Female Sexual Dysfunction Issues from Breast Cancer

There was a time before pink ribbons. There were no marathons. October was all about jack-o-lanterns and ghosts. Breast cancer, or any type of cancer for that matter, was not something that was openly discussed. Or mentioned. There was something shameful about cancer. As recently as the mid-1900s, people spoke about cancer in whispers and allowed relatives to die in attics rather than let anyone know they had cancer.

Obviously, times have changed. Awareness campaigns have brought this once hidden disease front and center. The entire month of October is dedicated to breast cancer awareness, and the world is seemingly awash in pink. In fact, there is a chart depicting the colors for all of the different types of cancer. The vast majority of people have either experienced a bout with cancer or know someone who has. It is still a dreaded disease, but it no longer carries a stigma of shame.

Except, sometimes it still does. Men have sexual and intimacy issues related to certain types of cancers and women have their own list. Breast cancer is, perhaps the one that affects women the most, if for no other reason than it is so wide-spread. Statistically, 1 out of 8 women will be diagnosed with breast cancer sometime during her life. The survival rate gets better all the time but sexual side effects can take their toll long after treatment is over. According to the National Cancer Institute, 50% of women who undergo treatment for breast cancer experience long-term sexual dysfunction.

According to Susan R. Davis, MD, of Victoria, Australia’s Monash University Medical School, “Sexual problems are among the most common and least talked about side effects of breast cancer treatment. About 70% of the women in our study were experiencing a meaningful loss of desire and sexual function a full two years after diagnosis.”

Body image, vaginal dryness and uncertainty about what to expect can play large roles. So, can having premature menopause be brought on by chemotherapy. It can be temporary that lasts during and for a period of time following treatment or it can be permanent. The ovaries stop functioning, and hormone levels plummet over a period of weeks or months rather than over a few years as it does when it happens naturally. Menopause is rarely pleasant, but the suddenness of it happening prematurely can significantly intensify symptoms for younger, premenopausal women.

Fortunately, the news isn’t all bad! Breast cancer may initially put a halt to all thoughts and desires for sex and intimacy but things do not have to stay that way. A lot of women are uncertain or even afraid to have sex. Their partners may also be hesitant for fear of hurting them or being perceived as pushing something to quickly. If this goes on for very long, professional counseling should be considered. For many others, there are some simple ways to move past this roadblock that have proven effective. Some suggestions are:

Vaginal moisturizers – unlike lubricants, which are used during sex, these are absorbed to introduce moisture back into the vaginal area for a period of several days

Lubricants – in addition to the vaginal moisturizers, if there is still a painful sensation during intercourse, lubricants can help

Exercises  Kegel exercises, focusing on tightening and releasing the sphincter muscle, can improve intercourse

If you are experiencing some level of sexual dysfunction during your struggle with breast cancer, know that you aren’t alone. Talk to your doctor. Get a referral for counseling. Talk with your partner and trusted friends. Don’t be silent.

Is It Safe to Start Exercising After Treatment?  

Hurray! You just walked out of your last cancer treatment! Depending on the amount of time that has passed since your original diagnosis, you have spent several months or more trapped in what often felt like a never-ending nightmare. There have been times when you questioned ever making it through but, finally, here you are. Now, you can go home or head to the beach or book a cruise and just do nothing for a long, much-deserved rest. Right?

Maybe not…

Actually, you probably weren’t thinking that at all. Becoming the next cancer survivor and making it through treatment is a major turning point. Life rarely goes back to the way it was before diagnosis. The vast majority of those that have walked this path before you have found a new priority in life and it is twofold; getting the most out of each additional moment that has been given to you and keeping cancer from returning.

Common sense and current research agree that exercise for cancer patients will help for both. It’s fairly obvious that your level of fitness can only add to being able to enjoy the things in life that are most important. Exercise will certainly help with that. As for the benefits of exercise for those who have completed cancer treatment, multiple studies are confirming that exercise can increase energy levels, improve quality of life, decrease fatigue and reduce the chances of cancer returning.

According to Kerry Courneya, PhD, professor and Canada Research Chair in Physical Activity and Cancer at the University of Alberta in Edmonton, Canada, “Several recent studies suggest that higher levels of physical activity are associated with a reduced risk of the cancer coming back, and a longer survival after a cancer diagnosis.”

