112 - Dr. Jessa Landmann - Cancer Related Fatigue

Today, Ivelisse welcomes naturopathic doctor and integrative oncology expert Dr. Jessa Landmann to discuss cancer-related fatigue and her book, Beyond Cancer Fatigue: A Path to Reclaiming Energy. 

Dr. Landmann explains why fatigue is a common yet often overlooked survivorship challenge with limited conventional solutions, emphasizing a proactive, root-cause, and individualized approach. She explores key biological drivers like inflammation and muscle loss from treatment, along with emotional factors such as trauma, fear of recurrence, and negative self-talk—encouraging listeners to “talk to yourself like your best friend.”

The conversation offers practical, holistic strategies to restore energy, including gradual movement to rebuild strength, anti-inflammatory nutrition rich in colorful fruits and vegetables, omega-3s, and adequate protein, and comprehensive thyroid testing beyond standard labs. 

Dr. Landmann also addresses hormone-related changes, the importance of connection, faith, and purpose, and shares evidence-based sleep support tools such as CBT-I, screening for sleep disorders, light exposure, aromatherapy, exercise, and acupuncture.

Learn more about Dr. Jenna Landmann here.

Suggested Resources

• Dr. Jessa Landmann's Blog
• BOOK:  Beyond Cancer Fatigue: A Path to Reclaiming Energy  (enter discount code BBP20 at checkout until June 4, 2026)

Your donations power our podcast's mission to support cancer patients with hope, insights, and resources. Every contribution fuels our ability to uplift and empower. Join us in making a lasting impact. Donate now! 🌟

Transcript

Meet Dr Jessa Landmann

Ivelisse Page 0:06

Hi, I am Ivelisse Page and thanks for listening to the Believe Big podcast, the show where we take deep dive into your healing with health experts, integrative practitioners, biblical faith leaders. And cancer thrivers from around the globe. Welcome to today's episode on the Believe Big podcast. My name is Ivelisse Page and it's always a pleasure to spend this time with you. Today, I have the privilege to welcome Dr. Jessa Landmann, a leading naturopathic doctor and expert in integrative oncology to this podcast. Since graduating from the Canadian College of Naturopathic Medicine in 2013, Dr. Landmann has dedicated her career to empowering cancer patients through a holistic approach that blends evidence-based, complimentary therapies with conventional care. Her work focuses on personalized support using nutrition, acupuncture, and botanical medicine to help patients thrive through every stage of their cancer journey. Beyond her clinical practice, she is a respected researcher, speaker, advocate for integrative cancer care. She serves on the steering committee for the action center in Calgary and is a co-investigator in the clinical research exploring innovative cancer treatments. Most recently, she is part of an international clinical collaboration where she will train oncologists in the field of integrative oncology. Her book Beyond Cancer Fatigue, A Path to Reclaiming Energy coming out. Well, actually just came out in March. Correct?

Dr. Jessa Landmann 1:58

That's right.

Ivelisse Page 1:58

Offers hope and guidance for survivors rebuilding strength and treatment. Welcome to the show, Dr. Jessa.

Dr. Jessa Landmann 2:06

Thank you so much for having me.

Ivelisse Page 2:09

Well, we always love to start the podcast with our guest favorite health tip. So can you share one with us?

Dr. Jessa Landmann 2:17

Yes. There are so many good ones out there, but the one I think that doesn't get focused on enough or recommended enough is to talk to yourself like you would your best friend. We are often too hard on ourselves and use too much of our own negative self-talk. And, it impacts our health more than I think we realize. So. Treat yourself like you would your best friend.

Why Cancer Fatigue Matters

Ivelisse Page 2:43

I love that. I don't think I've heard that before, but I really like that advice. We are our hardest critic, so I love that you shared that. So, Dr. Jessa, you describe cancer related fatigue as one of the most unrecognized challenges in survivorship. What inspired you to devote an entire book to this topic, and how has your work to help bridge that gap between conventional oncology and integrative approaches to healing?

