Cancer-related fatigue with secondary breast cancer

Cancer-related fatigue (extreme tiredness) is one of the most common symptoms experienced by people with secondary breast cancer.

Everyone knows what it feels like to be tired sometimes, but cancer-related fatigue feels much more severe. It can come and go or be unrelenting and it can be distressing and frustrating.

Fatigue has many causes, from psychological factors such as the stress of coping with the diagnosis, to physical ones such as the side effects of treatment, loss of appetite, medication, disturbed sleep, or progression of the cancer.

Diane talks about her experience of fatigue and secondary breast cancer.

Signs of fatigue

There are a number of common signs of fatigue which include:

  • tiredness that is not related to any activity
  • tiredness that doesn’t go away or keeps returning however much rest or sleep you have
  • feeling weak, as though you have no strength
  • sleeping more or difficulty sleeping
  • feeling confused, lack of concentration or unable to focus your thoughts
  • breathlessness or feeling light-headed
  • feeling irritable, sad or depressed.

Managing your energy levels

Fatigue is difficult to assess and measure and it can be difficult to describe.

It may have a significant impact on your ability to cope, your mood and your relationships. Fatigue can also affect your everyday activities and quality of life. Many people find that it stops them working, socialising and generally living life in the way they wish to. There are a number of things you can do to help manage your energy levels and reduce the effects of fatigue.

  • Tell your doctor or palliative care team about your fatigue so you can be fully assessed. Causes such as anaemia can be treated, which should improve the fatigue.
  • Information and support can help you manage fatigue. For example, you can ask to be referred to a specialist, such as an occupational therapist, in your local palliative care team who may be able to suggest adaptations or equipment that may help.
  • You may need to accept that you can’t do everything you want to do and that some days will be better than others.
  • Keeping a fatigue diary can often help to work out your patterns of fatigue. This can be useful when talking to your specialist team and when planning day-to-day life. Your hospital may provide you with a fatigue diary to use or you can download one from our patient resources page.
  • Be realistic about what you can do. Prioritise your tasks and plan your days so you have a balance of activity and rest. Stop any activity before you become too tired so that you keep some energy in reserve. By prioritising the things you have to do you can pace yourself throughout both your good and bad days.
  • Prepare for a special occasion or days out by planning additional rest before and after.
  • Regular physical activity has been shown to improve energy levels and reduce fatigue. Short achievable periods of gentle strengthening exercises as well as short walks can help increase your appetite, give you more energy and improve wellbeing.
  • Pain can worsen fatigue by affecting your ability to be active or to sleep well, or by reducing your appetite and lowering your mood. If your pain is not well controlled, talk to your specialist or palliative care team.
  • Try to eat as well as you can so your body continues to get the nutrients it needs. If your appetite is poor, it may help to eat smaller amounts more often and drink plenty of fluids to keep hydrated. You could also ask to be referred to a dietitian for advice.
  • Being able to continue to do things for yourself is important for most people. However don’t feel guilty if you need to ask for help. Accept offers of practical help from others as a way of managing your energy levels so you can continue to do other things you enjoy.
  • Counselling, talking therapies and complementary therapies can be helpful in relieving stress and anxiety, which may contribute to fatigue.

Macmillan Cancer Support publishes an information booklet called Coping with fatigue which you may find useful. Order it free from Macmillan's website or call 0808 808 00 00.

Support for you

If fatigue is having a big impact on your everyday life you don’t have to cope alone. You can talk to other people with secondary breast cancer on our Forum or call us free on 0808 800 6000 for information and support. You can also meet other woman at one of our Living with Secondary Breast Cancer meet-ups. Find out if there’s a group in your area.

Last reviewed: November 2016
Next planned review begins 2017