013
All figures created with DALL·E.
Yoga
What is Yoga?
Yoga is a way to relax. It connects your feelings and thoughts, which can help you feel calmer. Through the exercises, you get to know your body better.
Yoga combines:
– exercises for the body
– calm, steady breathing
– paying attention to yourself
There are different types of yoga — for example, Hatha yoga or Dru yoga. They can differ in how they are done and in how intense they are.
Yoga can be done in different places — for example in yoga studios, gyms, or courses offered by your health insurance provider. There, you receive instruction and support from trained staff. Yoga can also be done at home on your own — for this, you need an exercise mat and comfortable clothing. There are many yoga videos on the internet; some experience with yoga is useful, because there is no teacher with you. Ask your care team or your health insurance provider about what is available.
Yoga compared with no yoga
Start of training: during cancer treatment
It is currently not clear whether yoga during cancer treatment reduces tiredness. So far, this has only been examined in a few studies. That is why nothing certain can currently be said about this.
Studies in which yoga was practiced during ongoing cancer treatment show mixed results. Some show possible improvement, while others show no difference. Overall, the studies available so far are not enough to say for sure whether yoga during treatment helps reduce tiredness.
Yoga compared with no Yoga
Start of training: after cancer treatment
In the short term (up to 12 weeks after starting), yoga can help you feel less tired and more energetic.
How to read the figure below:
An empty battery means severe tiredness and no energy; a full battery means full energy for everyday life. No one has a full battery all the time. In people without fatigue, the average battery level is about 84%.
More energy with Yoga
after 12 weeks
People who did yoga after cancer treatment reported having more energy than people who did not train. The improvement was small but noticeable. The results come from 5 studies with a total of 602 participants. The studies mostly showed similar results. They looked at the first 12 weeks of yoga, which is why this time period is reported here.
Medium-term and long-term effects of yoga
Few studies have looked at whether yoga still helps with tiredness after more than 3 months, so nothing certain can be said yet.
Only a very few studies have looked at how people are getting on 3 to 6 months or longer after yoga training. These studies are small and do not provide reliable results.
Messer, S., Oeser, A., Wagner, C., Wender, A., Cryns, N., Scherer, R. W. et al. (2025). Yoga for fatigue in people with cancer. Cochrane Database of Systematic Reviews (5), CD015520. https://doi.org/10.1002/14651858.CD015520
Montan, I., Löwe, B., Cella, D., Mehnert, A., & Hinz, A. (2018). General population norms for the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale. Value in Health 21(11) [Epub 16 May 2018]. https://doi.org/10.1016/j.jval.2018.03.013
All figures created with DALL·E.
Progressive muscle relaxation (PMR)
What is progressive muscle relaxation (PMR)?
Progressive muscle relaxation is a method for relaxing your muscles. Your body feels calmest when your muscles are not tense.
This is how the method works:
– First, you tighten your muscles tightly.
– Then, you let them go again.
Tightening and relaxing your muscles helps you become more aware of your body.
Progressive muscle relaxation can be learned in different settings — for example in prevention courses offered by your health insurance provider or in health and relaxation courses. There, someone shows you step by step how the method works. Progressive muscle relaxation can also be done at home on your own — for this, you need an exercise mat and comfortable clothing. There are many videos and instructions on the internet; some previous experience is useful, because there is no instructor with you. Ask your care team or your health insurance provider about what is available.
Progressive muscle relaxation compared with no progressive muscle relaxation or with other options (for example exercise or other relaxation methods)
Start of progressive muscle relaxation: during cancer treatment
Progressive muscle relaxation may help some people with cancer feel more energetic and less tired. At present it is not possible to say for sure how strong this effect is, or how it compares with other options.
In several studies, people with cancer who did progressive muscle relaxation regularly reported having more energy than people who did not do these exercises. Some studies also compared progressive muscle relaxation with other active methods such as exercise or other relaxation techniques. The results were not consistent: in some studies, progressive muscle relaxation worked better, while in others there was no difference. The studies differed a great deal in how the exercises were done, how long the programmes lasted, and how tiredness was measured.
The results come from only a few studies with small numbers of participants. The studies differ from each other considerably, and overall their quality is low. We therefore cannot say for sure how well progressive muscle relaxation helps with tiredness, or whether it is better than, worse than, or about as effective as other active methods.
Wang, Y., Yang, L., Lin, G., Huang, B., Sheng, X., Wang, L. et al. (2024). The efficacy of progressive muscle relaxation training on cancer-related fatigue and quality of life in patients with cancer: a systematic review and meta-analysis of randomised controlled studies. International Journal of Nursing Studies 152, 104694. https://doi.org/10.1016/j.ijnurstu.2024.104694
All figures created with DALL·E.
Mindfulness exercises or meditation
What are mindfulness exercises or meditation?
