Many women treated for breast cancer say they have problems remembering, thinking, and concentrating during and after treatment. These problems are commonly called “chemo brain” or “chemo fog” -- though women treated with hormonal therapy also complain about memory issues. Doctors call these issues “cognitive impairment” or “cognitive problems.”
Some women may have trouble with:
- learning new tasks
- remembering names
- paying attention and concentrating
- finding the right words
- organizing thoughts
- making decisions
- remembering where things are (keys, glasses, etc.)
At the same time, fatigue is the most common side effect of breast cancer treatment. Some doctors estimate that 9 out of 10 people experience some fatigue during treatment. Fatigue from treatment can appear suddenly and can be overwhelming. Rest doesn't ease fatigue, and it can last for months after treatment ends.
Fatigue is hard to describe. You feel like you don't have any energy and are tired all the time. But there's not a specific cause, such as doing errands all day, working out, or other exertion. When you're tired from exertion, if you get enough sleep that night, you usually feel better the next day. With fatigue, you feel generally tired all the time and lose interest in people and the things you normally like to do.
Symptoms of fatigue include:
- lack of energy
- sleeping more
- not wanting to do normal activities or being unable to do them
- paying less attention to personal appearance
- feeling tired even after sleeping
- trouble thinking or concentrating
- trouble finding words or speaking
Almost every treatment for breast cancer can cause fatigue, and many pain medicines, such as codeine and morphine, also can cause fatigue.
A study has found that doing more moderate to vigorous exercise can help ease both chemo brain and fatigue in women who have been treated for breast cancer.
The study was published online on July 4, 2017 by the journal Breast Cancer Research and Treatment. Read the abstract of “The effects of physical activity and fatigue on cognitive performance in breast cancer survivors.”
To do the study, the researchers had 299 women who had been treated for breast cancer wear an accelerometer for 7 days in a row. An accelerometer is a small device that measured how fast the women moved. From the information the accelerometers collected, the researchers calculated the average daily minutes of moderate to vigorous exercise each woman did.
The women also completed a number of questionnaires and tests on an iPad application. The researchers worked with Digital Artefacts -- the company that developed the commercial neuroscience app BrainBaseline -- to create an iPad app tailored to the study. The app included questionnaires and activities designed to measure attention, memory, and multitasking skills.
"Other studies of cancer survivors have relied on small samples of cancer survivors and used self-reporting measures of physical activity and cognitive function, which can be very biased," said Diane Ehlers, postdoctoral research at the University of Illinois and one of the study’s authors. "What makes our study novel is that we had objective measures for both physical activity and cognitive performance, and a nationwide sample of breast cancer survivors."
The researchers found that women who did more moderate to vigorous exercise per day had less fatigue, which allowed them to have better cognitive function.
"We found that higher levels of daily moderate-to-vigorous physical activity were associated with better performance on the cognitive tasks measuring attention, memory, and multitasking," Ehlers said. "What was notable was that physical activity's effect on cognitive performance was mediated by fatigue. This provides evidence that physical activity interventions targeting fatigue in cancer patients and survivors might provide promising models for improving cognitive function as well."
"The data suggest that being more physically active could reduce two of the more commonly reported symptoms in breast cancer survivors: fatigue and cognitive impairment," said study leader Edward McAuley, professor of kinesiology and community health at the University of Illinois. "Most people think, 'If I exercise, I'll become tired.' In our study, exercise actually was associated with reduced fatigue, which in turn was associated with better cognitive function."
While this study looked for an association between exercise, cognitive function, and fatigue, there are many other benefits to regular exercise if you’ve been diagnosed with breast cancer:
- a lower risk of breast cancer coming back (recurrence)
- easier to maintain a healthy weight
- more energy
- better mobility
- more muscle mass and strength
- healthy bones
- better sleep
If you’re busy with work, household chores, and family matters, finding time to exercise almost every day can be hard. Exercising also can be extremely difficult if you’re recovering from breast cancer treatment or having troubling side effects. Still, it’s worth your while to make time to move.
It can help to break up your exercise into 20- or 30-minute sessions that add up to about 5 or more hours per week. Walking is a great way to start. Maybe you walk 30 minutes before going to work and 30 minutes on your lunch break. You can add a few more minutes by parking farther away from your building or taking mass transit. Or you can make plans to walk with a friend after work -- you’re more likely to stick with exercise if someone else is counting on you. Plus, you can socialize at the same time.
Visit the Breastcancer.org Exercise section for tips on how to find the right exercise for you, exercising safely, and how to stick to an exercise routine.
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