Fatigue In Breast Cancer Survivors Linked To Inflammation

Image source: freedigitalphotos.net / Marin

Image source: freedigitalphotos.net / Marin

Fatigue In Breast Cancer Survivors Linked To Inflammation

A common complaint amongst breast cancer survivors, especially if they have been through the gamut of conventional medicine treatments, is fatigue.  I hear this all of the time and, indeed, suffered through it myself after going through 6 months of chemotherapy.

The Link Between Fatigue, Inflammation and Chemotherapy

An interesting study reported in 2012 [1] found that high levels of inflammation may promote fatigue in women treated for breast cancer.

The study followed 633 women, all breast cancer survivors with an average age of 56 years and treated for stage I, II or III breast cancer.  It was discovered that 40% of the women in the study had elevated levels of C-reactive protein (CRP) in their blood, which is a marker of inflammation.  40% of the women also suffered from fatigue.  Interestingly, women with elevated CRP levels were 1.8 times more likely to feel fatigue.

“Fatigue is common among breast cancer survivors and may persist for years after cancer treatment, clustering with comorbid symptoms such as depression, anxiety, sleep disturbance, and pain that reduce participation in life activities and quality of life”, researchers reported.

This makes sense, especially in view of the fact that chemotherapy and radiation are both associated with increasing inflammation in the body.  In fact, a recent study [2] indicated that chemotherapy leaves a long-lasting epigenetic imprint in the DNA of the blood cells of breast cancer patients and that imprint is associated with inflammation up to 6 months after treatment is completed!

Omega-3 and Omega-6 Fats Play A Role In Inflammation

Going back to the first study and those 633 women [1] the researchers investigated the intake of omega-3 fats, which are highly anti-inflammatory, as well as omega-6 fat intake, which tends to be pro-inflammatory.  It was found that a higher intake of omega-6 fats (found in most cooking oils and processed foods) was associated with both higher CRP levels and a 2.6 greater likelihood of feeling fatigued.

Conversely, women who were including omega-3 fats in their diet had the lowest levels of CRP and reported feeling less fatigue.

Inflammation Is Associated With Reduced Survival

It is well known that inflammation is associated with reduced survival among women with breast cancer [3] and inflammation also increases the risk of atherosclerosis and development of further cancers.  Cancer is, after all, an inflammatory condition.

The good thing is there is something we can do about all of this.

Good Nutrition and Omega-3s Are Helpful

Both inflammation and fatigue can be improved with simple dietary changes.  Follow the recommendations on my page Diet And Cancer and include plenty of fresh salads, vegetables, whole grains and modest amounts of fruit in your diet. And most especially, get those healing omega-3 fats into you!

Omega-3 fats are easily included in the diet and the best source is freshly ground organic flaxseed.  Freshly ground is best because the fats have not degenerated as with some commercially prepared flaxseed oils and freshly ground includes the best quality fiber and lignans.

The 15 Best Reasons To Take Flaxseed

Flaxseed has been shown to have wonderful health benefits – here are 15 of the best things it does for us:

  1. May protect against primary breast cancer [4], [6] 
  2. Decreases incidence of hot flashes [6]
  3. Increases cancer cell death [6]
  4. Decreases HER2 expression (a protein associated with breast cancer malignancy) [6] 
  5. Decreases breast cancer cell proliferation [5], [6]
  6. Improves normal cell membranes
  7. Improves breast density
  8. Exhibits anti-invasive properties [5] 
  9. Decreases risk of primary breast cancer [4], [5], [6]
  10. Reduces risk of breast cancer mortality by 33-70 percent [5], [6]
  11. Increases effectiveness of tamoxifen [5]
  12. Increases effectiveness of Herceptin [5]
  13. Improves mental health and depression [6], [7]
  14. Good for bowel health due to high fiber content
  15. Great for cardiovascular health

16 Tips For Including More Flaxseed Into Your Diet

A common complaint among breast cancer survivors is that they simply forget or can’t be bothered grinding up the flaxseed and finding ways to incorporate it into their diet, so here are my best tips on delicious ways you can use it:

  1. Sprinkle it on salads
  2. Add it to freshly prepared juices
  3. Put it in smoothies
  4. Put it in sandwiches by mixing it with mustard, mayo or mashed avocado (that way it doesn’t fall out!)
  5. Mix it into muesli, granola, or oatmeal
  6. Mix it into hummus or dips
  7. Mix it into guacamole
  8. Mix it into protein shakes
  9. Add it to organic yogurt
  10. Combine it with organic cottage cheese for some extra special anti-cancer properties (see the Budwig Diet)
  11. Sprinkle it on vegetables
  12. Sprinkle it on soup just before serving
  13. Mix it into baked goods
  14. Mix it in with any nut butter
  15. Sprinkle it into casseroles
  16. Mix it into pancake batter

1. Fatigue, Inflammation, and Omega-3 and Omega-6 Fatty Acid Intake Among Breast Cancer Survivors — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341143/
2. Epigenetic changes associated with inflammation in breast cancer patients treated with chemotherapy — http://www.sciencedirect.com/science/article/pii/S0889159114000567
3. Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717751/
4. Consumption of flaxseed, a rich source of lignans, is associated with reduced breast cancer risk — https://www.ncbi.nlm.nih.gov/pubmed/23354422
5. Flaxseed and its lignan and oil components: can they play a role in reducing the risk of and improving the treatment of breast cancer — https://www.ncbi.nlm.nih.gov/pubmed/24869971
6. Flax and Breast Cancer: A Systematic Review — https://www.ncbi.nlm.nih.gov/pubmed/24013641
7. Omega-3 fatty acids and major depression: A primer for the mental health professional — http://www.biomedcentral.com/content/pdf/1476-511X-3-25.pdf

GET MY BEST TIPS on getting through breast cancer and preventing recurrences by signing up for my free e-newsletters and e-books on the right. You can also “like” me on Facebook (Marnie Clark Breast Health Coach) to get my inspirational snippets, news and updates. I promise to do my utmost to keep you informed and empowered on your healing journey… and beyond.