In fact, it is now believed that exercise during treatment can also be beneficial for your health care.  Research strongly suggests that it is safe, both during and after cancer treatment, and that it can make a positive difference in how you feel and how your body responds and tolerates treatment. Of course, the type and level of exercise will depend on your overall health and should only be started after getting your doctor’s approval.

Types of Exercises for Cancer Patients

Suggestions for types of exercise that can help cancer patients include:

  • Flexibility Exercises – this is primarily stretching, designed to aid in maintaining mobility.
  • Aerobic Exercise – also known as cardio, strengthens the heart and lungs.  Walking, jogging, swimming and similar aerobic exercise lowers the risk of heart attack, stroke and diabetes, as well as promoting weight loss.
  • Resistance Training – use of weights or isometric exercises, which build muscle, important because people lose muscle, but gain fat, during cancer treatment.

If you did not exercise consistently before your cancer diagnosis or, even if you did, getting started on an exercise program during or following treatment may feel like more than you can manage. Life is hectic and demanding without cancer: throw it in the mix and everything can feel overwhelming. The good news is that exercise can help alleviate that feeling. The benefits can be significant. You don’t have to train for marathons. All you have to do is just get started.

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

Does Acupuncture Help Cancer Treatment?      

There are still those who dismiss acupuncture as having a legitimate role in the area of medicine and healing. They are uninformed. This integral part of traditional Chinese medicine has been around for thousands of years and is no longer confined to only Chinese medical centers and small offices hidden in strip malls. Acupuncture is now being taught at Harvard Medical School.

No, the folks at Harvard are not in the process of closing the door on current cancer treatment and replacing it with acupuncture. What is happening, though, is the recognition of the important role that it and other forms of complementary treatment can have for cancer and many other conditions. Steadily, and with increasing acceptance, this ancient healing technique is being incorporated into medical practices all over the country. It is estimated that, currently, a third of all acupuncturists who are certified to practice in the U.S. are medical doctors.

Acupuncture is done through the process of inserting very fine, FDA-approved (since 1996), metal needles into precise points on the body. Insertion locations are based on meridians, which are a highly complex network of energy pathways. Long before being deemed worthy of study at Harvard, practitioners of this ancient form of treatment relied on a deep understanding of how the body works, all without benefit of modern scientific equipment.

Does Acupuncture Help in Treating Cancer?

If the question was “does acupuncture heal cancer?”, it would be harder to answer. Some advocates would say that it can, while the majority would drown them out by saying there is no evidence to substantiate that. But, what can claim to heal or cure cancer? What acupuncture has been proven to do is to be very effective at relieving many of the symptoms associated with cancer and the side effects of cancer treatment.

Several independent studies have borne this out, especially one published in the Journal of the American Medical Association, based on a group of breast cancer patients undergoing high-dose chemotherapy. The patients who were given acupuncture along with traditional medications experienced significantly less nausea than those who did not receive acupuncture. Other studies found similar results with post-chemotherapy fatigue, pain relief and a preliminary study in Sweden reported acupuncture cutting hot flashes in half.

Cancer Symptoms Controlled or Reduced with Acupuncture

Acupuncture has been shown to be effective in relieving or reducing many of the symptoms associated with breast cancer and other types of cancer, as well as the side effects of other forms of treatment. Some of the most common include:

  • Pain
  • Fatigue
  • Nausea – associated with chemotherapy
  • Vomiting – associated with chemotherapy
  • Weight loss
  • Anxiety
  • Depression
  • Insomnia and inability to sleep through the night
  • Lack appetite
  • Dry mouth
  • Hot flashes
  • Nerve issues
  • Constipation and diarrhea
  • Digestion issues following surgery

Western medicine has been slow to embrace the use of acupuncture and other forms of seemingly non-scientific medicine. That is changing and our options are the better for it. The medical community is beginning to embrace the complementary nature of the incorporation of acupuncture into treatment plans for cancer; to be used in addition to, not in replacement of, current recommended treatment protocols. If tiny needles can help relieve any of the list above, perhaps the question should be “why not give patients the benefit of acupuncture?”

