- Question from Anonymous: My treatment has been bi-lateral mastectomy, Adriamycin/Cytoxin/Taxol, radiation, and Herceptin. Can fatigue resulting from this treatment be ongoing for months, and even years? It has been over 1 year since my last treatment, and I'm still fatigued more than normal.
That is a long treatment for breast cancer, and it is not unreasonable that fatigue continues for months, if not for a year or year and a half. We have limited longitudinal research that tracks women for a year or year and a half. We have found for some women, particularly if they're symptomatic from the Taxol (chemical name: paclitaxel) they've received, and if they have muscle aches and joint pain, many of those tensions can contribute to the feelings of fatigue. And, combined with not wanting to engage in physical activity, it can become a vicious cycle of resting and the more you rest, the more fatigued you get.
Just think if you're in bed with the flu for a week, you don't on day 8 get up and feel terrific. It takes quite a bit longer than that after a week of not being active to regain your energy. It's very analogous with your breast cancer treatment if you've had a very long course of treatment that it's going to take you much longer to recover.
- Lillie Shockney, R.N., B.S., M.A.S. What about issues associated with a patient's psychological well-being after treatment? For example, feeling clinical depression and figuring out how to emotionally transition back into her life which has been disrupted for so long.
The majority of patients when they finish treatment describe it as somewhat of a feeling of abandonment, like they've fallen off a cliff. They've been so busy with treatment, once they are done, for most women they are left on their own to resume a "normal" life. Psychologically or emotionally, the next 6 months are filled with uncertainty, anxiety, and challenges with trying to resume a "normal" life. And many concerns and fear of recurrence surface at a time when the support system of the healthcare providers is much less than when they were in treatment.
We've just recently begun developing supportive programs to help women transition physically and emotionally in the first year after treatment. We know that physical activity after treatment can not only improve fatigue, but it definitely has significant psychological benefits. Women with breast cancer who engage in physical activity feel better, they feel more resilient, they're less depressed. So, there's a definite link between physical energy and psychological resilience.
On Wednesday, January 16, 2008, our Ask-the-Expert Online Conference was called Managing Fatigue During and After Treatment. Diana Dyer, M.S., R.D., Tish Knobf, Ph.D., R.N., F.A.A.N., A.O.C.N., and Lillie Shockney, R.N., B.S., M.A.S. answered your questions about ways to keep up your energy, how nutrition can affect fatigue, and how exercising can help.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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