Is Fatigue a Sign of Mets?
 

Is fatigue a sign of mets? Wouldn't I have a lot of energy after treatment? It has been a year and I would think that I would have energy because my body is not fighting cancer anymore.

Re: Is Fatigue a Sign of Mets?
 

Spitfire,

I see that we have the same type of cancer (ER/PR negative) and that we were diagnosed at the same time. I was told by my onc that hitting the 2 year mark is an important milestone with our type of cancer. However, the fear of mets and the risk may diminish over time but will always be present.

I was told that the following would be signs of mets: new lumps on breast, chest, or arm pit; bone tenderness, pain, shortness of breath; rash on breast; nipple discharge. Fatigue was not one of the signs I was told to be on the lookout for.

I also get tired but I attribute this to having major hot flashes. It is hard to get a good nights rest when you are sweating one minute and then are cold the next.

Take Care,
Brenda

Re: Is Fatigue a Sign of Mets?
 

I feel tired a lot. But I was told that it's normal because I have been thrust into menopause suddenly at 40. But if you are concerned you should speak to your onc.

Re: Is Fatigue a Sign of Mets?
 

I think having been through what we have that it's not unusual for our bodies to be fatigued for a good while. Certainly more easily tired. There have been hormonal upheavals too
Lots of healing and recovery going on
And just because we've had cancer doesn't mean that something else might not be going on. Perhaps a low blood count?
Absolutely confer with your doctor. But easy does it!
Keep the faith

Re: Is Fatigue a Sign of Mets?
 

Thanks for your insight. I have not been able to sleep more than 5 hours ever since starting chemo 2 years ago. I suddenly wake up around 2-3:30am every night and can't get back to sleep until around 6, when I should be waking up. My hot flashes are sporadic and vary in intensity. I don't nap during the day because I can't sleep even though I am very tired. I'm sure if I could sleep for longer than 5 hours at a time I would not be as fatigued, but I have tried everything. My body can't heal if it doesn't get sleep. I feel that I am never going to recover.

Re: Is Fatigue a Sign of Mets?
 

Hi Spitfire, I am so sorry you haven't been able to sleep ... I too can have this problem. I have alternated between taking an Advil PM right before I go to bed, and taking Natural Calm, a magnesium supplement, right before bed. Magnesium is something that is good for you anyhow, but of course check with your doc.

Either of these knocks me out and I sleep right through most nights. I started taking a baby aspirin a day because it is supposed to help prevent a bunch of stuff (my onc told me to go ahead and do it) so I usually now opt for the Natural Calm. You can find the NC at a health store to try it ... if you find it works for you, you can get it for half price on Amazon. I don't go to bed without it, and take it with me when I travel. :)

Hope this helps!

Carol Ann

Re: Is Fatigue a Sign of Mets?
 

Thank you all,

Are there any blood tests that I should ask for? I have tried everything and have had this problem consistently for 2 years now.

Re: Is Fatigue a Sign of Mets?
 

I am not aware of any ... but again, may want to ask your doc. Mine does know I take the Natural Calm and told me to go for it, if it helps me sleep! Which it definitely does. It also helps with constipation ... my mornings have gone from a struggle in that to a smile on my face most days. :)

Carol Ann

Re: Is Fatigue a Sign of Mets?
 

Hi Spitfire, I do understand your concern. But the fatigue may well have another explanation
I too have been fatigued for a long time after finishing Chemo in July 2014. You and I both had Docetaxel and Carboplatin in our TCH combination, and I am told that platinum salts are particularly prone to causing ongoing fatigue. They are known to cause neurological damage in hands and feet, ie neuropathy, and may well also cause some damage to brain cells, which makes it harder for the brain to then do its usual processes required for complex thinking. So after a while of working fine in the morning, cognitive fatigue starts up and makes everything you do, both mental and physical, very hard.

It is a bit like having a traumatic brain injury, which also causes fatigue. I am told it gradually gets better, but can take years. Doctors want to call it depression because it stops you doing things you enjoy, makes you reactive and frustrated and unhappy. But if you start with energy each day and then lose it, and that's when the problems hit, it is not depression which doctors/oncologists etc want to call it and to treat, (though I am sure it can lead to depression I think if not accommodated).It seems to be about learning to budget your energy to get the important stuff done yet still have joy in your life. Hard.
best wishes
Jessica

Re: Is Fatigue a Sign of Mets?
 

Jessica, thanks! This so explains why I take alot of afternoon naps. :) I know I am so fortunate to be able to do this!

Carol Ann

Re: Is Fatigue a Sign of Mets?
 

Ask to have your red blood cell magnesium, ferritin, zinc, copper and ceruloplasim levels checked.

Low magnesium and zinc levels will affect your ability to sleep.
Low ferritin can cause fatigue. Regular blood checks for anemia can miss iron deficiency.
Low zinc affects pancreatic enzyme production which reduces your ability to absorb nutrients.
High copper inhibits zinc absorption and low zinc elevates copper levels both of which are known to be pro-cancerous and found often in breast cancer patients.