Can Getting a Biopsy Spread Cancer?

Few things are harder to deal with in life than being diagnosed with cancer. Having this happen to someone you love can be even more difficult. The shock, fear and uncertainty about the future are more than enough to deal with. No one should also be faced with bad information in the form of myths and internet rumors making it even more confusing to know what to do next.

The idea that a biopsy can spread cancer has been floating around for years. Unfortunately, when people hear things often enough, a certain aura of credibility begins to form. This may be harmless and even somewhat entertaining when it’s about Big Foot or the Loch Ness Monster, but it is a totally different matter when it might make someone opt not to have a test that could provide a valuable diagnosis.

Needle biopsies, the primary method of diagnosing many types of cancer, do not cause the cancer cells to spread. In fact, the Mayo Clinic did a study on 2,000 patients, which showed no evidence that biopsies cause disease to spread. What it did show, however, is that patients whose diagnoses are confirmed by biopsies have better outcomes and longer survival rates than those who don’t.

The biopsy is an extremely valuable tool for the doctor to use in making a definitive diagnosis and choosing the best treatment for the patient. There have also been many cases in which the biopsy was instrumental in determining that a growth or lump was benign, thereby sparing the patient from a needless surgery. How unfortunate would it be to have a breast removed only to discover that a simple test could have revealed that it was unnecessary? That is the danger of inaccurate information, especially for those who don’t choose to view website.

Biopsies spreading cancer is not the only cancer-related myth floating around. Here are some of the more well-known ones:

  • Does eating sugar make cancer worse? No. Cancer cells consume more sugar than normal cells but eating sugar will not make cancer worse nor will stopping make cancer go away.
  • Do artificial sweeteners cause cancer? No. Despite all of the sad tales of mice on the internet, researchers have determined there is no evidence to support that this is true.
  • Is cancer contagious? No. Although there may be a very slight risk in the case of organ donation from someone who had cancer.
  • Does attitude, either positive or negative, affect risk or recovery from cancer? No. Although a positive attitude may aid in coping with the disease.
  • Will cancer get worse if exposed to air? No.
  • Do cell phones cause cancer? No. This is another popular theory that has no supporting evidence. Cancer results from genetic mutations and the frequency produced by cell phones does not damage genes.
  • Do power lines cause cancer? No.
  • Do antiperspirants or deodorants cause breast cancer? No.
  • Does hair dye cause cancer? No. At least not for the end user. Professional hair stylists and barbers who are regularly exposed to large quantities of these chemicals may end up with an increased risk for bladder cancer.

It can be difficult to know what is true and what is not, especially at a time when we are being constantly bombarded with massive amounts of information. Much, if not most, can be ignored. When it comes to decisions regarding your health, however, there is never an excuse for simply believing prevailing opinion. Always do the research necessary to make informed decisions.

If you would like to learn more about biopsies, please watch the following video.

Tips On Transitioning Back to Work After Treatment

When U.S. Navy Rear Admiral Irve Le Moyne finished his cancer treatment at Houston’s MD Anderson Hospital, he rang a brass that he had installed on the way out of the oncology department. He also wrote this poem that hangs near the bell:

Ring this bell
Three times well
Its toll to clearly say

My treatment’s done
This course is run
And I am on my way!

— Irve Le Moyne

Ringing the bell to signify that treatment is over is practiced in hospitals and cancer centers all over the country. It is an emotional moment, filled with great joy, relief and not a small amount of trepidation. Treatment may be over, but, now what? The goal has been to beat the monster and regain the life that has been on hold for months, if not longer. Is that possible? Where do you start?

A major challenge looming on the near horizon is the decision about the right time to go back to work. The vast majority of breast cancer survivors are able to return to their jobs with very little problem. Most of us tell ourselves that work is a necessary evil and that we live for the weekend, but the truth is that our jobs are an important part of our lives, and returning to work is a positive stage of recovery. It will immediately give you a sense of normality and of being, once again, more in control of your life, something that has been missing since that day you were diagnosed.

There is a flip side, however. Not everyone experiences the same treatment for breast cancer, but whether yours included chemotherapy, radiation, surgery or all of the above, it has taken a major toll, physically, mentally and emotionally. You may be experiencing side effects, like hair loss or chemo brain, which is a form of cognitive impairment that affects thinking and memory and makes it hard to focus. In almost everyone, energy levels are usually affected to some degree.

