Tiredness after treatment for breast cancer
Fatigue (tiredness) is probably the most common side effect of breast cancer treatment. It’s a feeling of having no energy and makes it difficult to do simple, everyday things.
Rest doesn’t make fatigue better. Fatigue can affect the way you think and feel. Even things that you usually enjoy doing, like reading or watching TV, can be difficult. It can affect your relationships and make you impatient with people around you. You may avoid socialising because it’s too much effort.
It’s not unusual for fatigue to last for months after treatment is over. Occasionally, in some people, it may last for a year or two after their treatment has ended. Some women taking hormonal therapies, which are given for several years, find that tiredness is an ongoing problem for them.
There are ways of dealing with fatigue and some causes of fatigue can be treated. Our section on coping with fatigue has helpful tips on ways of saving energy and dealing with tiredness.
If you’re experiencing fatigue, you may:
feel that you’ve got no energy or strength and could spend all day in bed
have difficulty doing the smallest chores, and everyday activities like showering or cooking can seem impossible
have difficulty concentrating or thinking clearly, or in making decisions and remembering things
feel breathless after very little exertion or feel dizzy or light-headed
have sleep problems
lose interest in sex
feel more emotional than usual.
Sometimes, fatigue is linked to problems such as depression, sleep problems, pain, anaemia or thyroid problems. So it’s important to find out if there’s a particular cause of your fatigue so it can be treated.
The most important thing is to tell your doctor or nurse how you’re feeling. Don’t play it down. Tell them how your fatigue is at its worst.
Your doctor can take blood samples to find out if you have anaemia (low red blood cells), or to find out if your thyroid gland is underactive. Both these conditions can be treated with medicines.
Fatigue is a common symptom of depression. It’s not unusual to feel depressed, anxious or stressed after treatment for cancer. If you think you’re depressed, talk to your doctor or nurse. You and your doctor will be able to work out if what you’re feeling is depression or fatigue. Talking about your feelings with a professional counsellor can often help depression and antidepressants may help you feel better.
If sleep or pain problems are causing or contributing to your fatigue, then improving these will help you feel better.
Coping with pain is tiring and affects the quality of your sleep. If you have effective treatment for your pain, this may improve your energy levels.
What you can do to help yourself
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Taking care of yourself is very important and can help you to feel better. There are ways you can pace yourself to help manage your fatigue. Here are some tips:
Eat well and keep to a healthy diet. This can help you feel better and may help you to have more energy.
Regular exercise can help to reduce fatigue and build up energy levels. It doesn’t need to be strenuous and short walks are a good way to begin. Exercise also helps you to sleep better, makes you more relaxed, and can improve anxiety and depression.
Complementary therapies may help to reduce stress and anxiety, and may improve fatigue. Relaxation, counselling and psychological support are available at many hospitals.
Keeping to a routine, going to bed at the same time and getting up at the same time can help. Try not to stay in bed in the morning after you’ve woken up.
Balancing your everyday activities with enough rest will help you to manage your fatigue.
Allow family, friends, neighbours, social workers and carers to help you. Generally, people are glad to help and particularly if you can tell them what you need. Make a list of tasks you’d like help with, such as shopping, taking out rubbish, paying bills or setting up direct debits to pay bills. Some tasks, such as shopping, can be done online and delivered to your home, if you have internet access.
It can be difficult to cope with children when you’re feeling exhausted. You may sometimes feel that you’re letting your family down. Explain to your children that you can’t do as much with them as before. Involve them in some household chores, if they’re old enough. Accept offers of help from people you trust, to help look after your children at times and take them to and from school or childcare.
You might find that you can’t carry on working or that you have to reduce your hours. There may be things that your employer can do to help, such as changing your hours or finding you lighter work (if your job is physical).