Fatigue

Hi DebbiePoppy,

Thank you for getting in touch with us and welcome to our online community.  My name is Adrienne and I’m one of the Cancer Information Nurse Specialists at Macmillan. 

I’m so sorry to hear about the pain you are experiencing and how fatigued you’ve been since finishing radiotherapy.  Unfortunately this is not unusual but something that can be managed. 

Pain in the breast after radiotherapy can be sharp/stabbing pain or feel more like an ache.  This usually diminishes over time but it’s important that you let your healthcare team know about it.  They can assess the pain and recommend or prescribe medication to help.  Remember, any new, changing or worsening symptoms should be reported as soon as possible because the sooner they are assessed, oftentimes the easier they are to manage/treat. 

It's important to keep doing your arm and shoulder exercises too.  This can help reduce stiffness and minimise discomfort. 

Cancer/treatment-related fatigue is different from the tiredness someone without cancer may get.  During or after radiotherapy it’s not unusual to get tired more quickly, after less activity.  It may not be helped by rest or sleep. For most people, fatigue gets better after treatment finishes. But for some, it may continue for some time after.  Some people find their fatigue is very mild and it does not really affect their daily life. But for others, it is very disruptive.

It is important to tell your healthcare team about your fatigue and how it makes you feel.  Be honest and do not say you feel fine if that is not how you feel.  There may be things they can do to help.  

There are also things you can try to help cope with and manage the fatigue such as eating a healthy, balanced diet and staying well hydrated.  Nutrition is vital when it comes to the body’s healing process.  The body needs energy to compensate for inflammation and to allow the tissues and healthy cells to heal. 

Exercise is also important with fatigue and although you may feel like this is the last thing you can do, it’s important to find a balance between moving and rest.  Physical activity can actually help reduce fatigue.  It can also help to boost your appetite, give you more energy, build up your muscle strength and improve sleep.  Tips for keeping active:

• Do not exercise if you feel unwell, are in pain or have any other symptoms that worry you, such as feeling breathless. Let your GP or cancer doctor know if you feel like this.
• Set yourself simple achievable goals. Try not to do too much too soon and find a good balance between exercise and rest.
• Plan some activity into your day. For example, walk to the shops instead of driving, if you can.
• Try some regular, gentle exercise, such as walking. Or simple strengthening exercises, such as climbing stairs.
• Do something you enjoy, such as gardening.

keeping a fatigue diary may be helpful, so you can identify what times of day you have more energy and help you plan activities for when you have the most energy. 

There are different complementary therapies that may help with fatigue, such as relaxation, massage therapy (such as reflexology) and yoga.  You should only have a massage from a therapist who is trained and qualified to treat people with cancer. They should have some knowledge of cancer and its treatments. It is important to tell your therapist about the cancer and the treatment you are having.  They should avoid the area where you had the radiotherapy as massage and the oils used can make the skin that was irritated by your treatment much worse.   You can contact the Complementary and Natural Healthcare Council (CNHC) to find a qualified massage therapist.  Some cancer centres offer complimentary therapies and you can look to see what is in your area here.  Always check with your clinical nurse specialist or doctor before having a massage.

We have a booklet called Coping with Fatigue that may be helpful for you to look at.  It has information on help with fatigue, living with and managing it. 

I would also really encourage you to join our breast cancer forum on our online community.  It is a very welcoming and supportive place to receive some peer support from others who are going through or have been through a similar situation.

I hope this information was helpful but please don’t hesitate to give us a call if you’d like to discuss things further.  It can help and offers you the opportunity to ask any questions that may arise.

Take care and best wishes,

Adrienne

Cancer Information Nurse Specialist

You can 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:  AMc/RH