Balance Problems, Weakness, and Falls

If you have cancer, you might be at greater risk for balance problems, weakness, and falls. This can be caused by your cancer, cancer treatment, and other health problems. You may feel weak, unsteady on your feet, or confused, which could make you more likely to fall.

What makes you more likely to fall?

There are many things that can increase your risk of falling.

Age and medical history

You might be at greater risk of falling if you:

• Are more than 65 years old
• Have a history of falls
• Have vision problems
• Recently had surgery
• Were recently in the hospital

Side effects of cancer or cancer treatment

Some side effects of cancer or cancer treatment can also put you at greater risk for falls. This includes:

• Confusion or memory problems
• Poor balance or coordination
• Dizziness when you stand up
• Fatigue
• Muscle weakness, especially in your legs
• Changes in how you walk (gait)
• Numbness and tingling in your fingers or toes (peripheral neuropathy)
• Bowel and bladder problems (if you have to get to the bathroom quickly or more often)
• Anemia (low red blood cell counts)
• Not getting enough to eat or drink

Learn more about managing these and other cancer-related side effects.

Slipping and tripping hazards

If you are at greater risk of falling, it’s especially important to be aware of slipping and tripping hazards around your home.

Common hazards that can increase your fall risk include:

• Clutter
• Dim lights
• Throw rugs
• Stairs
• Uneven floors
• Pets that get near or under your feet

Certain medicines and chronic diseases

If you have cancer and also have another chronic disease, you could be at greater risk for balance problems, weakness, and falls. This includes Parkinson disease, chronic pain in the muscles and joints, diabetes, strokes, and heart disease.

Certain medicines used for sleeping, anxiety, depression, or high blood pressure can also put you at greater risk for falls.

Treatment of balance problems, weakness, and falls

Treating your balance problems and weakness can often lower your risk for falls. The type of treatment you need will depend on the cause of these problems and how bad they are.

Physical and occupational therapy

To increase your strength and balance, your cancer care team might have you work with a physical therapist or a cancer exercise specialist. They can teach you strength, balance, and coordination exercises. They can also teach you how to use equipment (wheelchair, walker, cane) to help you get around more safely.

An occupational therapist can help you adjust your daily routines to make them safer and easier. They can also teach you how to use equipment that helps with day-to-day tasks like meal preparation, shopping, and grooming.

Support services

Home health care staff can help you find ways to make your home safer and lower your risk of falling. They can also help you find services in your community that might help with meals, transportation, and other needs.

Symptom management

Your health care team might also work with you to manage your cancer symptoms and other medical conditions.

For example, your health care team might have ways to treat common side effects like fatigue, confusion, and anemia. Treating these could help improve your balance and make you less likely to fall.

Changes to your medicine

If you have problems with balance, weakness, or falls, it’s important to go over your list of medicines with your health care team. Changing some of your medicines could lower your risk of falling.

It’s also a good idea to get all your prescriptions filled at the same pharmacy. This can help keep track of ongoing medication changes.

Tips for preventing falls

It can be hard to recover from a fall so, so it’s best to take steps to prevent one in the first place.

If you feel weak or unsteady on your feet, it’s a good idea to ask someone to stay with you. That way if you fall, are injured, or become confused, they can help you get the care you need.

You can also lower your risk of falls by increasing your strength and balance, making your home safer, and being careful about the way you move.  

Increasing your strength and balance

One of the best ways to lower your risk of a fall is to be as active as you can. Take these steps to increase your strength and balance:

Build core strength. Activities like walking, swimming, and tai chi help build core strength and balance. Check with your cancer care team before exercising to make sure it’s safe for you.

Try to be active each day. Start slowly (5-10 minutes) then build up as you feel stronger.  

Work with a physical therapist. If you feel weak or unsteady, ask your cancer care team about going to a physical therapist or a local cancer rehabilitation program.

Eat foods that build muscle. Try to eat a balanced diet. Include enough protein and calories to help you build muscle.

Making your home safer

There are many things you can do to make your home safer and reduce your risk of falls.

Remove tripping and slipping hazards. This includes clutter, throw rugs, uneven floor surfaces, and electrical cords.

Keep walking paths clear. Walking paths should be clear of clothing, throw rugs, and other hazards.

Tape the edges of rugs to the floor. There is special tape, usually called “rug gripper” or “carpet tape”. Place it on the underside of rugs to keep them from moving.

Choose safe footwear. Wear shoes, non-skid socks, or slippers when walking or standing. Avoid slippery shoes or open-heel bedroom slippers.

Add extra lighting. Make sure your rooms are well lit.

Make staircases safer. Add handrails and non-slip treads to your stairs.

Prevent falls in the bathroom. Place a bathmat or non-slip stickers on the floor of your tub or shower. If possible, add grab bars on the walls. You can also put a stool or chair in the shower and sit while bathing.

Moving carefully

Taking extra care about the way you move is also an important way to prevent falls.

Get up slowly. If changing positions makes you feel dizzy or unsteady, take extra time when you get up from lying down. Sit on the side of the bed for about a minute before you stand up.

Keep canes, walkers, or wheelchairs nearby. If you use a cane, walker, or wheelchair, keep it by your bed or next to where you sit. Use it every time you get up, even for short trips. Make sure it is the right size and you know how to use it.

Take care around pets. Be careful around pets that tend to get near or under your feet.

Ask for help. If you notice you're having problems with weakness, poor balance, or changes in mood or memory, ask for help getting up or walking.

When to call your health care team

It’s important to contact your health care team if you:

• Have a fall, even if you don’t think you got hurt.
• Notice new weakness, numbness, or changes in your thinking (such as if you are confused, don’t know where you are, or become forgetful).
• Feel weak or unsteady so that a fall seems likely.
• Are concerned you may have been hurt from a fall.

Call 911 or go to the emergency department

If you are with someone who falls:

Call 911 right away if they aren’t breathing. (Unless they are in hospice or have a Durable Power of Attorney for Health Care that states they don’t wish to be revived.)

Call 911 right away if they are unconscious.

Call 911 right away if they are bleeding, or if they have fluid draining from their mouth, ears, or nose.

While you wait for help to get to you:

• Let the person stay where they’ve fallen until you know if there are serious injuries.
• If you can’t move them, make them as comfortable as possible until help comes.
• If they can answer you, ask if they have any pain.
• If they are not in pain and not bleeding, help them back to a bed or chair. (If possible, get help moving the person.)
• Apply pressure and ice packs and to any area that is bleeding. (Put ice in a plastic bag and wrap the bag in a towel.)