How to Manage the Fatigue of Metastatic Breast Cancer

Devastated. Crushed. Shocked. These are just the beginning of a long list of emotions felt by those who have just learned that the cancer they thought they had beaten is not only back but that it has metastasized, meaning it has spread to a different organ in the body. Once this happens, the classification changes to stage IV and treatment becomes geared toward life extension rather than cure.

Metastatic breast cancer affects the entire body. When the cells migrate away from the point of origin, chances are they go to multiple locations and it will just be a matter of time before they are discovered. Symptoms for breast cancer that has metastasized vary depending on the location. Some of those manifest as:

  • In the bones, there may be pain, frequent fractures, constipation, fatigue or mental fogginess as a result of high calcium levels
  • In the lungs, shortness of breath, difficulty breathing, coughing, chest wall pain and extreme fatigue
  • In the liver, nausea, extreme fatigue, swelling in the stomach, feet and hands due to fluid collection, yellowing or itchy skin and fatigue
  • In the brain or spinal cord, pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement and seizures.

Whether specifically listed or not, fatigue becomes a constant condition regardless of the location of metastatic breast cancer and is something that significantly affects quality of life. Ask someone with cancer how they feel and “disfigured” will almost always be part of their response. Cancer fatigue, though, is different from regular tiredness because, not only is it more severe and lasts longer, it is usually not relieved by sleep or rest. The level of fatigue is generally disproportionate to the amount of activity or exertion. Perhaps most significant of all, it is persistent and never seems to go away.

According to the National Institutes of Health, “Some studies have reported that fatigue in cancer patients has a greater negative impact on quality of life than all other symptoms, including nausea, pain and depression.”

Chronic fatigue affects all areas of an individual’s life as well as having a negative impact on family and friends. It is an important issue for anyone dealing with cancer in any of its stages but it is critical for someone with metastatic, stage IV, cancer. In the past, this diagnosis was treated mainly by keeping the patient comfortable. Today, however, even though there is not cure, it can be controlled for increasingly longer lengths of time. For this to include a decent quality of life, the related fatigue must be addressed.

The first place to start is to talk to your doctor. There may be drugs or medications that he can recommended to help alleviate some of the fatigue. That said, recent research has found that counseling and healthy lifestyle practices, including exercise and better dietary choices, are more effective in managing fatigue than drugs.

Some more specific tips are:

  • Manage your energy by planning and moderating activity.
  • Include extra calories if losing weight and make sure to get sufficient protein, 46 grams per day for women and 56 grams for men.
  • Drink plenty of fluids and avoid caffeine. If vomiting or experiencing diarrhea, extra fluids are essential.
  • Consider vitamin supplements but in addition to, not in place of, a healthy diet.
  • Regular, moderate exercise can go a long way in relieving anxiety and depression, as well as fatigue.
  • Mange stress by meditating, reading, listening to music, joining a support group or whatever brings relaxation.

If nothing seems to help, consult with your doctor to see if there might be an underlying medical condition that you are unaware of. Chronic fatigue can be overwhelming. Be sure to reach out to your medical team and your personal support system.

If you would like to learn more about this subject, please watch the following video: