We don't retain more chemo, but the fatigue is cumulative.
Invasive (Infiltrating) Ductal Carcinoma Questions
Less energy as chemo goes on?
Asked by oceanblue24 on Wednesday, May 9, 2012
Less energy as chemo goes on?
I'm half way through my chemo & I'm finding I have less energy & a lower positive attitude then when I started. My blood work has always been very good so I don't think it's that. I was on AC by-weekly for 4 treatments & now I'm on the 7th of 12 Taxol treatments. Does our body accumulate & retain more chemo as we go along? I just need to get out of this funk I'm in. Any suggestions?
11 Answers from the Community
Your drug is somewhat built-up and will linger for days after you finish depending on the drug, and whether it is metabolized in the liver or kidney. One thing we are doing, my wife with panc CA and me as caregiver, is investing in our energy levels and the balance of energy in our bodies. We are doing this with the aid of healing touch therapy and acupuncture. We had never used anything like this modality before this happened and now we will never stop. The strengthening of both our minds and bodies with these energy-balancing approaches is part of an integrated approach to medicine that doesn't abandon the conventional but rather works along side it. The outcome may be the same but the tumor shrank 30% in the first cycle and we are now headed for surgery in two to three weeks. Staying strong physically is difficult but buoyed by a strong mental/spiritual energy that is balanced is our goal. I believe in the power of prayer too and so you can see, we are trying to incorporate all of the love, energy and good medicine we can employ. I hope that helps.
Research has shown that exercise actually helps with the fatigue and depression, and can also reduce the risk breast cancer recurrence and mortality. For many, the difficulty may be in the paradigm shift of exercising to reduce fatigue or depression. Although I'm not a breast cancer patient, so my fatigue experience may be different, for me, exercising when I don't feel like it is part my 'fighting' cancer.
A good commentary article with references:
Holmes' original landmark study:
An exercsie and fatigue study:
A meta-analysis of randomized controlled trials:
A nurses fatigue study among breast cancer patients:
Aerobic fitness typically declines in patients undergoing chemotherapy, many of the drugs we are given have a negative effect on the cardiovascular system. Exercise can diminish this decline and has even been shown to increase aerobic fitness druing treatment. It's a bit of a viscious cycle - chemo makes us tired, we don't feel like exercising, we get more tired as we exercise less, etc.
Another reference with if you are interested:
Promoting a Healthy Lifestyle among Cancer Survivors
Consult with your oncologist first, although they typically are not well informed on exercise, then see if exercise can help you with the fatigue and diminishing motivation. I hope this may help you!
I was pretty much the same way. being anxious, believe it or not can be very exhausting. The fact that the chemo drugs are running wild throughout your body is only part of it. It's draining mentally, financially, emotionally, physically.. Any way we look at it we are drained. i chose to lie down frequently and listen to soft mellow music. For you it may be different. but frequent rest periods helped me a lot. Stay encouraged the treatments will be over soon. Just remember to breathe
I think the fatigue is more related to the impared cardiovascular function due to the toxicities associtated with your chemo drugs, Adriamycin in particular, plus the other emotional things Phylmena mentioned rather than the drugs remaining in our systems:
Adriamycin/Doxorubicin (A in AC) has a half life of 12-18 hours.
Cyclophosphamide has a half life of 3-12 hours.
Taxol has a half life of 5.8 hours.
Resting at times is fine but not exercising during treatment is like putting your body in a cast, your muscles will atrophy plus the adriamycin decreases aeorobic ability - so you will get progressively more tired unless you do something to combat it.
There is an article in the latest issue of Oncology Times about exercise for cancer patients:
The Holmes article I referenced in my first reply indicated a 24-40% reduction in breast cancer death and breast cancer recurrence in women who began exercsing at diagnosis, the optimal benefit in their study was 3-5 hours per week of walking at a pace of between 2-2.9mph (3mph is a mile in 20 minutes).
These researchers found evidence that aerobic exercise protected the heart against some of the toxicities of Adriamycin:
Modulation of Anthracycline-Induced Cardiotoxicity by Aerobic Exercise in Breast Cancer
More breast cancer survivors over the age of 65 are now dying from Cardiovascular disease than from breast cancer:
Cardiovascular disease competes with breast
cancer as the leading cause of death for older
females diagnosed with breast cancer:
a retrospective cohort study
The paradigm shift I think of is that we are subjecting our bodies to chemo, radiation, and surgeries, and the toxicities and side effects that come with them, but are reluctant to go out an put some effort into walking a number times a week? If we were told to take another drug to reduce our cancer mortality and cancer recurrence by 24-40% we'd do it. Exercise needs to start being considered as a 'medicine' - paradigm shift.
You might want to consider giving exercise a try, at least all these studies found that it wasn't detrimental to treatments, and the upside could be significant.
Best wishes to you regarding your fatigue and regarding your treatment outcome!
You are soooooo close to being done! Just 5 taxols remaining! Yeah - I got more and more tired as the chemo wore on. My schedule was the reverse of yours. My AC was second, and that stuff just kicked my butt!
The comments about exercise definitely held true for me. I'm an athlete, and about 9 times out of 10, getting up and moving made me feel better, feel happier, sleep better, and so on. I also had a horrible horrible time with appetite. So, the exercise helped me want to eat. Anyway, about one time out of 10, staying on the couch was the right choice.
What did I do? I rode my bike every single day of chemo. Every.single.day. Some days, I rode all of minutes... Other days, I felt better and rode much longer. I rode and ran errands by bike and commuted to work by bike and even rode to chemo. It made a huge difference.
So, if you're doing no exercise now, just try to walk a few minutes a few times each day... That's it. If you're exercising now - awesome.
I know that 5 weeks seems so long away... So very long. But you're nearly there. The light is right there - right there at the end of that tunnel, and then it will be all uphill from there. I found that once two weeks passed after my last treatment, everything just started improving.... and what a relief that was! With your last treatment being taxol, you'll probably just start to feel better after about 10 days after your last treatment, I bet (guessing based on my taxol experience).
Thanks for posting your exercise experiences leepenn, quite an integrative exercise approach you did!
My last post, unless someone has anything specific to ask, is this link to another Oncology Times article:
Cancer-Related Fatigue: Exercise Remains Best Prevention and Treatment
If you haven't waded through the pervious article links, or found them too technical, this one is much shorter, is an easy read, and covers most of the topics mentioned thus far.
Regarding oncologists and exercise, unfortunately, most are not well informed. Worse yet, they are not reimbursed to prescribe or discuss exercise with us, it is considered an non-reimbruseable procedure. I've talking extensivley with a retired oncologist about this, and my own oncologist readily admits that he knows little about exercise. Oncologists are running businesses, and they specialize, that is why I refer to exercise recommendations from oncologists and cancer researchers who specialize in exercise and oncology.
A quick and full recovery to you oceanblue24, however you may choose to approach it!
I had the very same experience and I use to call Taxol the Devil drug. Without the energy and nothing any longer feeling normal as you knew it the positive attitude does tend to fade. Unfortunately for me I was falling into a serious depression, isolating and my Dr. finally told me if I didn't do whatever I could to think positive, I was going to end up regressing my recovery. I know everyone says it, but it is so true. Mind over matter is truly strong and a positive attitude makes a INCREDIBLE differnce.
You have a great support system here to keep you positive. Keep using it.
PUSH FORWARD AND PULL THROUGH
I just wanted to let you know that your question helped inspire an article on the site about battling fatigue after chemotherapy. Perhaps you will enjoy reading it. Please comment below the article if you have any other suggestions for WhatNexters!
Best of luck!
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