First Person

Fatigue is breast cancer patients' frequent post-treatment companion


Miami Herald writer and online producer Andrea Torres is chronicling her breast-cancer experiences in Tropical Life.

Cancer treatment and fatigue

• 24 percent of breast-cancer patients had fatigue after surgery.

• 31 percent had fatigue at the end of treatment (radiation, chemotherapy, etc.).

• 11 percent had fatigue 6 months after treatment.

• 6 percent still had fatigue 12 months after treatment.

• At each interval, at least one-third of patients with fatigue also had mood disturbances.

• Tumor size was a predictor of cancer-related fatigue.

Cancer-related fatigue was associated with disability.

Source: Journal of the American Society of Clinical Oncology, April 16, 2012

A six-month trip to breast-cancer treatment country has left me with jet lag.

I’m sleepy most of the time. I’m not endangering anyone on the road, but I am annoying a few drivers. I apologize to those who have had to honk their horns to rouse me. I like to close my eyes when I’m stuck in traffic.

Last week, the elevator door opened and a co-worker discovered that I like to snooze for the few seconds it takes to get to my floor.

I’m not upset about it; I’m just doing my best to accept the situation while it lasts. Post-treatment fatigue is well-documented, and generally fades with time.

A recent study in the Journal of the American Society of Clinical Oncology found that almost one-third of breast cancer patients had cancer-related fatigue at the end of treatment. Six months later, about 10 percent said they were still experiencing fatigue, and about six percent continued to have symptoms a year after treatment.

The study’s findings were based on 218 women who were treated for early-stage breast cancer with surgery and some type of preventive therapy, usually radiation, chemotherapy or both.

I was treated for stage IIIA breast cancer with chemotherapy, a bilateral mastectomy and radiation, which ended three months ago. My oncologist put me on Tamoxifen and Prolia, and though I worried about taking them, I haven’t had any serious side effects from either drug. Feeling tired most of the time has been the most bothersome issue.

At first I thought it was psychological because fatigue often accompanies depression. But I’ve been responding to the antidepressant medication and cognitive therapy I’ve received at University of Miami Sylvester Comprehensive Cancer Center’s Courtelis Center For Psychosocial Oncology. I’m still not used to the surgery scars, and my breast implants feel foreign, but I don’t cry about it anymore. On the days I care, I use sweaters or jackets to hide them.

Diet and exercise can affect energy levels. I’ve been walking for fitness, but running is out of the question because I get dizzy. I avoid caffeine because the drop from the high isn’t worth it. I only eat chicken, not beef, pork or fish, so I’ve been taking Omega-3s and other supplements and drinking the bottles of wheat-grass juice my mom buys me. They’re labeled “clean green energy.” I hope the claim is true.

When I went out to dinner recently with a guy I’d met, it was clear that I was sleepy and wanted to go home. After dropping me off, he sent me a text message: “I will be praying to Hypnos [the Greek god of sleep] to grant you the power of sleeping with your eyes open, so you can pretend to be interested in what I am saying.”

I laughed and responded: “Let’s hope the god answers your prayers.”


Part 1: At age 33, I’m dealing with breast cancer

Part 2: Cancer treatment complicates dreams of pregnancy

Part 3: Hanging in when chemotherapy gets rough

Part 4: Tough surgery choices: Mastectomy vs. Lumpectomy

Part 5: Silicone implans are not the only way to go in breast reconstruction

Part 6: Rebuilding the breast from body tissue

Part 7: Body fat can be used to build breast

Part 8: Facing my fears after mastectomy

Part 9: Taking control of the fear that comes with breast cancer

Part 10: Doctor knows about being a breast cancer survivor

Part 11: Radiation therapy gives her hope

Part 12: Finding strength from others

Part 13: Facebook, medication help breast cancer patient deal with depression

Part 14: A new outlook on 2012

Part 15: Breast cancer patient faces genetic mystery

Part 16: Using diversion to cope with harsh reality

Part 17: After radiation therapy ends

Part 18: Friend’s breast cancer journey is not as fortunate

Part 19: Anti-tumor meds come with scary story

Part 20: Reentry into the world after breast cancer treatment

Part 21: Too much fear, too little trust

Part 22: Chemo brain complicates return to work

Part 23: The Cancerous tumor is gone, not the fear

Part 24: Drawing strength from a singer’s defiant spirit

Part 25: A breast cancer message at Ultra Music Festival

Part 26: High hope for new drug

Part 27: Religion is an unavoidable topic

Part 28: Treatment changes social life

From the Editor: Journalist confronts cancer, takes readers along

Read more Health stories from the Miami Herald

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