How Your Doctor Can Help
The first step is to try to figure out the source or sources of your fatigue. There may be more than one reason youâre feeling this way.
Your doctor can do tests to check for anemia or hypothyroidism. If you have one of these conditions, treatments can help.
If you think your cancer treatment is the cause, talk to your doctor about ways to help you manage it, or discuss other options.
How You Feel Emotionally
Being diagnosed with cancer can be hard to accept. Youre likely to go through a range of emotions before, during and after your treatment. This is very normal.
You might have a lot of worries, some of these might include:
- will my treatment work?
- will I be able to deal with side effects?
- how will my family and friends cope?
- will I have enough support?
- will I be able to keep working?
- how will I get to the hospital for my treatment?
- will the treatment be painful?
- what if I lose my hair?
All these worries can make you feel anxious or down. Anxiety and depression are common in people with cancer. Theyre often very draining emotions.
Fatigue can be worse if you are taking a combination of these drugs.
What Else Can Cause Fatigue
Many other factors can make you feel tired and fatigued if you have cancer. Some of these include:
- not sleeping well at night or sleeping too much during the day
- treatment may be harder for you to cope with especially if you’re elderly
- your tiredness may make it harder for you to concentrate so everything seems more difficult making you feel even more tired
- travelling to and from the hospital for treatment
- having a lot of visitors when you are staying in hospital
- looking after children
- other health problems such as diabetes, problems with your lungs, heart problems and being overweight
You can ask your nurses to tell your visitors that they can only stay with you for a short time. Don’t feel bad if you have to do this. You need a lot of rest and your friends and family will understand.
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How We Treat Cancer At Ctca
We only treat cancer at CTCA. Our team of multidisciplinary cancer experts takes a personalized, patient-centered approach to treating cancer and its side effects.
In addition to using conventional cancer treatments to attack the cancer itself, we provide evidence-informed supportive care therapies to help patients tolerate treatment and reduce side effects, including:
- Nutritional support, which includes the option of meeting with a registered dietitian wholl develop a personalized plan for your nutritional needs
- Behavioral health care, which may include working with therapists to help with depression, anxiety and stress, and using techniques such as talk therapy, mindfulness and relaxation techniques
- Access to professionally led support groups for patients and their loved ones, both in-person and online, including our Cancer Fighters community, where you can connect with cancer survivors
- Naturopathic support, which includes consultations with our naturopathic providers who counsel patients on the use of natural, non-toxic techniques to support the healing process
Providers at CTCA work together under one roof, providing convenient access for patients.
If youd like to get a second opinion or talk to someone at CTCA about getting help for fatigue or other cancer-related side effects youre experiencing, or chat online with a member of our team.
Mechanisms For Intervention Effects
The literature reviewed above suggests that a variety of different intervention approaches may be useful for cancer-related fatigue, including physical activity, psycho-education, cognitive-behavioral, and mind-body approaches. These interventions have different targets and may work through different mechanisms, including cognitive, behavioral, and biological mechanisms. For example, cognitive approaches to treating cancer-related fatigue specifically target maladaptive thoughts about fatigue, including catastrophizing138. Given that catastrophizing predicts more severe and persistent fatigue symptoms in cancer patients19, reducing the use of this coping mechanism may be one of the active ingredients that promotes reductions in fatigue. Even more physical approaches may work by changing thoughts and beliefs about fatigue for example, patients felt more confident about their ability to manage fatigue after learning certain yoga postures148, which might lead to reductions in fatigue symptoms.
Low Levels Of Red Blood Cells
Cancer and its treatment can affect your bone marrow. The bone marrow is where your body makes red blood cells which carry oxygen around your body.
A lower than normal red blood cell count is called anaemia. Having too few red blood cells means your blood carries less oxygen and you can have:
- shortness of breath
- tiredness and lack of energy
- an increase in heart rate
- chest pain
Inflammatory Breast Cancer Symptoms
Unlike other breast cancers, inflammatory breast cancer rarely causes breast lumps and may not appear on a mammogram. Inflammatory breast cancer symptoms include:
- Red, swollen, itchy breast that is tender to the touch
- The surface of the breast may take on a ridged or pitted appearance, similar to an orange peel
- Heaviness, burning, or aching in one breast
- One breast is visibly larger than the other
- Inverted nipple
- No mass is felt with a breast self-exam
- Swollen lymph nodes under the arm and/or above the collarbone
- Symptoms unresolved after a course of antibiotics
Unlike other breast cancers, inflammatory breast cancer usually does not cause a distinct lump in the breast. Therefore, a breast self-exam, clinical breast exam, or even a mammogram may not detect inflammatory breast cancer. Ultrasounds may also miss inflammatory breast cancer. However, the changes to the surface of the breast caused by inflammatory breast cancer can be seen with the naked eye.
Symptoms of inflammatory breast cancer can develop rapidly, and the disease can progress quickly. Any sudden changes in the texture or appearance of the breast should be reported to your doctor immediately.
For women who are pregnant or breast-feeding, redness, swelling, itchiness and soreness are often signs of a breast infection such as mastitis, which is treatable with antibiotics. If you are not pregnant or nursing and you develop these symptoms, your doctor should test for inflammatory breast cancer.
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Breast Cancer Fatigue Before Diagnosis
How do I tell when I have breast cancer? This has been the question most people ask but they dont have the most appropriate answer. Breast cancer eats slowly into the body which can make it difficult to be identified in the early stages. Breast cancer fatigue before diagnosis is common among the cancer patients and it must be monitored and managed properly.
This can be characterized by low energy in the body and weakness which are rarely experienced by healthy people. Such condition may be treated lightly before cancer diagnosis and can easily be assumed to be the normal sleep. The fatigue may be experienced as a result of breast cancer without the knowledge of an individual or may be caused by the treatment process.
You dont have to wait for the breast cancer condition to get worse to take the necessary steps for diagnosis and treatment. Today therere better ways for cancer diagnosis which are effective and cost effective in terms of budget. You can totally depend on the related symptoms and fatigue to tell o the cancer condition but a lot more needs to be done.
Across the world, different people have reported extreme fatigue which later turned up to be caused by the breast cancer. You should work closely with your doctor for the right diagnose when you feel extreme levels of fatigue.Impact of the breast cancer fatigue.
Why Exercise = More Energy
Are youasking: How can exercise give me more energy? I can barely go to the grocerystore! I admit that it seems counterintuitive. But if you think about whatexercise does to the body, it might make more sense.
Exercise in any form brings oxygen to your muscles. This is true whether exercise is aerobic , resistive or yoga .
All theseexercise types also take away waste products. They bring fresh oxygen, freshnutrients! Circulation is truly the key to healthy tissues.
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Fatigue And Physical Performance Evaluation
At the baseline , demographic and anthropometric characteristics, cancer location and staging, as well as pharmacologic history, have been assessed. All outcomes were also evaluated at the end of the 4-week rehabilitation treatment , and at 2 months follow-up .
The primary outcome measure was the Brief Fatigue Inventory , a multidimensional self-report scale that assesses the effects of fatigue on health-related quality of life originally reported by Mendoza et al. . This survey is composed of nine questions scored on a 010 point scale. The BFI is presented as two parts. Specifically, the first three questions rate the current, usual, and worst levels of fatigue over the last 24 h, while the remaining six questions are related to the impact of fatigue on activity, mood, walking, work, relationships, and enjoyment of life. A total BFI score is then calculated by the mean of the nine scores, where scores 13 indicate slight fatigue, scores 46 moderate fatigue, and scores 710 severe fatigue.
Physical Medicine And Rehabilitation
In cancer pre- and rehabilitation, exercise is a very suitable means to reduce fatigue and improve the overall quality of life and participation . Improvement of muscular strength, endurance capacity, sensorimotor functions, and flexibility seems to be of high clinical relevance concerning the overall quality of life, general health, survival, and return to work . There are recent international recommendations for exercise in cancer patients, which serve as a guide for the fitness and health care professionals working with cancer survivors . Cancer survivors can safely engage in exercise to restore physical functioning, enhance the quality of life, and mitigate CRF .
In some cases, cancer patients are not able to perform systematic and regular exercise due to different painful musculoskeletal conditions, such as plantar fasciitis or calcaneal spur, calcifying tendinopathy of the shoulder, tennis elbow, or Achilles tendinopathy . In most cases, such painful musculoskeletal conditions prohibit active participation in exercise programs and therefore have to be treated before starting vigorous exercise .
Availabletreatment options for fatigue in BC patients
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Physical Activity Physical Deconditioning And Body Mass Index
Physical inactivity is correlated with cancer-related fatigue patients who are more fatigued typically report lower levels of physical activity104, 105. Lack of physical activity may lead to physical deconditioning, which makes everyday tasks more challenging and potentially contributes to the development and persistence of fatigue. Indeed, cancer survivors with post-treatment fatigue show decreased cardiorespiratory fitness106. However, few studies have examined the temporal association between activity, deconditioning, and fatigue, making it difficult to determine causality. There is evidence from longitudinal studies that lower levels of physical activity after treatment completion predict persistent fatigue in breast cancer survivors19, 107, although elevated fatigue during treatment may have preceded lower physical activity in these reports. In either case, low levels of physical activity and associated decreases in cardiorespiratory fitness may play an important role in the development and/or persistence of cancer-related fatigue. Elevated body mass index has also been linked with fatigue, and a longitudinal study of women with early-stage breast cancer found that BMI was one of the key predictors of fatigue at 619 and 42 months post-treatment101. Body mass index also predicted persistent fatigue in a longitudinal study of post-treatment breast cancer survivors, above and beyond other risk factors65.
Is Your Fatigue A Symptom Of Cancer
Could your fatigue be the first symptom of cancer? At one point or another, we have all experienced fatigue. For most of us, it is temporary, usually caused by stress or being overworked.
For some people, however, fatigue can become persistent, occurring daily. When fatigue becomes frequent, it is natural to be concerned about what may be causing it.
One of the first things many people think maybe the culprit for their fatigue is cancer. When might feeling tired be a sign of cancer and how often is it?
We often hear about cancer patients who are extremely fatigued, but a lot of cancer-related fatigue is caused by the side effects of cancer treatment, not always cancer itself. In other words, for people with many cancers, the fatigue begins after diagnosis.
While fatigue alone without other symptoms is uncommon in many cancers, for people with leukemias and lymphomas fatigue may well be the first symptom.
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What Causes Fatigue And Weakness
In people with cancer, weakness might be caused by having and recovering from surgery, low blood counts or low electrolyte levels, infection, or changes in hormone levels.
However, the causes of cancer-related fatigue are often harder to determine because there are often many factors involved. It might be from the cancer itself and/or a side effect of the cancer treatment. How cancer and treatment might cause fatigue is not well understood, but some possible reasons are:
- Cancer and cancer treatment can change normal protein and hormone levels that are linked to inflammatory processes which can cause or worsen fatigue.
- Treatments kill normal cells and cancer cells, which leads to a build-up of cell waste. Your body uses extra energy to clean up and repair damaged tissue.
- Cancer forms toxic substances in the body that change the way normal cells work.
Besides direct effects of cancer and its treatment, people with cancer often also experience other things that can add together to increase fatigue. These are things like surgery, stress and worry, changes in activity level, and changes in blood counts, electrolytes, and hormone levels.
What Are Some General Signs And Symptoms Of Cancer
Most signs and symptoms are not caused by cancer but can be caused by other things. If you have any signs and symptoms that don’t go away or get worse, you should see a doctor to find out whats causing them. If cancer is not the cause, a doctor can help figure out what the cause is and treat it, if needed.
For instance, lymph nodes are part of the bodys immune system and help capture harmful substances in the body. Normal lymph nodes are tiny and can be hard to find. But when theres infection, inflammation, or cancer, the nodes can get larger. Those near the bodys surface can get big enough to feel with your fingers, and some can even be seen as swelling or a lump under the skin. One reason lymph nodes may swell is if cancer gets trapped there. So, if you have unusual swelling or a lump, you should see your doctor to figure out whats going on.
Here are some of the more common signs and symptoms that may be caused by cancer. However, any of these can be caused by other problems as well.
Sometimes, its possible to find cancer before you have symptoms. The American Cancer Society and other health groups recommend cancer-related check-ups and certain tests for people even though they have no symptoms. This helps find certain cancers early. You can find more information on early detection at the American Cancer Society Guidelines for the Early Detection of Cancer.
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Finding The Cause Of Your Fatigue
If youre experiencing unexplained fatigue thats concerning you and interfering with your daily activities, start with a visit to your primary care physician to investigate more common reasons for fatigue.
Your physician will probably ask about the level of fatigue youre experiencing and when it began. He or she should evaluate medications you may be taking for other health conditions because fatigue is a side effect of some medications.
Some common blood tests your doctor may order include:
- A blood chemistry panel to check for kidney disease, liver disease, electrolyte imbalance and signs of cardiovascular disease
- A complete blood count to screen for conditions such as anemia, immune deficiency or infection
- Thyroid function tests to evaluate thyroid gland function
- A vitamin D test to determine whether you have vitamin D deficiency
Other screenings may include a psychological analysis to determine whether youre depressed or a sleep study to see whether youre at risk for obstructive sleep apnea.
If those tests are negative, your physician should start looking for another possible underlying cause of fatigue.
Summary And Future Directions
While research into the etiology, course, and treatment of cancer-related fatigue is relatively new, much progress has been made in recent years however, considerable opportunities remain. While some well-powered studies have examined risk factors for fatigue in breast cancer patients and survivors, most studies examining underlying mechanisms have involved small to very small sample sizes. While a few studies employing repeated-assessments have been conducted, most have been cross-sectional in design. Thus, more longitudinal studies that involve assessment of cancer patients pre-/post-completion of initial treatment and into survivorship are needed. While multiple factors have been observed to be linked with cancer-related fatigue, it has yet to be determined which factors predispose, precipitate or exacerbate/maintain the patients experience of fatigue. For example, longitudinal studies examining and comparing the effects of chemotherapy- and radiation-induced inflammation on functioning during survivorship are warranted. Also, additional studies employing statistical analytic techniques that can evaluate hypotheses about causal pathways are needed. These will require multiple assessments of established or promising biomarkers of fatigue. Such studies should also assess fatigue using multidimensional scales normed on and/or tailored to breast cancer patients.
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