Hi,
I was diagnosed with stage 4 April 2025 (primary April 2020]. Mets in posterior calvarium, spine, sacrum, pelvis, femoral head, rib. I‘m on anastrazole, started with ribociclib but got interstitial lung injury so now on palbociclib. On the positive side it has been over a year with no progression but currently I am really struggling will profound tiredness that is really impacting my quality of life.
I have reduced my working hours to 2 days a week but I am even struggling with that. The oncologist has reduced the palbociclib dose to 75mg but sometimes I seem to feel worse on treatment breaks, which I seem to have had a lot of recently. I also have a massive seroma in my abdomen, diep flap donor site, that causes me back issues, particularly walking/standing, but they don’t want to drain or do surgery because of infection risk, if I try to walk more than about 50mtrs without elbow crutches I feel like my legs are going to give out under me.
Blood tests etc haven’t offered any solutions so I am looking for any helpful strategies that people use to manage fatigue. I have an indoor bike I was using regularly, which the physio thought would be a good safe exercise, but currently I am struggling to do that. I do also wonder if it is worth a GP visit rather than the oncology team.
I know there isn’t going to be a magic panacea but I appreciate if you can share what works for you.
Hi Morsey
I am sorry you are struggling with fatigue and with the challenges from your seroma. I don’t know whether it’s worth pressing for reconsideration of what to do about that, given how much it is impacting your quality of life? It’s also not helping your fatigue, as gentle exercise is often a helpful management strategy.
I am one of the Community Champions on the breast cancer pages. I have secondary breast cancer, but my cancer isn’t oestrogen fed so I have no experience of anastrazole, nor are the CDK4/6 inhibitors used on my type of cancer. I know drugs like anastrazole can cause fatigue. Some members seem to have more issues with some brands than others; you will find a number of threads on this on the main breast cancer forum. So if you have been issued different brands recently, it may be worth considering.
Whilst my drug and treatment experience has been different, I think fatigue is a feature for many of us. For me, it’s about trying to keep to a routine. Getting up in the morning even if I feel tired, doing as much exercise as I can (I find things like aqua and aqua Zumba classes work well as they support body weight). Trying to eat healthily / keep a healthy weight. Accepting some days are better than others. As you say it might be worth talking to your GP. Also, did your blood test check your thyroid function? That can be affected by treatment.

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Hi Coddfish,
thank you, I had heard of different brands of anastrazole etc having more or less side effects but had forgotten. I do have a different brand now so possibly that is having some impact, at least it’s something to try, my latest ones are different again so maybe that will make a difference when I start those.
I have had a thyroid test and they are going to do another one, iron, B12 etc have been checked. I do know my haemoglobin, RBC and Haemocrit are always flagged as low on my blood tests, as are my sodium levels but they don’t seem to consider that significant.
Hopefully the next brand of anastrazole is the answer, or at least partially, if not maybe a trip to the GP.
It’s interesting about your red blood cells and haemoglobin. It reminds me that it took me a little while to recover after chemo, radiotherapy and a liver procedure and part of the answer was needing the red blood cells that had been ‘born’ during chemo to be replaced by post-chemo ones. Whatever the rationale, I think treatment and the stress of it all take their toll.

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