These have all been checked and followed by my naturopathic oncologist but any lab can check them, you just need someone to order the test. Understanding how to correct imbalances is best done with a practitioner of integrative medicine.

Re: Is Fatigue a Sign of Mets?
 

Another thought, you might try Chinese Medicine to understand your fatigue more specifically to you. I have kidney qi deficiency, Qi deficiency, liver qi stagnation, blood stasis, and dampness related to my spleen. I've been working on these imbalances with acupuncture, herbs, diet, qigong, and trying to shift my attitude and ways of being.

I observed that my tongue looked bad two years ago, before I was diagnosed and knew that I had cancer. After the treatment finished my tongue looked like it was improving but then suddenly it got paler again. It turns out that a brain tumor was compromising my energy again.

If you haven't ever tried tongue diagnosis (a mainstay of western treatment in the days before all these medical tests, though without the chinese diagnosis) it is pretty revealing. Only a skilled practitioner can help you address and fully understand what is going on in your body though and how to address it. Try this tongue diagnosis tool:

http://eagleherbs.com/self-tests/tongue-diagnosis-38/

Re: Is Fatigue a Sign of Mets?
 

Wow Agness, you are a fountain of knowlege and wisdom. I had forgotten about good accupuncture for fatigue, but it is obvious: energy systems are the heart of the problem. I will look for a suitable local practitioner, and get those blood tests done. And I will study my tongue!
many thanks for your posts
Jessica

Re: Is Fatigue a Sign of Mets?
 

Jessica V - Thanks for the information. Can the fatigue and brain damage done by chemo be healed, or do you just have to learn to accept it? The doctors always asked about my hands and feet, but not my brain function.

Agness- Thanks for the blood tests. I will ask my doctor. I will also ask about my thyroid and cortisol levels. I am very fatigued, but I can't sleep. This has been going on for 2 years. I think it is very strange. Sleep would do wonders for me!

Re: Is Fatigue a Sign of Mets?
 

Actually, you have just reminded me to look into Cortisol, which disrupts sleep, appetite and circadian rhythms etc. I have just reread The Cortisol Connection, and think a lot of what they say is really relevent to me, maybe to you too. The point is to get your levels tested, and then to fight both your stress levels, and this chemical's effects so that you can reset it:

"Studies show an alteration in the normal secretory
pattern of cortisol. This fluctuating pattern, when normal, should
show the highest levels of cortisol in the morning, with a slow and gradual drop toward the lowest levels between midnight and 2:00A.M. (refer back to Figure 3.2 on page 45).
Stressed-out subjects with an altered pattern of cortisol secretion
are characterized by a low concentration of cortisol in the morning,the absence of a circadian rhythm, and a huge meal-related surge incortisol levels (see Figure 6.1)—all of which are consistently associatedwith obesity and related measurements. People with disrupted cortisol-secretion patterns have higher body fat (particularly in the abdomen), lower muscle mass (particularly in the arms and legs), and reduced basal metabolic rate (BMR, the number of calories burned at rest).
Elevated cortisol levels resulting from chronic stress have
been associated with the following conditions:
• Increased appetite and food cravings
• Increased body fat
• Decreased muscle mass
• Decreased bone density
• Increased anxiety
• Increased depression
• Mood swings (anger and irritability)
• Reduced libido (sex drive)
• An impaired immune response
• Memory and learning impairment
• Increased symptoms of PMS—premenstrual syndrome
(cramps, increased appetite)
• Increased menopausal side effects (hot flashes, night
sweats)

Researchers at the Institute of Psychiatry
at King’s College, in London, have determined that stressrelated
depression actually progresses in two distinct phases. The
first phase is characterized by an overexposure to cortisol, creating a
“toxic” effect whereby too much cortisol actually destroys crucial
brain cells responsible for good mood. The second phase is a compensatory
mechanism where the brain becomes resistant to the effects
of cortisol as a way to “protect” itself from cortisol’s damaging
effects. So the brain cells (neurons) are deprived of cortisol, creating
a dramatic underexposure that leads to a host of memory and
psychological problems. Unfortunately, this syndrome of cortisol resistance leads to a deepening of depression and symptoms of fatigue and confusion, a combination that is very much like the symptoms seen in people with PTSD (posttraumatic stress disorder).

Re: Is Fatigue a Sign of Mets?
 

You ask: " Can the fatigue and brain damage done by chemo be healed, or do you just have to learn to accept it?"
They used to say that we are born with all the brain cells we will ever have, but this has been found to be incorrect, and also the brain can set up new neural pathways when old ones are damaged or destroyed. Damaged cells may be repairable
Neuroplasticity explains that the brain learns to use new pathways where neuralpathways are damaged, and even to start to use different parts of the brain for functions based in damaged parts of the brain.
But that all takes energy, time and patience to build up. And can take years. So we have to learn to budget our energy and our brainpower, to spend them on the right things at the right times, and to be aware of our energy levels and our capacities in the meantime. I got myself quite sick and distressed by pushing myself too hard, too fast. I have had to go back to 3pm naps, early bedtimes, and planning my morning energy sensibly, and also making sure I have time for my pottery class each week and not just work.