Manage Expectations – Yours and Everyone Else’s

The number one, most important thing that you can do to make transitioning back to work a positive experience is to anticipate and manage expectations. This includes your expectations, as well as those of your boss, co-workers, friends and family.

According to Mary McCabe, RN, director of the Cancer Survivorship program at Memorial Sloan-Kettering Cancer Center in New York, “Everyone’s ready for treatment to be over, not just you, and although they’ve been supportive, your friends and family may be expecting you to spring back right away. It’s an education process. They need to understand that when the therapy stops, that doesn’t mean that the effects of the therapy stop immediately.”

Even though you would no doubt prefer to simply dive back in at the same level as when you left, it will be up to you to make sure that everyone understands treatment may be over but it’s going to take some time for you to be back to your old self. Transitioning means just that; gradually reclaiming the long hours, extra duties and activities.

Expect varied reactions from your co-workers. Some will want to throw a party and others may be uncomfortable for a variety of reasons that have nothing to do with you. Allow them their reactions and keep in mind that what you share or choose not to share is totally up to you.

There will be other decisions to make about returning to work. You will need to honestly assess your stamina and whether you can return full time or should inquire about gradually increasing hours. There might even be the possibility of doing some work from home. Employers are not required to lower standards to accommodate an employee but they do have to offer reasonable accommodations like restructuring, offering part-time or modified work schedules and certain others that might make life a little easier for now.

Above all else, never lose sight of the fact that, while returning to work is a goal, your priority is your return to health.

How to Give a Self-Breast Exam

Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.” Johns Hopkins Medical Center

When you hear a new noise while driving down the road or feel even the slightest vibration that wasn’t there the last time, you know there is something going on with your car. We spend so much time in our vehicles that they feel like an extension of our bodies, and we can feel when something is different. The sad thing is that this is often truer with our cars than when there is actually something wrong in our own bodies. Sad is perhaps not the best word choice; perilous or at risk might be better.

This analogy is especially appropriate when we are talking about breast cancer. Every year, the nation turns pink in October and there are pink ribbons everywhere reminding us about being aware of the importance of early detection. The first step in that process is not filling out forms in the doctor’s waiting area: it is learning how your breasts normally look and feel. In order to be able to notice any changes that might indicate a problem, you must first learn breast self-awareness.

One of the best ways to become tuned in to the normal shape and look of your breasts is to practice doing a self-breast exam. Most healthcare professionals recommend doing this self-exam once a month. Try to do it close to the same time each month. Hormonal cycles affect the breasts, so for women who are premenopausal, it is better to do the medical exam at the end of the menstrual cycle. Postmenopausal women can simply pick a day to consistently do the exam each month.

Self-Breast Exam Steps

Self-breast exams should be repeated in different positions on the same day.                    

  • In the Shower – examine each breast, one at a time, by moving the pads of your finger in a circular motion around the breast and armpit. Start at the outside of the breast and move to the center. Feel for lumps, thickening of tissue or anything that feels like a knot. Be aware of any changes from the previous month.
  • In Front of a Mirror – start with arms at your side and visually inspect your breasts. Then, raise both arms overhead and look for changes in shape, swelling, dimpling or changes in nipple color or shape. Rest palms on hips and press to flex chest muscles, once again looking for dimpling, puckering or changes. Most women do not have exactly the same size or shape for both breasts so only look for changes.
  • Lying Down – lying down allows the breast tissue to spread out evenly along the chest wall. With a pillow under your right shoulder, place your right arm behind your head. Using your left hand in small circular motions, gently examine your right breast and armpit. Using light, medium and then firm pressure, squeeze the nipple and check for discharge and lumps. Repeat this process for the left breast.

If you notice any of following during your self-exam, make an appointment to consult with your doctor as soon as possible:

  • Discharge
  • Unexplained change in size or shape
  • Dimpling or puckering
  • Lump
  • Tender areas
  • Redness or warmth
  • Itchy, scaly skin

Become familiar with your breasts so that you can be your own early warning system. Remember, however, self-exams are not able to detect tumors as small as those found with a mammogram. Your best bet is monthly self-breast exams combined with yearly visits to your doctor for mammogram screening.

