Receiving a cancer diagnosis thrusts patients into a world of complex treatments and difficult decisions, but it’s the pervasive undercurrent of fatigue that often makes everything harder to manage.
This persistent, overwhelming tiredness, known as cancer-related fatigue, is not just another symptom—it’s a fundamental yet frequently overlooked aspect of cancer recovery. It stems from a combination of the body’s response to the cancer itself, the effects of chemotherapy and/or radiation, and the emotional burden of a life-altering diagnosis. More than just a feeling of tiredness, cancer-related fatigue seeps into every facet of life, complicating daily activities, diminishing work capacity, and impairing cognitive function.
At Specialised Health, we see this often, placing it at the forefront of our rehabilitation efforts—right alongside the more traditionally acknowledged elements of cancer treatment. Understanding and managing this fatigue is essential, not only for recovery but also for enabling patients to reclaim their lives post-treatment.
Meet Ben
Recently, we had the privilege of working with Ben (name changed for privacy), a client whose experience underscores the profound challenges of cancer-related fatigue. Ben, a high-functioning lead engineer, was diagnosed with colorectal cancer, a common type of cancer that originates in the colon or rectum. This cancer is characterised by the growth of tumours in the lower part of the digestive system and is typically treated through a combination of surgery, chemotherapy, and radiation.
In Ben’s case, his situation was further complicated by liver metastases—a condition where cancer cells spread from the original tumour site to the liver, increasing the complexity of treatment and recovery. Ben came to us near the end of his treatment, but the impact on his life remained significant. He was battling extreme fatigue, poor sleep, low endurance, and severe discomfort at his surgical sites. His recovery was also hampered by the side effects of chemotherapy, which included fluctuating energy levels, vision impairments, and reflux. Additionally, the requirement to wear a drainage bag for 24 hours post-treatment every fortnight—a distressing necessity for many in his condition—severely affected his confidence and his ability to socialise.
Despite these hurdles, Ben remained committed to his job and was eager to increase his working hours. However, the unpredictability of his fatigue, coupled with the absence of a structured return-to-work (RTW) plan, made managing his professional responsibilities challenging.
A Structured Approach to Recovery
After assessing Ben’s unique challenges and goals, we determined that our Bounce Program, a structured fatigue-management and rehabilitation program, was the perfect fit for him. While Bounce follows a structured three-phase methodology model with proven strategies, we tailored it to Ben’s specific needs, ensuring it supported both his physical and cognitive recovery.
Here’s what that looked like for Ben:
- Fatigue & Energy Management:
- Pacing strategies based on his energy cycles, using Heart Rate Variability (HRV) data to objectively track his recovery.
- Adjustments to his work and exercise schedule to align with his chemotherapy cycles.
- Pain & Mobility Improvements:
- Self-myofascial release and targeted mobility exercises to reduce surgical site discomfort.
- Strength training to increase endurance and prevent compensatory movement patterns.
- Cognitive Endurance & Work-Specific Support:
- Focused cognitive pacing strategies to improve his ability to sustain attention and concentration throughout the workday.
- Collaboration with his rehab provider and GP to implement a structured RTW plan, allowing a gradual and sustainable increase in work hours.
- Cardiovascular Endurance & Functional Strength:
- A progressive return-to-cycling plan, tailored to weather and fatigue fluctuations.
- Functional strength training to rebuild his ability to ride to work and participate in recreational activities.
The Results
After 12 weeks in the program, Ben made remarkable progress across multiple areas:
- 40% improvement in functional task performance (PSFS: 22/40 → 37/40)
- 13% increase in perceived physical, social, and emotional well-being (RAND SF-36: 75% → 86.5%)
- 41% reduction in fatigue impact (MFIS: 29/84 → 17/84)
- 23.5% improvement in lower limb strength and endurance (30-sec sit-to-stand: 13 reps → 17 reps)
- Tripled his weekly work hours from 7.5 to 22.5 hours per week
More importantly, Ben felt in control of his recovery. He no longer needed daytime naps, was confident in his pacing strategies, and could ride to work again—even taking on some longer 60km recreational rides.
He shared that learning how to track and adjust his energy levels was a game-changer, reducing his mental load when dealing with multiple post-treatment challenges. With a structured plan in place, he felt reassured that he could continue progressing while managing the ongoing impact of chemotherapy.
Why Rehabilitation Matters
Cancer treatment doesn’t end when chemotherapy stops. The physical and cognitive toll of cancer lingers, often making the return to normal life—including work—incredibly challenging. Exercise Physiology plays a critical role in bridging this gap, helping individuals like Ben regain strength, manage fatigue, and gradually rebuild function in a structured and sustainable way.
For case managers, employers, and health professionals supporting cancer survivors, rehabilitation needs to be a key part of the plan—not just treatment. And when fatigue is a major barrier, Specialised Health’s Bounce Program offers a tailored, evidence-based approach to help clients return to work, life, and the activities they love.
Author: Tessa Nielsen