What is fatigue? | ASK THE EXPERT

Extreme tiredness, also known as fatigue, is one of the most common and distressing side effects of breast cancer treatment. The Beacon spoke to Dr Yoland Antill, Medical Oncologist from Cabrini and Frankston hospitals in Melbourne, about the causes of fatigue and what can help.

What is fatigue?

Fatigue is a feeling that you have no energy or that normal tasks are taking a lot more energy than usual. Sometimes you might not have the energy to do normal tasks at all. Fatigue can be physical, mental or a combination of both, and can fluctuate over time.

What causes fatigue during breast cancer treatment?

Treatments are a common cause of fatigue. The level of fatigue you experience can depend on the types and lengths of treatment you have together with personal factors that also impact fatigue, such as emotional wellbeing and physical fitness.

Recovery from surgery takes a lot of physical energy, with bigger operations taking longer to recover from than smaller surgeries. Experiencing pain can also contribute to fatigue, especially if it affects your ability to sleep.

Chemotherapy and radiotherapy can cause fatigue. The longer the duration of treatment, the more likely you will be fatigued.

If you have lost blood during your surgery or become anaemic (low red blood cells) during chemotherapy, this can add to fatigue as well. Some medications that may be used during treatment, such as drugs to prevent nausea or reduce pain, can also have side effects that contribute to fatigue.

Travelling for treatment can be exhausting as well, especially if it’s happening on a daily or weekly basis.

Why can fatigue continue even after treatment?

Depending on its cause, fatigue can last from three to 12 months, or even longer, after your treatment has finished. This differs from person to person.
Research suggests ongoing fatigue could be a result of one or a combination of some of the following:

  • side effects of hormone treatments and menopausal symptoms
  • chronic anxiety or depressed mood
  • ongoing pain issues
  • a very busy work and life schedule
  • sleep difficulties
  • a lack of physical fitness
  • being physically inactive
  • an unhealthy diet.

What can I do to manage fatigue?

Moderate exercise has been shown to greatly assist in reducing fatigue. Aim for at least 20 to 30 minutes of moderate intensity physical activity three to four times per week. This could include activities such as walking, swimming or cycling. An additional two or three sessions of strength or resistance training is also recommended, such as yoga, weights or Pilates.

Work exercise into your daily routine. You may have a lot of friends and colleagues asking how they can help after your diagnosis. One of the best ways they can help is by joining you for regular exercise and offering encouragement and support to live a healthy, active lifestyle during and after treatment.

The weather and time pressures are common ‘excuses’ that I hear from women when it comes to living healthily. If weather is a barrier to exercising daily, there are options such as indoor exercise, wearing weather-appropriate clothing and exercising in the early mornings or evenings. A well-balanced diet can help.

Weight gain, which is common with some breast cancer treatments, can cause fatigue. Large and heavy meals can cause fatigue. Try to have smaller and more frequent lighter meals.

Take time to rest throughout the day between activities, but limit the length of naps so that you are still able to sleep at night.

Give your body time to recover after treatment. Try to work up to your usual level of daily activity rather than stepping straight
back into old routines.

If you are struggling with everyday tasks due to fatigue, ask friends and family for extra support and practical help at home.

What help is available?

If fatigue is concerning you, talk to your breast care nurse, GP or specialist. They can help you to identify what might be causing your fatigue and suggest approaches to help reduce or manage it.

If you think depression or anxiety might be contributing to your fatigue, referral to a psychologist or counsellor may be helpful. Your cancer specialist and GP might talk to you about a referral to a specialist, such as a dietitian or exercise physiologist.

Some hospitals (public and private) run cancer rehabilitation programs for people who have completed or are going through active cancer treatments. These programs can help address cancer-related issues and improve quality of life.

Dr Yoland Antill

Dr Yoland Antill

Issue 81
Summer 2017