Dr. Jessa Landmann 3:11

So I have been practicing for almost 15 years and people will start to come. People will see me at different stages of their cancer journey. I guess you can say so many during cancer treatment, but a lot in survivorship as well. And what I notice. Which is very common is that the most common reason people were coming to see me was for fatigue. I'm just not bouncing back to way to the way that I was before. I'm just not feeling better. And it is something that is incredibly frustrating for patients because on the conventional side of things, and, and this isn't a criticism for family doctors or whatever, but there's not a lot of therapies in, in those toolkits to help, you know, there's no prescription medication for cancer fatigue. And so a lot of times doctors are really at a loss of how to help their patients and people often get the advice of, just be patient. Just give it time. You'll feel better over time. Be compassionate. And, I really think it's not the best advice. People really need to be proactive. And so as a naturopathic doctor, our therapies are really focused on, on this lifestyle modifications, right? These natural things. And it's incredibly successful at helping to improve energy levels. So, I just had so many success stories over the years that I had been saying to myself for years, you know, I, I need to write a book about this because it doesn't exist. So, and that is, that is the gap, is that this is an area that, just isn't well addressed. So I wanted to provide a resource for people that they can use, they can pick it up. It's meant to be used as a self-help. Book so people can identify what is causing their fatigue, and then there's lots of options that they can try to help and to try to help themselves.

Root Causes of Exhaustion

Ivelisse Page 5:09

Yes, yes. In chapter two, you shared decoding your fatigue. Why am I so tired? It breaks down the biological and the emotional roots of exhaustion. What are the most and perhaps surprising causes of fatigue that survivors overlook, and how can understanding these root causes transform their recovery?

Dr. Jessa Landmann 5:29

So, the main causes, I guess let's talk about the biological causes. If you were to read a research paper, it will really focus on overall inflammation. So inflammation caused from chemotherapy or radiation, or different medications or ev or even just an improper diet or stress or sleep. Inflammation is caused from, from all of these things. Inflammation is a huge energy drainer, and that is one of the biggest recognized causes of fatigue. Also muscle loss. So people I don't think appreciate that. Just the exposure to chemotherapy or those types of medications. Increases your rate of muscle loss 24 times more faster than just age related muscle loss. And as we lose muscle, we lose strength. And that is a huge contributor to fatigue. So those are some of the biggest biological ones. The emotional ones are ones any cancer survivor is gonna probably resonate with when they hear this. It is the, you know, potential trauma. From going through really scary treatments or potentially disfiguring surgeries, painful procedures, anxiety about the future, like fear of recurrence or a feeling of loss of how their, how their life has changed, maybe changes to relationships. I think that's what sparked my health advice about the mind. So I think the most overlooked part is really, is our mental emotional coping. Sometimes if it's physical, let's say it's pain, some, sometimes treating physical things is, is easier than treating our mind, I would say.

Starter Kit Habits to Rebuild Energy

Ivelisse Page 7:20

I would agree with you. You know, I always share with people that when I was going through cancer, that the mental battle was harder for me than the physical battle. And the physical battle was painful after the surgeries, but it is all of the self-talk and the things that are being thrown at you, the statistics and everything that is negative, that is coming your way, and it's really huge energy that it takes to reverse those thoughts and to think in a different manner so that your emotions stay in check and that your body gets out of that fight or flight mode and can really rest and repair. And, in your starter kit of practical tools, you know, you offer simple strategies to begin rebuilding energy. Which of these habits, like hydration or pacing or movement, have you seen make the greatest difference early on?

Dr. Jessa Landmann 8:16

So that starter kit is based on recommendations from a practice guideline from the American Society of Clinical Oncology, of lifestyle factors and complimentary therapies that they've identified with the most research for helping fatigue. So those are cognitive behavioral therapy, exercise, Tai chi, mindfulness, even acupuncture is in there as as well. But I would say one of the biggest things that people I guess, I would say is a miss for them if they're not doing this on a regular basis, is the physical activity. So, like I said, muscle loss is a huge contributor for fatigue. People are at a great risk. Of losing muscle loss, especially if they're older or if they've lost weight or if you know their dietary habits have changed from nausea or poor appetite, or just from being too tired to exercise on a regular basis. And so, you know where it starts though is prevention. So patients should be getting this advice before they even start treatment about the importance of moving your body every day, as much as you possibly can without overdoing it. That's a fine balance of course, for anyone going through treatment. And then maintaining that, so, it is easier said than done. It's a big ask when people are feeling fatigued to get up and moving, but people can start small. So sometimes it's just creating daily habits. So sometimes I might say to my patients, just start with shoulder roll. Every day or even, you know, grip, gripping your hands really tightly and then releasing. So simple movements like that where we're activating muscles and creating a daily habit then can kind of get people a little bit more motivated and maybe doing more, more vigorous activity. So that's usually a piece that I spend a lot of time educating my patients about.

