Is Fatigue a Common Symptom of Ovarian Cancer? Causes and Management

Fatigue is very common in people with cancer, including ovarian cancer, and it can be present before diagnosis, during treatment, and sometimes long after treatment ends. ^[1] This type of tiredness often does not improve with usual rest or a good night’s sleep and can range from mild tiredness to feeling completely drained. ^[1] Cancer-related fatigue is typically more persistent and debilitating than everyday tiredness and may linger for months to years for some individuals. ^{[2] [3]}

What Cancer-Related Fatigue Feels Like

• Feeling tired, weak, heavy-limbed, or “slowed down.” ^[2]
• Trouble concentrating, irritability, or lack of motivation. ^[2]
• Not relieved by rest, and can affect daily activities and enjoyment of life. ^{[1] [2]}

Why Fatigue Happens in Ovarian Cancer

Fatigue has many possible and overlapping causes, and the exact mechanism is not always clear. ^[4] The cancer itself, treatments, and overall health all contribute. ^[5]

Common contributors include:

• The cancer itself and effects on the body. ^[5]
• Treatments such as chemotherapy, radiation, surgery, targeted agents, and biologic therapies. ^[6]
• Pain, anxiety, distress, or depression. ^[5]
• Poor sleep or sleep-wake disruption. ^[5]
• Inadequate nutrition or weight loss. ^[5]
• Medicines (for example, some pain relievers) and changes in activity level. ^[7]
• Hormonal changes and overall life stress. ^[7]
• Post-treatment factors such as toxic byproducts from cell death, infection, fever, or injury to normal cells. ^[8]

When Fatigue Is Concerning

Fatigue is worrisome when it limits your ability to perform everyday tasks or doesn’t improve with rest; it’s important to tell your care team when this happens so they can look for treatable causes like anemia, sleep disorders, medication side effects, or mood changes. ^[9]

Practical Management Strategies

Address Underlying Causes

Treatment is guided by the cause when one is found (for example, treating anemia, pain, sleep problems, or depression), and supportive measures can help even when a single cause isn’t identified. ^[10]

Daily Energy Conservation

• Prioritize important activities and pace yourself throughout the day. ^[11]
• Take short naps (about 1 hour) rather than long daytime sleeps to avoid disturbing nighttime rest. ^[11]
• Accept help from family or friends for chores and errands. ^[11]

Gentle, Regular Exercise

Light, regular physical activity such as walking or easy cycling can gradually improve energy, strength, sleep, mood, and your ability to manage daily tasks. ^[12] Resting too much can paradoxically worsen fatigue over time, so a slow, safe return to activity is encouraged. ^[12]

Sleep Hygiene

• Keep a regular sleep-wake schedule.
• Limit naps to short durations and avoid late-day naps. ^[11]
• Create a calm sleep environment and limit screens before bed. While general principles are helpful, persistent insomnia should be discussed with your clinician. ^[9]

Nutrition and Hydration

• Eat small, frequent, balanced meals with enough protein and calories to support healing and energy. ^[13]
• Drink adequate fluids unless you’ve been advised to restrict fluid. ^[11]
• Consider a referral to a registered dietitian if intake is low or weight is falling. ^[13]

Safety and Activity Adjustments

• Avoid driving or operating machinery when you feel very tired. ^[13]
• Set realistic goals to maintain a sense of control and purpose without overexertion. ^[14]

Emotional Support

Stress, anxiety, and low mood can intensify fatigue; counseling, support groups, and stress-reduction techniques may help. ^[5] If distress is significant, professional support is recommended. ^[9]

Special Note on Treatment-Related Fatigue

Certain ovarian cancer treatments (for example, PARP inhibitors like niraparib) commonly cause tiredness; structured rest, pacing, hydration, and gentle exercise are routinely advised, and you should inform your team if fatigue becomes severe or limits function. ^{[13] [11]}

Evidence-Based Self-Care Checklist

• Tell your care team about persistent or worsening fatigue so they can check for reversible causes. ^[9]
• Plan your day with periods of activity alternating with brief rests. ^[11]
• Try 10–20 minutes of light activity most days, progressing slowly as tolerated. ^[12]
• Eat protein-rich, calorie-dense small meals and hydrate well. ^[13]
• Protect nighttime sleep; limit naps to about an hour. ^[11]
• Seek help for pain, anxiety, or sleep problems. ^{[5] [9]}

Bottom Line

• Fatigue is very common with ovarian cancer and its treatments, and is often not relieved by rest alone. ^[1]
• Multiple factors usually contribute, including the disease, therapies, sleep and mood changes, and nutrition. ^{[5] [7]}
• A combination of identifying and treating underlying issues, pacing your day, gentle exercise, healthy sleep habits, good nutrition, and emotional support typically provides the best relief. ^{[10] [12] [13] [11] [9]}

Would you like help creating a simple, week-by-week plan to safely build up gentle activity while pacing your energy?