For more information please watch this video:

Why Are Mammograms Important? 

Every generation has its version of “if we can…”. One of the most popular has always been, “if we can put a man on the moon, why can’t we cure the common cold?” Or, of significantly more interest, “why can’t we cure cancer?” Unfortunately, we have yet to manage to do either. The good news, however, is that, according to the American Cancer Society, the mortality rate for all types of cancer combined has fallen by 25% over the past 20 years.

The death rates for breast cancer have followed the same downward trajectory, steadily decreasing since 1989. Early screening, including mammograms, along with new and more effective treatment protocols are credited with this hopeful trend. Since the Breast Cancer Awareness campaigns were launched in 1985, early detection has been the mantra for healthcare professionals, activists and survivors. Mammograms have played a huge role in the crusade to save lives through early detection and treatment.

In the early 1900s, German surgeon Albert Salomon is credited with first using x-rays in an attempt to diagnose breast cancer. He recognized the importance of compressing the breast to get a clearer image. Many others followed with innovative improvements, but the concept is basically the same today. During a mammogram, the breasts are compressed between two flat surfaces, spreading the breast tissue out as much as possible during the x-ray in order to display a clear and detailed image on a computer screen.

Mammograms play an important role in early breast cancer screening by finding tumors too small to be found through a physical exam. By doing this, it is believed many lives are saved. Healthcare professionals and early detection advocates stress that finding the tumor as early as possible, while still small and contained, greatly increases the odds for successful treatment.  Mammograms are also used as a diagnostic tool to help determine if there is breast cancer after a lump or other sign or symptom has been discovered.

While not exactly a pleasant procedure, a mammogram is relatively quick, generally lasting about 20 minutes. Some worry about radiation exposure, but it is actually very slight. The statistics for mammograms reducing the risk of dying as a result of breast cancer range from 25-40%. Most recommendations are that women should begin yearly mammograms at age 40, or earlier, if they are at high risk.

This brings us to the controversy that has surrounded the use of mammograms since 2009 when the U.S. Preventive Services Task Force recommended changing the starting age for women with average risk to age 50 instead of 40. Many argued that this was motivated by insurance companies not wanting to pay for the testing, but others voiced concerns that mammograms are not perfect and produce false negatives as well as false positives. Another faction argues that these tests result in over-diagnosis and over-treatment of conditions that would never pose a true health risk.

There was considerable push-back within the healthcare community. The American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the American Cancer Society, the National Cancer Institute and the National Comprehensive Cancer Network published guidelines stating that all women, regardless of perceived risk, should begin mammogram screening at age 40.

There is no arguing the life-saving potential of early detection through mammograms. However, the best advice is always to be your own health advocate. There’s far too much at stake in not being as knowledgeable about whatever issue you are dealing with, especially one as serious as cancer. The only decision that you should ever make when it comes to your healthcare is an informed decision.

Should You Avoid Fish Oil While Getting Chemotherapy?

Anyone who ever picks up a book on healthy diet or listens to a talk show featuring one of the more well-known nutritionists knows that fish oil is a good thing. It isn’t pleasant to take, but we are advised to push past that because it has so many health benefits. But is that true across the board? What about the questions that have been raised about interference with chemotherapy treatment? 

Without a doubt, fish oil is an excellent source for omega-3 fatty acids and is one of those supplements that has gotten a lot of attention here. Omega-3 is vital for cells to properly function but is not produced by the body, which means that it must be provided by diet or through supplements.

Cardiovascular health issues have been prime motivators in researching omega-3 fatty acids. There has been a lot of interest in the fact that heart disease in Japanese men is less than a third of what it is for men in the U.S. Research seems to indicate that it has a lot to do with the amount of fish eaten by Japanese as compared to Americans. Beyond heart issues, the list of health benefits attributed to fish oil is long. Really long. As with most supplements, the entries will vary depending upon whose list it is, but some of less controversial of those are:

  • Support healthy cholesterol
  • Maintain normal triglyceride levels
  • Maintain already normal blood pressure
  • Promote joint health
  • Assist with weight management
  • Promote eye health
  • Support a healthy respiratory system
  • Enhance mental focus
  • Maintain muscle mass in older adults
  • Strengthen the immune system

Those benefits are hard to argue with. Plus, when someone is diagnosed with cancer, one of the first things that everyone around them says is that they should start eating a healthier diet and take supplements to help the body remain strong during treatment. A supplement that has proven to help with the issues on this list would, understandably, jump to the top. Results from recent research, however, has found that this particular supplement may do more harm than good to cancer patients.

