Even though you are "living beyond breast cancer," fatigue may still very much be a part of your life. That's because the effects of surgery, radiation, and chemotherapy can linger. It may take a while for your body to "catch up." Be patient. For some women, fatigue lasts only a few weeks. For others, it can take over a year. Many women tend to jump right back into their normal lives after breast cancer thinking that they're strong enough to do whatever it is they used to do. But it's important to give your body plenty of time to heal.
Right now, your job is to listen to your body and give yourself a break. Don't think that you have to be Superwoman now that you've made it past the battle stage.
Everyone has days when they feel overly tired. But fatigue is different from feeling tired. When you're tired, you usually feel better after a good night's sleep. Fatigue is an ongoing lack of energy, a weakness that encompasses your entire body. It can also be accompanied with a loss of interest in people and in things you normally like to do.
Where does fatigue come from:
For women who have gone through breast cancer, fatigue usually comes from worry, diagnosis, treatment, other medical conditions and lots of other emotional baggage like stress. Sometimes the reality of the diagnosis hits women only after it's all over because it's the first time women actually have a moment to stop and think. This can create even more fatigue.
Medical problems that may cause fatigue:
After surgery, which disrupts your body's normal rhythms, fatigue usually follows. In most cases, it usually lasts longer than you expected too. With radiation, fatigue tends to accumulate over the course of the treatment and can also last for an extended amount of time. After chemotherapy, fatigue may be greatest because your blood cell counts are at their lowest.
Nausea and pain as well as pain medication can quickly zap your energy. Fatigue may also result from changes in your appetite, eating pattern or diet, increased weight, lack of exercise, premature menopause and problems with sleeping.
Hot flashes can also deplete your energy. When they wake you up in the middle of the night, you're missing out on much needed sleep. If steroids are a part of your treatment regimen, you may not be getting adequate rest as well. Even if you're sleeping for more than 8 hours, it might not be enough because steroids interfere with deep, restful sleep.
Ways to manage fatigue:
Listen to your body — Fatigue is your body's way of telling you to slow down. Fighting it will only make you more exhausted. Accept the warning signs and stop trying to do more than you need to do. Sit. Meditate. Listen to your breathing. If these are too Zen for you, take a walk, enjoy a sunset, just do something that helps you relax.
Exercise — Doing a physical activity three times a week for at least 30 minutes will boost your energy and reduce the number of hot flashes you may have. You're more likely to get a good night's rest as a result. As always, you should consult your doctor before starting or altering any exercise program.
Practice good nutrition — Eat right and drink lots of water. Keep to low-fat foods as often as possible and try to eat smaller portions.
Catnap — If you need to rest for a little while, don't sleep for longer than 30 minutes at a time and do it before 2 o'clock. Waking up groggy means that you've rested for too long.
Keep to a routine — Try to maintain a consistent daily schedule by going to bed and getting up at the same time each day.
De-stress — Develop an understanding of what stresses you out the most and then try to figure out how to make things easier on yourself. Don't be afraid to ask for some help.
Limit caffeine — You don't have to give up caffeine entirely but try to avoid it in the afternoon and at night.
Don't forget about sex — A recent survey found that sex was the second-best remedy for sleep problems.
Delegate — Now's your chance to cash in on the goodwill and friendships you've built up in the past. In other words, let someone else do the dishes!
See your doctor — Most of the medical causes of fatigue are treatable. Your doctor will figure out what is contributing to your fatigue and make the appropriate treatment decisions.
When will it end?
There really is no expiration date on fatigue. A general rule of thumb is that it takes about as long as the time from diagnosis through the end of treatment. So, if your diagnosis and surgery took 4 months, followed by six months of chemotherapy, it may take at least 10 months to recover from fatigue. But, fatigue related to breast cancer treatment has been known to go on for years, even when you do everything possible to eliminate it.
Weiss, M. and Weiss, E. Living Beyond Breast Cancer: A Survivor's Guide for When
Treatment Ends and the Rest of Your Life Begins. New York: Three Rivers Press; 1997. p 275-276.
