Fatigue

Fatigue is very common during breast cancer treatment. Patients may be affected by fatigue differently depending on their overall health, level of physical activity and their mental health status during the treatment. There are also studies that indicate a genetic predisposition to increased fatigue secondary to cytokines, or signaling molecules in the body.1

The National Cancer Institute reports that up to 96% of all cancer patients will experience some level of fatigue during and after their cancer treatment. Chronic fatigue is often severe and debilitating and is not alleviated by simply getting additional rest or avoiding physical activity for a day or two. However, acute fatigue is short in duration and may be effectively managed through drug therapy and rest.2

Fatigue may develop into another condition known as Chronic Fatigue Syndrome. This is a debilitating condition that may prevent cancer patients from even having the energy to make it to their treatment appointments, maintain their work schedules or interact with family and friends.  This type of fatigue can have long lasting impacts on recovery and can even affect life after cancer treatment.

What Are The Causes Of Fatigue?

Breast cancer patients will experience various types of fatigue, including emotional, mental and physical fatigue. For most cancer patients, fatigue is manageable by modifying daily activities to accommodate for physical and mental exhaustion. However, it is important to remain physically active during treatment. Fatigue may be caused by the cancer itself, in that many people with cancer lose weight as a result of the cancer’s metabolism. Fatigue may also be caused by the rigorous hours of treatment or recovery from treatment.

Treatment for Fatigue

Fatigue during and after treatment may lead to a greater risk for developing other health-related conditions. This can include depression, cardiovascular problems, and weight gain, which can add to exhaustion and fatigue. Research was performed with breast cancer patients who were placed on a moderately intense exercise program during and after their cancer treatment. They showed a markedly decreased incidence of depression and cardiovascular problems compared to those who were not. Researchers also determined that the exercise program had to be developed for the individual patient and that a one-size fits all approach to an exercise program is not recommended. 3

Patients that experience acute fatigue are generally recommended to rest and relax. They may also be tested for anemia, as it may cause fatigue as well. Pain can cause fatigue and must be appropriately managed. Acute and chronic fatigue can be treated using a variety of antidepressant drugs to help control anxiety, depression and mood changes that are often associated with breast cancer treatment.

Cognitive behavior therapy, also known as CBT, can be used to help patients understand their thoughts and how they affect their behaviors. CBT is used to treat anxiety and depression, but can also be used for breast cancer patients as they begin to see their roles in the world after diagnosis. Negative attitudes and underlying fear and stress can be examined and potentially corrected, helping the patient to overcome the emotional stress that may be limiting recovery. Research through the HEAL study indicates that fatigue can negatively impact the quality of life of survivors for two to five years post-diagnosis. 4

For most patients, a structured exercise program combined with rest is effective for managing fatigue during and after breast cancer treatment. Talking with the medical team about your symptoms of fatigue and early treatment is essential to ensure the best quality of life that you can have.

References

1 Collado-Hidalgo, A., Bower, J. E., Ganz, P. A., & etal. (2008). Cytokine gene polymorphisms and fatigue in breast cancer survivors: Early findings. Brain, Behavior, and Immunity , 1197-1200.

2 Fatigue Overview. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/pdq/supportivecare/fatigue/Patient/page2

3 Schneider, C. M., Hsieh, C. C., Sprod, L. K., & etal. (2007). Effects of supervised exercise training on cardiopulmonary function and fatigue in breast cancer survivors during and after treatment. Cancer , 918-925.

4 Meeske, K., Wilder Smith, A., Alfano, C. M., & etal. (2007). Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report . Quality of Life Research , 947-960.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.