Cancer-related fatigue is one of the most challenging treatment-related side effects. Your level of cancer-related fatigue may vary from day to day or last for extended periods. Survivors experience fatigue related to cancer treatment, but fatigue can also be a side effect of the logistical, mental, and emotional toll cancer takes on someone. This mental and emotional fatigue can often be minimized and particularly challenging to cope with as a survivor. Learn how to address your fatigue in mindful ways so you can navigate the days ahead.

1. SICK AND TIRED OF
BEING SICK AND TIRED
COPING WITH CANCER
RELATED FATIGUE

2. SPOON THEORY
A N H O N E S T & C O M P A S S I O N A T E C H O I C E F O R H O W Y O U S P E N D Y O U R E N E R G Y
Julie Larson, LCSW - www.julielarsonlcsw.com
Introducing…

3. EVERYTHING WE DO
REQUIRES ENERGY
Having a hard
conversation
Brushing
teeth
Running
errands
Connecting
with friends
Walking
the dog
Making a
meal
Julie Larson, LCSW - www.julielarsonlcsw.com

4. TOP TREATMENT
RELATED SIDE EFFECTS
• Loss of appetite
• Loss of hair
• Pain
• Anemia
• Nausea & Vomiting
Julie Larson, LCSW - www.julielarsonlcsw.com

5. BREAK IT DOWN:
Cancer related fatigue is different
than “normal” activity related fatigue
Usually not resolved by a cup of
coffee or a nap – lasts longer
Not fully understood
Not a one size fits all strategy
Energy level permeates many
different areas of our life
Julie Larson, LCSW - www.julielarsonlcsw.com

6. ENERGY ZAPPERS
WEAKNESS FATIGUE DEPRESSION
• Extreme tiredness
• Listless
• Drained
• Exhausted
• Decreased strength
• Loss of muscle mass
• Heaviness
• Slow – harder to move
• Hopelessness
• Lack of motivation
• Lack of interest
• Unrelenting sadness
Julie Larson, LCSW - www.julielarsonlcsw.com

7. IMPACT OF FATIGUE
Mental Emotional Physical
Julie Larson, LCSW - www.julielarsonlcsw.com

8. BUT YOU DON’T
LOOK SICK?
• Fatigue can be a silent,
lingering and insidious side
effect of cancer.
• Often a side effect survivors
“mask” and struggle to
explain to others.
• Leaves many survivors
feeling alone – all of which
compound the fatigue!
Julie Larson, LCSW - www.julielarsonlcsw.com

9. YEP. KNEW ALL OF THAT.
… NOW WHAT?!
1. How do YOU understand and respond to your differing energy levels?
2. What can you say to OTHERS to manage expectations and help them get it?
3. Can this change over time?
Julie Larson, LCSW - www.julielarsonlcsw.com

10. SPOON THEORY
FIRST DEFINED BY CHRISTINE MISERANDINO
An analogy to help you visualize
your energy, so you make
intentional choices about how
you navigate your day based on
how much energy different
activities demand.
Spoon Theory fine tunes your
self-awareness, helps you
understand your own limits and
and communicate with others to
set boundaries and protect
yourself. Julie Larson, LCSW - www.julielarsonlcsw.com

11. HOW DO YOU “SPEND” YOUR SPOONS?
Get out of bed
Get dressed
Get medication
Watch TV, Play Games
Shower/bathe
Read or Study
Work on Computer
Calling a friend
Laundry
Make a meal
Going for a walk
Running an errand
Hard conversation
Working
Time with friends
Travel
SPOON
=
UNIT
OF
ENERGY
Julie Larson, LCSW - www.julielarsonlcsw.com

12. RESEARCH HAS SHOWN THE MOST
EFFECTIVE TREATMENT FOR FATIGUE…
Julie Larson, LCSW - www.julielarsonlcsw.com

13. KEY FACTORS FOR THOSE WHO
MANAGE THEIR FATIGUE…
Julie Larson, LCSW - www.julielarsonlcsw.com

14. SELF CARE ALWAYS BEGINS
WITH SELF-AWARENESS
How many Spoons
are available to you
on this day?
Develop a habit of checking in with yourself.
Can I name the feeling I am having?
Where am I feeling this stress in my body?
What am I doing that is helpful?
What am I doing that is not working well for
me?
Julie Larson, LCSW - www.julielarsonlcsw.com

15. WHAT IMPACTS YOUR AMOUNT OF
SPOONS ON A GIVEN DAY?
• Bad night of sleep
• Upcoming medical appointment or scan
• A social event the day before
• A hard or emotional conversation that is still
on your mind or upcoming
• Work deadlines
• Negative self-talk
• Caring for others (children, friends, older
parents?)
• Physical labor the day before
The number of Spoons you have each day may change over time.
Julie Larson, LCSW - www.julielarsonlcsw.com

16. VISUALIZE ENERGY BANK ACCOUNT
“What draws on my energy in an unhelpful
way?
STRESSFUL RELATIONSHIPS WORRY PAIN
SLEEP PROBLEMS
“What isn’t working? What is
helpful?”
HEALTHY EATING REGULAR EXERCISE HUMOR
MEANINGFUL WORK
Julie Larson, LCSW - www.julielarsonlcsw.com

17. TAKING INVENTORY
PLANNING:
Watch for patterns. Learn your triggers. Begin to
assign values to physical, mental and emotional
tasks.
PRIORITIZING:
Cancer can bring clarity to what matters to you.
What is urgent? What is important to you? Talk
with your loved ones to get a shared vision around
how you prioritize energy.
PACING:
Balancing optimism with realism. Managing
expectations. Hope for the best, prepare for less.
Watching for signs of crossing your limit.
Julie Larson, LCSW - www.julielarsonlcsw.com

18. KNOWING
WHAT TO
DO IS NOT
ENOUGH
Begin tracking your effort to address cancer related
fatigue
Problem solve
Seek support from others on the same journey
Talk about the strategies to address fatigue, your
small successes and obstacles with other survivors
and your health care team
Keep a diary
Take notes on what you have done (even if it is
small) so you can see change over time
Julie Larson, LCSW - www.julielarsonlcsw.com

19. THE
IMPACT OF
FATIGUE
Mood Performance
Socialization
Self-
confidence
So, doesn’t it also mean that addressing
our fatigue could have a beneficial
impact on all of these things!
Julie Larson, LCSW - www.julielarsonlcsw.com

20. REQUIRES SPECIAL
POWERS
ADAPTIVE
FLEXIBLE
GIVE YOURSELF
TIME
Julie Larson, LCSW - www.julielarsonlcsw.com