Mindfulness- and meditation-based methods include, for example, meditation, breathing exercises, or paying conscious attention to the body. They can reduce stress and tiredness and help you focus on the present moment.
Mindfulness- and meditation-based methods can be learned in different settings — for example in prevention courses offered by your health insurance provider or in health and relaxation courses. There, you are given a guided introduction and supported by trained staff. You can also do them at home on your own. There are many videos and instructions on the internet; some experience with mindfulness or meditation is useful, because there is no teacher with you. Ask your care team or your health insurance provider about what is available.
Mindfulness exercises and meditation
Mindfulness- and meditation-based programmes may help people with cancer feel less tired and more energetic. At present it is not possible to say for sure how large the effect is, or which people benefit most.
In studies on mindfulness, meditation, and mindfulness-based stress reduction (MBSR), people reported less tiredness and more energy than people who did not take part in these programmes. The results suggest that these methods may be helpful for some people.
However, the studies differ a great deal:
- they looked at different forms of meditation and mindfulness;
- the programmes started at different times during the illness;
- improvements were measured using different questionnaires.
Because of this, we cannot say for sure:
- how much mindfulness or meditation improves tiredness;
- when they are especially helpful (during or after cancer treatment);
- for whom they are most suitable.
The evidence on mindfulness- and meditation-based methods comes from studies that do not make clear comparisons at fixed time points. They also do not provide easy-to-understand numbers about the size of the effect, so the effect of these methods cannot be shown here with exact numbers.
What does this mean for you?
If you are interested in these programmes, they may be a useful addition to other methods — especially if they feel right for you.
Requier, F., Demnitz-King, H., Whitfield, T., Klimecki, O., Marchant, N. L., & Collette, F. (2023). The effect of meditation-based interventions on patients with fatigue symptoms: a systematic review and meta-analysis. Psychologica Belgica 63(1), 64–81. https://doi.org/10.5334/pb.1182
All figures created with DALL·E.
What else can I do in everyday life?
You can plan your day so that your energy lasts better.
The following steps may help:
Plan what matters:
- In the morning, ask yourself: what is really important today? What can wait?
- Plan demanding tasks for times when you feel a little better.
- Break large tasks into smaller steps.
Take breaks:
- Take short breaks regularly, before you are completely exhausted.
- A break might be a short walk, a brief lie-down, or sitting quietly.
- Try not to nap for too long during the day, so that your sleep at night is not disrupted.
Pace yourself:
- Spread tasks across the week (for example household chores, shopping, or appointments).
- Combine trips when you can (for example a doctor’s appointment and the shopping on the same day).
- Ask yourself: what could someone else do for me?
Accept support:
- Ask family, friends or neighbours for help — for example with shopping or heavy tasks.
- Ask your care team what advice and support services are available.
- Many people with fatigue find it a relief to accept help rather than try to manage everything on their own.
Deutsche Fatigue Gesellschaft (2017): Tips for everyday life. Available online at https://deutsche-fatigue-gesellschaft.de/damit-leben/tipps-fuer-den-alltag/, last updated 4 December 2017, last accessed 10 February 2026.
Krebsinformationsdienst, Deutsches Krebsforschungszentrum (2026): Persistent tiredness and exhaustion in cancer. Available online at https://www.krebsinformationsdienst.de/nebenwirkungen-bei-krebs/fatigue, last updated 10 February 2026, last accessed 10 February 2026.
Further support and information
If you would like to know more about the German healthcare system — for example about counselling centres, costs, patients‘ rights, or services for people with cancer — you can find reliable information here:
- Information about counselling centres can be found on the following website:
https://www.krebsinformationsdienst.de/krebsberatungsstellen - Information about health insurance, long-term care insurance, and health promotion can be found on the website of the Federal Ministry of Health, where you can also use the citizens‘ hotline:
https://www.bundesgesundheitsministerium.de/service/buergertelefon.html - Information about patients’ rights can be found here:
https://www.bundesgesundheitsministerium.de/themen/praevention/patientenrechte/patientenrechte.html - Information about support and projects for people with a migration history, and for people with disabilities, can be found here:
https://www.hi-deutschland-projekte.de/crossroads/ - Information about self-help groups in your area can be found on the following website:
https://www.nakos.de/ - IInformation about the telephone counselling service (Telefonseelsorge) can be found on the following website:
https://www.telefonseelsorge.de/telefon/
or call:
0800 1110111 - Information about the Muslim telephone counselling service (Muslimische Telefonseelsorge — MuTeS) can be found here:
https://www.mutes.de/
or call:
+49 30 44 35 09 821 - Information about the Russian- and Ukrainian-language telephone counselling service can be found here:
www.russische-telefonseelsorge.de
or call:
+49 30 44 03 08 454
If you have questions about this health information or would like access to the methods report, please contact: divoinform@uni-bremen.de