Hi, I have received a stage 1a melanoma diagnosis and am having a wide excision. I have had iron deficiency without anemia since July and being taking supplements. My vitamin d level is low so taking supplements. My worry is the fatigue and my low energy is a real struggle. Could th cancer have spread anyway? I also have a loss of reflex in my knee on the same side as my melanoma which was on my thigh.
Dear LunaMissy
Thank you for contacting us here at Macmillan Cancer Support. My name is Rae and I am a Cancer Information Nurse Specialist.
Fatigue is a well-known side effect of having a cancer. You are not alone in feeling this. Having iron deficiency without anaemia will also add to this feeling, and a vitamin d deficiency can also cause tiredness.
Having a cancer diagnosis can also cause stress and worry, which ultimately can lead to more tiredness.
Your GP should be able to monitor your blood levels and let you know when they are back in the correct range.
Fatigue needs to be managed in different ways, depending on what is causing it. Your melanoma clinical nurse specialist can assess your fatigue as part of a holistic needs assessment (HNA). You can also talk to your GP about your fatigue. These professionals can help make sure that any changes you are going to introduce are suitable.
We have a fatigue diary which can help keep track of your energy levels. This can help you pinpoint how much the fatigue is affecting your day to day activities.
When trying to help reduce your fatigue, you can think about the amount of physical exercise you can manage. If you have not been as active recently, your muscles become weaker, which increases fatigue. There is good evidence that physical activity can actually help with fatigue. Please do check with your team or GP first though.
Other ways to help fatigue are eating a healthy, well-balanced diet, prioritising sleep and complementary therapies such as relaxation, yoga and mindfulness-based stress reduction MBSR) can help.
In response to your question about whether your grade 1a melanoma could have spread, this would be unusual. Stage 1A melanoma is considered an early stage of cancer and is generally confined to the top layers of skin.
It is always important to talk to your melanoma team about any new symptoms that you are experiencing, such as loss of reflex in your knee. They will be able to further advise as why this is happening.
LunaMissy, please do give our nurses on the Support Line a call, or webchat if you prefer. Talking things over in person can really help. We also have local Macmillan support available and you can find that here.
Best wishes
Rae, Cancer Information Nurse Specialist
You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.
Ref/RH/KH
