Fatigue and Breast Cancer: More Common than Not

This post was written by H&W instructor Susannah Haarmann, PT, WCS, CLT, who authored and instructs the course, Rehabilitation for the Breast Oncology Patient.

According to Schmitz et al, 94% of people experience fatigue as a side effect during breast cancer treatment, and, unfortunately, this condition commonly persists after treatment ends. Fatigue is often described as an unrelenting sense of tiredness that interferes with daily functioning. The symptoms of fatigue, such as generalized weakness, inability to concentrate and impaired short-term memory are often disproportionate to activity levels and unresponsive to sleep (Mitchell, 2010).

The causes of fatigue during cancer treatment are often multi-factorial and may be related to anemia, pain, deconditioning, hormonal and electrolyte imbalances or emotional distress, among other reasons. Physicians may attempt to alleviate the symptoms with pharmaceutical interventions such as pain and sleep medications or iron supplements, however, the only intervention that has been shown to have a significant effect in lowering fatigue levels is exercise. The NNCN states that exercise has been shown to lower fatigue levels by 40-50% (NCCN, 2008).

Radiation, chemotherapy and surgical intervention have been associated with fatigue, however, a Cochrane review by Markes, et al showed that exercise can improve physical function even during cancer treatment (Markes, Barckow & Resch, 2006). Patients who continue exercise within safe parameters during cancer treatment have been shown to reap the following benefits; improved energy, appetite, and psychological states, and even a greater functional capacity.

Furthermore, exercise during and after cancer treatment, has been shown to improve overall treatment outcomes and lower patient’s risk of cancer recurrence, as well as decrease the risk or limit other side effects of breast cancer treatment such as lymphedema, fatigue and osteoporosis. Susannah Haarmann’s course “Rehabilitation for the Breast Cancer Patient,” will explain safe parameters of exercise before and after cancer treatment to improve the health and overall quality of life of cancer patients.

References:

Markes, M., Borkcow, T., & Resch, K., Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database of Systematic Reviews (4). CD005001.
Mitchell, S., Caner-related fatigue; Clinical practice guidelines in oncolog. J. Natl. Comp. Canc Netw, 2010; 5 (10), 1054-1078.

Schmitz, K, Speck, R., Rye, S., DiSpio, T., Hayes, S., Prevalence of breast cancer treatment sequelae over 6 years of follow-up. Cancer, 2012; 118(8) 2217-2225.