Food as Anti-inflammatory Fuel

Ivelisse Page 10:18

That's great. That's great advice. You know, sometimes when people think exercise, they think, oh my goodness, I'm gonna, I'm already tired. How am I gonna do something so intense? And it can be as gentle as shoulder rolls and walking to your mailbox or gentle things. So I'm glad that you clarified that. Mm-hmm. Especially when someone's in the battle. It can be difficult to do what you once did. In the power of food you, you say is a key part of your book? You know, at Believe Big, we always encourage patients to ask their oncologist how nutrition can compliment the treatment. Many times they'll say, eat whatever you want, and we're like, no, actually food is medicine. So what anti-inflammatory or energy supporting foods do you recommend for those battling persistent fatigue?

Dr. Jessa Landmann 11:06

Yeah, so it's true. The advice sometimes is really non-existent or too generic and really though it's not that complicated. It, it is a little, it is a little pretty basic, but sometimes people still don't really know this'cause there's a lot of advice out there about different types of diets to follow, be a vegetarian or juicing or keto or whatever, right? There's a lot of stuff out there, so it's confusing. But really the basics is, so, as I said, inflammation is one of the biggest causes of fatigue. So an anti-inflammatory diet is high. And fruits and vegetables. So that is anything that is colorful, and it doesn't matter which one. So if you like berries, choose berries. If you like oranges, choose oranges, or you like broccoli and peppers, but not tomatoes, that's fine. There's not any one better than the other. Another huge part of an anti-inflammatory diet would be, oh, would be Omega-3 fats. So those would be found in, you know, fish or fish oil supplements. If people don't like fish, nuts and seeds, olive oil, avocado, things like that. Those are the biggest parts of an anti-inflammatory diet. And the next biggest piece dietary wise is protein. So a lot of people, again, start to read that, meat is bad and be really kind of fearful of what they're eating. And if they choose not to eat meat, that that's fine. You can still get enough protein in a plant-based diet as just being knowledgeable about how to do so and meat on its own also isn't always the bad guy. So research with meat is pretty clear about processed meats and red meat of being the ones to avoid, but white meat and eggs and fish and things like that seem to pose no risk, at all really. And, so making sure people are, have ample protein again to contribute to gaining muscle. But protein also helps with sleep and even mood. So lots of reasons to up your protein.

Ivelisse Page 13:13

Yes. And I've always also have heard, you know, even with red meat, that as long as it is grass fed, grass finished, then the level of omegas that are in there is at a, a state that is your body can absorb and it is not harmful to you. Whereas the process meats, like you talked about, or even ones that are just generic that, you know, they came from a, cow farm that did not, was not an open range. And, the animals have been stressed and that can cause the meat to be unhealthy. So have you heard similarly?

Dr. Jessa Landmann 13:48

I have and, and there's actually been quite a few studies comparing this factory raised red meat versus more, you know, grass fed, pasture raised cows, and that they do have higher Omega-3 content. There is less fat and it is less inflammatory. So that, that is one good thing. The, the tricky thing is that, in studies that, look at people who've had cancer and who consume red meat, and what that might, do to their risk of a recurrence, let's just say, is those studies actually don't distinguish between the two types of farming practices. So I don't think we can quite say that the pasture raised grass fed is still going to be, you know, 100% okay. There are other aspects to red meat that pose a may pose a problem. Like the red, in the red meat, for example, is from higher content of heme and iron. And so when you cook that, that's actually inflammatory. So that's kind, that's the difference between red and white meat, is that, iron content. So, when I talk about nutrition, I'm, I'm careful to really say, you know, this is good, this is bad. Don't do this, do that. It is about balance, right? And, and general recommendations are no more than once a week for red meat. And so, you know, a little bit is probably okay, right?

Thyroid Check After Treatment

Ivelisse Page 15:15

That's good. In your, in your chapter on thyroid health, the body's energy engine, you note how often imbalances go undiagnosed. What signs might indicate a thyroid issue after cancer treatment? And what integrative therapies can support optimal thyroid function?

Dr. Jessa Landmann 15:34

So signs of low thyroid function can be almost identical to some things like menopausal symptoms or even just recovering from fatigue from chemotherapy. So, and they might feel cold or they might gain weight or have a be more constipated, fatigue, of course, even anxiety. So those are very non-specific symptoms that can look like a lot of things. Right. And so we need to do a full thyroid workup in cancer survivors, not just TSH, which is kind of the gold standard we need to test a full thyroid hormone panel. Including antibodies which often can be elevated. And so with thyroid health, complimentary therapies, that can help. So for example, if there are thyroid antibodies present, something like selenium has been shown to decrease antibodies. Selenium can be found in a Brazil nut, so people can use again, like you said, food as medicine. There's even been some research with dietary interventions. A Mediterranean diet or gluten-free diet that has also been shown to improve thyroid health over time as well.

Autumn Burns 16:50

Hi, this is Autumn Burns, director of Patient Impact for Believe Big, and I would like to invite you to a Taste of Hope, Believe Big's Maryland fundraising dinner on Thursday, April 23rd from 5:30 to 9:00 PM. This is more than a dinner. It's an unforgettable experience. Enjoy an elevated immersive dining experience crafted by Baltimore's best chef, Zach Trabbold of Evolved Catering and his acclaimed culinary team. Every course will be thoughtfully prepared with exceptional ingredients and incredible flavor you'll be talking about long after the evening ends. But the real heart of the night, hope. You'll hear powerful stories of lives impacted right here in our community. Discover how integrative medicine is changing cancer care, and have the opportunity to participate in a paddle raise that directly supports families navigating cancer. Individual tickets are$150. Tables of eight start at a thousand and special tables of honor options are available to celebrate a loved one. Seats are limited. Cocktail attire requested. So gather your friends, your family, and join us in Upperco for a night where extraordinary food, meaningful connection and generosity come together to create hope. Visit believebig.org to reserve your seat today.

Ivelisse Page 18:15

Okay, and you know, many women struggle with exhaustion and hormonal changes post-treatment, and then from estrogen, finding your mojo after menopause. What practical steps can women take to regain energy and joy while now navigating both survivorship and midlife transitions?

Dr. Jessa Landmann 18:34

Oh, that's such a big question.

Ivelisse Page 18:36

Yeah, we could do a whole podcast on that one.

Dr. Jessa Landmann 18:40

Definitely. Yeah. And I have actually all dedicated to just menopause after cancer, but you know, it really is individualized. So most women, if after, let's say breast cancer who are kind of thrown into this menopausal transition and are dealing with those types of symptoms. Most people have hot flashes. That is very common, but, but not everyone. And so if that's something that is disrupting sleep, for example, that's definitely going to impact energy levels. So we wanna address hot flashes by say something like acupuncture. Acupuncture works really well for hot flashes or if someone has joint pain or, um, you know, brain fog thing, things like that. Right? So it, it's very individualized and there's many complimentary therapies that can help with each symptom. You know, the gold standard for a natural menopause would be hormone replacement therapy, which would, is contraindicated in these women. Right? And so it does feel a little bit more of a, you know, we're coming at things in individually, and it can be frustrating, but we usually start with what is most bothersome for women and what's gonna impact their life the most? What's gonna have the biggest effect? And then, and then go from there.

Ivelisse Page 19:59

Yeah, I found even with my surgical menopause and other women that I've talked to until you've gone through that, it's really interesting how difficult it is as far as losing weight. And also keeping on muscle mass, and I hear that all the time from women. Is there any recommendation or suggestions you can share? Because like you said, for those of us who have had a cancering process, hormone replacement is not an option.

Dr. Jessa Landmann 20:28

Yeah, so sometimes it's even just understanding what estrogen does to the body and how we can hack those changes. So, for example, estrogen helps our blood sugar to get into our cells. So that is why in menopause natural or cancer induced rates of diabetes actually go up in women and cancer survivors. And that is because less estrogen means there's more sugar floating around in our bloodstream, and it's not getting into our cells if it's not being used, it's more likely to be stored as fat. And so one thing we can do to decrease our blood sugar is by movement. So our muscles take out blood sugar from our bloodstream. And so if after a meal, for example, instead of going and sitting back at your desk, if it's lunchtime or going, sitting on the couch after dinner, make being really intentional about going for a walk for 15 or 20 minutes or standing more and cleaning around the kitchen or walking around the house more instead of being sedentary to take those sugars and fats actually out of the bloodstream to so they don't get stored as fat. And that can help to prevent weight gain. So that's one little trick. And again, it's a lot of education about just how much estrogen does for our body and the muscle part of it. You know, we shouldn't be afraid to use some extra supplemental support as well. So creatine is being talked about a lot right now in studies and social media. I see it's good for muscle, but it's also good for our brains. So. I don't think women should shy away from just getting a little extra support that way.

Testosterone After Prostate Cancer

Ivelisse Page 22:16

Thank you. Those are great tips. And your chapter on testosterone vitality after prostate cancer focuses on men's unique recovery. What can male survivors do to restore strength, confidence, and stamina, especially when fatigue affects not only their body, but also you know their identity.

Dr. Jessa Landmann 22:36

Yeah, men don't get enough love, I think in this area. You know, they're, they're not as apt to reach out for, for help and say things like, I'm tired, or I'm really upset about my body changes because they experience a lot of the same things, the weight gain and hot flashes and brain fog and, and problems sleeping. And so yeah, we have to be really intentional about asking these guys. And a lot of the advice for men is similar for women. So if they do have hot flashes, acupuncture work really well. I'm giving them very similar dietary advice about, you know, we might just have to be maybe a little bit tighter with our diet as well. Unfortunately as we age, we can't, we don't, we can't really have maybe as many of those cheat days. They do have the benefit of already having more muscle mass than women. And so making sure they are, you know, still that resistance exercise. Things like that. And then also knowing how to recognize these, these mood changes. In men it's a little bit different than women. You know, women might come across as being, you know, showing more sadness or crying and men might come across as maybe being more busy or avoidant or maybe a little bit more angry or, just, you know, you know, even, even like substance use actually can go up in men. We have to screen for that. And so, even just making sure to encourage them to possibly even go to, to see, to see a therapist if that's something that can help them. Men would benefit from that.

Faith Community and Mindset

Ivelisse Page 24:15

Yes. Yeah, I agree so much. Men aren't as, uh, many times asking the questions or calling the doctor and sharing about those type of issues after going through treatment. So I'm glad that you covered that and that you cover that in your book. Uh, you know, emotional and mental fatigue as we are talking about earlier also are powerful forces and lifting that cloud of depression and the stress and anxiety reset that you write about renewing the mind. How can faith, community, and complimentary practices such as mistletoe therapy, help patients experience emotional healing and res resilience?

Dr. Jessa Landmann 24:56

So the, the connection part is huge. So whether it's through, you know, a church or support groups or your friends or family members, of course, it's really easy for people to become isolated. They feel that may, they might be a burden to, to other people, um, which is really not true. Anyone who's been a caregiver just wants to help. Everyone is so desperate to help, right? And so staying connected that way is, is extremely important. Even if you're not talking about your problems, just the daily contact with people. So maybe that is just creating a routine. Or maybe you are volunteering or getting back to work or you're involved in some other community project where you feel like you have some meaning and joy and purpose and it's a huge area of what we're actually calling now, lifestyle psychiatry. I'm just using this, these lifestyle methods to help with your mood.

Restore Your Sleep

Ivelisse Page 26:00

Yes. Yeah. I noticed a lot of that as well. And I think so many times we need to even search for new things that bring us joy every day. I added pottery into my routine and learning something new and it brought this new joy of creating something time, just quiet, time to create and of course our faith, you know, uh, my faith always helped to build up the emotional resilience when I was having those difficult days, but mm-hmm. But you're right, connecting in some capacity is so important to keep that up. Mm-hmm. And on the flip side of that, I also feel like sleep is, like you mentioned, is so important, sleep restoration. And I think it's one of the toughest challenges I've heard, especially from many post-treatment individuals. So in, you're restoring your sleep rhythm. What practical and natural support, such as light therapy, supplements or calming routines have you found most effective for cancer thrivers?

Dr. Jessa Landmann 27:05

So the gold standard for helping with sleep is, it's called Cognitive Behavioral Therapy for Insomnia, or CBTI. So I trained myself in that intervention, um, a long time ago because it, it really is, it, it's quite effective. It's a bit of a wise process. So it starts with, one week, making sure that you're getting up at the same time every single day, and then the next week making sure that you're not going to bed until you are absolutely sleepy, not, not just tired, but like you're nodding off sleepy. And so that might mean you're actually staying up later than you usually do. And then you do that for a little while. And so there's a bit of a process to it, but it's, but it's very effective and it's more just about retraining your body to sleep as soon as you get into bed. So if people don't have access to a therapist though, or someone who is knowledgeable in that therapy. There's lots of things we can do actually. So with my patients, the first things I, I do rule out, and it's important for people to know this as well ruling out sleep apnea and restless leg syndrome. So those are two things that are very underdiagnosed. But sleep apnea can be as common in almost 50% of cancer survivors might develop sleep apnea and I bet you most don't even know. So it's very common, um, in people who've been exposed to chemotherapy and even in menopausal women. Restless legs is also very common when people have an iron deficiency, which is another thing that is very common in cancer survivors. So starting to rule out those two big things. And then I am kind of diving into complimentary therapies. One, we wanna start resetting the circadian rhythm. Lots of research with early morning light exposure to start doing that. Even things like, um, you know, aromatherapy, for example is very calming to the brain. Exercise has research. Very interestingly, acupuncture has been studied toe to toe against prescription sleep medications and has shown that it's almost as effective as well. So there are many different complimentary therapies. It's just trying to find what someone is willing to, to do, what they're most interested in, what matches, you know, their, their lifestyle the best, and going from there.

Final Hope and Next Steps

Ivelisse Page 29:31

Yeah, those are great tips. Thank you. And in closing, your book actually ends with final inspiration. And at Believe Big we always remind patients that even though when not everyone is cured, you know, everyone can heal. Right. And I think cancer has something to teach all of us. What encouragement would you offer to someone listening today who still feels defeated by fatigue and is searching for renewed hope and purpose?

Dr. Jessa Landmann 30:00

People do start to think that this is their new normal. That they're never gonna get back to feeling like they were again. And you know, it can be, uh, it can cause grief for people. So what I hope people listening to this, it's, it sounds easy coming from me, but it doesn't have to be your new normal. The thing is, is that. As you said, healing is not really a passive process. So yes, rest is extremely important, but we do have to be proactive and take steps to get ourselves feeling better. And it can start really small, like shoulder rolls for example, or incorporating one or two more fruits and vegetables per day and working your up your way up from there too, you know? Doing more of a moderate intensity exercise every day, and you're amazing in the kitchen and your mind is sound and you're meditating every day. It's not about perfection, but really it, it is about finding what it is for you because it is different for everyone. So, like I said, how I would approach fatigue in my practice is, is very different in, let's say a woman who has hot flashes and has depression to maybe someone who had five different surgeries or someone who has peripheral neuropathy and, and has pain, right? They're all experiencing a similar level of fatigue, but it's just getting to the root cause for them. And so I would offer that, you know, find someone who is experienced in integrative oncology who has this lens to work with you more on your level and you should see big changes.

Ivelisse Page 31:46

I love that. Well, thank you, Dr. Jessa for joining us today, and we will make sure to put a link to your new book in our show notes. Her book that just got released is Beyond Cancer Fatigue, A Path to Reclaiming Energy. So thank you again for joining us.

Dr. Jessa Landmann 32:06

Thank you.

Ivelisse Page 32:14

If you enjoyed this episode and you'd like to help support our podcast, please subscribe and share it with others. Be sure to visit believebig.org to access the show notes and discover our bonus content. Thanks again and keep Believing Big!