Breast Cancer and Post- Radiation Fatigue

No one who has not gone through radiation can truly understand how it affects you. In many cases, mine for instance, the chronic fatigue is pervasive. As I write this, it is early March. My surgery was last February, just over a year ago. My chemo was April to July, and my radiation was August and half of September. I thought (silly me) that because the doctor said it would take three to six months for me to feel better, that that meant I would be back to work and feeling mostly myself again by long before now. Wrong!

The fatigue began to hit me halfway through rads, as radiation therapy is referred to by those of us now living in the breast cancer world. It crept up on me slowly enough, but by the end of the sixth week, I was a basket case. I could not get out of bed for days. I felt creepy and sleepy and weak and useless. I could not stay up for more than a couple of hours at a time. I was forced to take frequent naps, and to half-sit, half-lie down the rest of the time. Walking up our thirteen stairs felt like scaling a mountain.

By the time three months had passed, I was seeing only marginal improvement. The insurance company, who had barely gotten their paperwork together enough to start payments, was already sending forms to my doctor, wanting to know if I could return to work yet. Vultures. That was another thorn in my side, and I felt helpless rage. I couldn’t even stand up long enough to do the dishes, and strangers were demanding that I go out into the world on my knees… Fortunately, doctors are well aware of this pervasive, mysterious fatigue and are prepared to stand their ground. You will have to do the same. Unfortunately, once you look normal again, even those closest to you begin to wonder at your apparent lack of energy. The one who wonders the most is you.

One day, I woke up feeling better than I had in months. Yipee, I thought, I’m winning! I plunged into my day, cleaning my house like a speed demon, so utterly thrilled to feel more like myself again. And I spent the next two days in bed, barely able to think clearly, and completely unable to do anything harder than get up to pee. The next time I had a good day, I was at it again. I was so happy to be able to function that I again spent the next two days in bed, and this time it hit me: I was not better yet. Every time I drained my resources, I fell two steps back, or more.

The fatigue continued. Now, six months after the end of rads, I am finally seeing significant improvement. My chemobrain is beginning to lessen (Chemobrain is discussed in it own chapter), and I am able to take forty-five minute walks with my dog, as long as I take a rest halfway through.

The first time I tried to travel by public transit, I felt like a snail. Everyone else was whipping by me. But try as I might, I could not hurry. I had to walk slowly, at my own pace… and I used to run five kilometers a day. The experience was sobering. Right about then I had another brilliant thought: how many of those grim-faced commuters had just spent the past year fighting for their life?

Chemo makes you sick. Radiation makes you tired. You need to push yourself – but push yourself slowly! Post-radiation can take months, a year, or longer to go away, and each of us is different. Three to six months is only a rough average, and by no means applies to everyone. When the doctors give you a time frame, they mean that’s when you might begin to feel a change, but it can be months longer before you have anything approaching your previous level of energy. That, at least, has been my experience.

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I have been so grateful to have had access to web-based support groups and to breast cancer information. Here's a list of Web Resources that helped me. If you know of other good ones, please e-mail me and I will add them to the list.

Wonderful Books

Walk-a-thon 2007