Published by BreastCancer.org
"I have not experienced cancer but I do have a disease in which fatigue plays a major role. Well-meaning friends sometimes say, 'I know what you mean. I was sooo exhausted after. . . .' With all due respect to the friends, no, they have no idea what I mean. Anyone who has not experienced the wall of fatigue, whether from breast cancer treatment or another type of cancer treatment or a disease in which fatigue is an integral part, cannot fully understand what it means. As a close friend of mine said after her own cancer: 'I simply cannot make myself do something whether it's for pleasure or out of obligation. I didn't know someone could feel like this so consistently.'" —Lynn
Fatigue is indescribable—and that's a big part of the problem. You can't point to a place and say, "See? Here it is." Nothing shows, and after months—sometimes years—of your living with this condition, some people around you may begin to think it's all in your head. Even you may begin to think so. But fatigue is real.
You get TIRED from exertion, from difficult or long-sustained effort—running a marathon, doing errands all day, managing your home and your kids' lives. When you're tired at the end of a day, if you get enough sleep you usually feel better the next day. Fatigue is less precise, less cause-and-effect. It's a daily lack of energy, a kind of weakness or inertia that pervades your whole body. It's a loss of interest in people and the things you normally like to do. Physical exhaustion blends with low spirits, and you wind up with fatigue.
"It's been four months since my last chemo treatment, but I still feel tired all the time, and nap nearly every afternoon. My husband is getting tired of me dragging around all the time." —Margie
If you're in the midst of breast cancer treatment, your body is in a war against cancer. It needs all its resources to fight the disease, so it shuts down your energy for other activities that would take away your strength from the battle. Fatigue is the result.
Contrary to what you might expect, fatigue may hit hardest during the easiest part of your breast cancer treatment. It may even hit when your treatment is over, when you're trying to catch up with everything you had to put on the back burner. For that's when you're trying to meet expectations of "normal" when you're still not yourself. That may be when the reality of your diagnosis begins to sink in—causing even more fatigue.
"Women are raised as little girls and young adults to be nurturers, to take care of the people around them. My patients feel that as long as they continue to provide care for the people they are used to taking care of, life is in order. However, they fail to realize that taking time to recover from and deal with their breast cancer, both physically and mentally, is the most important part of the healing process. Many times I will write patients a prescription to 'take time to heal,' so they realize how serious I am about this recommendation. Later on in their fight with breast cancer, my patients usually thank me for encouraging them to take this time out, and they continue to 'take time to heal' long after their active treatment is finished." —Kimberly L. Blackwell, M.D
The medical experts for Fatigue are:
• Lillian Nail, Ph.D., R.N., professor, Oregon Health Sciences University School of Nursing
• Russell Portenoy, M.D., neurologist, Beth Israel Medical Center and President of the Fatigue Coalition
• Marisa Weiss, M.D., oncologist, Thomas Jefferson University Health System/Fox Chase Cancer Center Network.
Some content was adapted from Living Beyond Breast Cancer by Marisa C. Weiss, M.D. and Ellen Weiss.