Living with a chronic illness can be tough, especially when it leaves you feeling persistently fatigued. Fatigue can be a result of the CML itself, as well as being a side effect of treatment, and it can have a real knock-on effect on your quality of life.
Many patients report that cancer-related fatigue is not like everyday tiredness. Rather, it is a deep exhaustion that cannot easily be overcome by a good night’s sleep. In some cases, dealing with this kind of side effect can even sap your willingness to take your medication.
Managing your levels of tiredness, then, is essential. While you may not be able to eradicate your tiredness entirely, there are various strategies you can try to boost your energy levels and improve your wellbeing.
Talk to your healthcare team
If you’re very concerned about fatigue, the first step is to talk to your healthcare team, who will be able to work with you to help you cope. It is important that they understand the impact of your fatigue on your daily life, so try to be specific about which activities you can no longer take part in. They may also run tests to find the causes, for instance by testing you for anaemia. If the fatigue is medication-related, it may be possible to reduce the dose you’re taking.
Make a note of any patterns you see in your energy levels (is the tiredness worse at certain times of day? is it associated with any particular medications?) and let your doctor know.
Although it may seem counterintuitive, gentle exercise has been shown to boost your energy levels and mood – and when you do go to bed, it helps you sleep better.
It’s important not to do too much too fast. Instead, consider a fitness programme that suits your abilities and circumstances, and build up gradually, even if you have to start by walking to the end of the street and back. Try to do some form of activity every day.
A healthy diet
A balanced diet can also help stabilise your energy levels and gives you the best chance of staying well during treatment.
Slow-release carbohydrates, like brown rice, porridge oats and sweet potato, will help keep your blood sugar levels stable between meals.
Lean protein sources, such as fish, pulses, eggs, and tofu, will fill you up and are important for maintaining muscle strength.
Fruit and vegetables contain essential vitamins and minerals. They also provide a source of fibre, important for healthy digestion. Try blending a banana and some frozen berries into a smoothie if you don’t have much appetite. Add some spinach for a kick of energy-boosting iron.
Eat at regular times, make sure to stay hydrated, and try to cut down on foods containing added sugar, which provide an energy ‘spike’ followed by a crash. You can also store some pre-prepared meals in the freezer for those days when you’re too tired to cook.
Self-care and sleep hygiene
Unfortunately, fatigue often goes hand in hand with psychological issues like depression and anxiety. It is easy to get stuck in a vicious circle, in which your racing mind stops you from sleeping – which in turn makes you even more tired and stressed the next day.
If you are having problems with sleep, make sure to address your ‘sleep hygiene’ by establishing a routine, spending some time relaxing before bed (without screens) and cutting out caffeine and alcohol. However, if nothing is working – or you think you might be depressed – it’s important to seek help from a trained professional.
It’s also a great idea to spend some time on self-care strategies like meditation, mindfulness, and yoga, as well as doing what you can to connect with friends. Be as kind as yourself as you can be. Dealing with CML isn’t easy, and you should give yourself credit for the small victories that arise along the way.
Some helpful links
Advice on sleep and tiredness. https://www.nhs.uk/live-well/sleep-and-tiredness/the-energy-diet/
How to get to sleep. https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/
Understanding cancer-related fatigue https://www.lls.org/treatment/managing-side-effects/cancer-related-fatigue
 Unnkrishnan R, et al. Comprehensive Evaluation of Adherence to Therapy, Its Associations, and Its Implications in Patients With Chronic Myeloid Leukemia Receiving Imatinib. Clin Lymphoma Myeloma Leuk. 2016;16(6):366-71.e3.