Fatigue And Cancer: How Long Is This Chemo Fatigue Going To Last?

Image source: freedigitalphotos.net / graur codrin

Image source: freedigitalphotos.net / graur codrin

Fatigue and Cancer – How Long Is This Chemo Fatigue Going To Last?

Updated August 1, 2019

People who are going through chemotherapy are generally focused on one thing: making it THROUGH the treatments.  Once the treatments have ended, however, the next question becomes “How long is this chemo related fatigue going to last?”

They are ready to move on with their lives but feel that the fatigue is holding them back.  I know I certainly felt like that when I was finished with 6 months of chemotherapy treatments.

Is It Fatigue or Depression?

One thing I like to suggest is keeping a diary for one week to identify the time of day when you are either most fatigued or have the most energy.  Note what you think may be contributing factors.  You might be surprised.  Some have found that they feel fatigued after thinking about something that depresses them.

Depression often masks itself as fatigue.  If you think that it’s depression with which you might be dealing, please see a qualified therapist.  And don’t be embarrassed about it – you have been through hell – all the way through from diagnosis to all those chemicals that were pumped into your system.  Depression is NOT unusual after all of that.

If you feel pretty sure that it’s just chemo related fatigue, however, read on.

How Long Is This Chemo Fatigue Going to Last?

The standard answer from most oncologists is that “it is not unreasonable that fatigue continues for months, if not for a year or year and a half” after the finish of chemotherapy  [1].

The real answer depends on how you take care of yourself.  I’ve known women who were still suffering from fatigue FIVE years later – but I noticed they weren’t very proactive with their health either.

There are quite a few things you can do for yourself that will reduce the length of time that you are feeling the effects of chemo-related fatigue.  Here are my top 6:

  1. Exercise – Do you spend time exercising each day?  At least 30 minutes per day doing some sort of weight-bearing exercise, walking, or yoga are highly recommended by most doctors.  One study also showed that the combination of 30 minutes of exercise combined with a good plant-based diet and a good support network improved the survival of breast cancer patients by as much as 68%. So there are plenty of good reasons to push through the fatigue and get exercising. I joined a gym after finishing chemotherapy, partly because I was part of a study being done by an exercise physiologist who was studying the effects of exercise on women who had been through treatments for breast cancer.  But also, I was aware of the good effects on the body that exercise has – it’s crucial to the good function of your entire nervous system, immune system, and it has been proven to reduce your risk of getting cancer again.  It also has some good psychological benefits, feelings of depression are definitely eased after exercising.  Drink plenty of water during your day too to help flush out accumulated toxins (and drinks containing caffeine DO NOT count because they pull fluid out of the body).
  2. Good Nutrition – Eating well may have been difficult when you were going through chemotherapy, but now that you’ve finished, this is a really good time to start rebuilding yourself with some excellent nutrients.  See my page Diet and Cancer for recommendations on the best things to eat.  Juicing is an excellent thing to do for yourself for a variety of reasons.  See my article The 12 Best Benefits of Juicing For Breast Cancer.
  3. Take Some Supplements – There are a number of things which will help you to rebuild your immune system – and your energy levels. For a list of my favorites, go to Marnie’s Must-Have Supplements for Breast Health. You don’t need all of these, just pick and choose the ones that make the most sense to you – or work with a naturopath or breast cancer coach to help you choose the best ones for you.
  4. Massage and Bodywork – Massage and bodywork can be very helpful to relieve post-chemo fatigue.  My own experience was that it also helped with those feelings of abandonment.  Many feel that they’ve been so incredibly busy and focused on their treatments that once they are done and left on their own to resume a “normal” life, they feel like they’ve fallen off a cliff.  Massage and bodywork help not only with the fatigue, but also with those “over the cliff” feelings.  Please be aware, however, that if you have had a number of lymph nodes removed, or if you have bone metastases, you will want to consult a massage therapist who has special training – an oncology massage therapist will know exactly what to do.  If you are considered “cancer free” (delightful words!) by your doctors, however, just ensure that your massage therapist is either licensed or certified.  Skilled touch is so beneficial at nearly every stage of the cancer experience.
  5. Get Plenty of Rest – It really helps to take little 20 minute “power naps” to recharge your energy both during and after chemotherapy.  It really helped me a lot and I didn’t feel one bit guilty.  If you can, balance periods of rest and work.  I also found it helped to work at a moderate pace than rushing through activities.
  6. Detoxify – If you have been through the gamut of chemotherapy and/or radiation, it really helps to do some cleansing. Work with a qualified naturopath or other health professional to get you started in the right direction.

I hope those suggestions help your energy levels!


[1] Tish Knobf, Ph.D., R.N., F.A.A.N., A.O.C.N – http://www.breastcancer.org/tips/fatigue/ask_expert/2008_01/).

I send my love to everyone taking this journey right now. If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, and/or “like” me on Facebook (Marnie Clark, Breast Health Coach) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.


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