Experimenting with mice, researchers have observed that the fatty acid found in fish oil, as well as some types of fish, can make cancer cells resistant to chemotherapy. According to Christine Metz, director of the Laboratory of Medicinal Biochemistry at the Feinstein Institute for Medical Research in Manhasset, N.Y., “Our research shows that when you affect the membrane of cancer cells by altering the fats in the outer covering of the cell, you can make the membrane stiffer or more fluid. These fats can make it more difficult for chemotherapy to enter the cell or make the cell better at pushing the chemotherapy out of the cell.”

This is not definitive proof that fish oil interferes with chemotherapy in humans. There are even studies that claim exactly the opposite. It is hard to prove just how fish oil does affect chemotherapy in humans, because testing would require giving someone with cancer a substance that could interfere with treatment. Many healthcare professionals, however, advise their cancer patients to discontinue use of fish oil the day before, the day of and the day after their chemotherapy treatment.

To learn more about fish oil, watch the following video:

Helping Kids Understand Breast Cancer Diagnosis

There is nothing easy about the day that you are sitting in your doctor’s office or get the call on the phone and learn that you have breast cancer. No matter how many donations you have made, events you have attended to raise awareness or the number of pink tee-shirts in your closet, actually hearing the words “you have cancer” can be an overwhelming shock. For parents, that reaction is even more extreme. Personal fear and panic quickly turn to how this is going to affect their children.

How children respond to most things depends a lot upon their age and level of understanding. For some parents, there is the temptation to shield especially young children from those things they believe will be upsetting or more than they should have to deal with. While well-intentioned, this is nearly always a mistake. Kids pick up on way more than most parents realize. Something as serious as breast cancer is impossible to hide. If children are left out about what is actually going on, they will come up with some explanation on their own, which will often be far worse than the truth.

Understanding Brings Reassurance

Your children get their cues from you. During difficult times you are going to react to everyone and everything around you differently. Help them cope with these changes by bringing them into the conversation, so that they understand why this is happening. The depth of explanation and the language you use will change as appropriate but these are some suggestions that many have found helpful:    

  • Talk to them. Find out what they know about breast cancer and correct anything that is not accurate. Describe the process and what to expect from your treatment. Let them know that there may be difficult days for you, physically and emotionally. Encourage them to ask questions and talk about what they are feeling.
  • Cancer is not contagious. It’s amazing sometimes to learn what children have been thinking but too afraid to admit. Make sure that they know that no one else, including them, can catch cancer and that it’s still safe to touch and hug.
  • Not their fault. Children tend to be pretty self-centered and experience the world as revolving around them. Just like with divorce, without ever telling anyone, children often assume the burden of responsibility when something bad happens. Somehow, it must be their fault. It is important to be proactive in reassuring them that this is not true, because they may not ever express it on their own.
  • Be open with the “C” word. Diffuse a lot of the fear and anxiety by talking openly and matter-of-factly about cancer. If they see that this is something you are facing openly and with confidence, then they will take those cues and run with them. Talk to them about how they might share what is happening with their friends. Have conversations with teachers and other parents so that your children can feel comfortable talking to them, also.
  • Remind them they are loved. Battling breast cancer requires a lot of time, effort and focus. Sometimes there won’t be a lot left over for the kind of interactions with your children as before your diagnosis. Children may see this as being forgotten or even neglected. But, children are also amazingly resilient. Simply explaining that you still love them and that other family members will help make sure that their needs are taken care of will go a long way to making them feel safe.

Breast cancer is never a good thing, but even the darkest clouds can have that proverbial silver lining. Going through an experience like this can actually bring parents and children closer together and be an invaluable teaching opportunity about priorities and the strength of family.

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: