By Joanne Gailius
We’ve talked about diagnosis, treatment, and lymphedema in the last 3 articles. Now let’s move onto two common, manageable secondary outcomes of breast cancer, CRF and Cording, “the other stuff”. These conditions are so common that every woman going through breast cancer needs to become educated on what they are and how to address them. Read on!
Cancer Related Fatigue (CRF) is experienced by 70 - 100% going through breast cancer treatment. Women describe it as whole-body tiredness that isn’t relieved by rest or sleep. We think CRF is due to many factors, including cancer itself, radiation, chemo, and stress. It may come on suddenly, isn’t associated with activities or exertion and may continue after treatment is over. The thyroid may become underactive especially if the lymph nodes in the neck have experienced radiation, causing increased fatigue by reducing your ability to metabolize. The combo of radiation and chemo may lead to anemia, increasing our fatigue by reducing the availability of oxygen in our blood. Our appetite may be reduced as well, making us less likely to eat nutritiously. Some medications that are prescribed during treatment may also cause fatigue. Then, there’s our emotional health as we go through medical interventions and treatments, causing stress, fatigue and sometimes depression. We know that healthy lifestyle choices can hugely impact CRF.
Energy conservation is important, wisely choosing where, when and what you’ll in a day. Don’t try to maintain your normal daily routines. Set gentler, kinder, more compassionate goals. The CRF Golden Rule is “Never Go Below 25% in Your Tank”. If you feel fatigue coming on, recognize that you simply don’t have a “reserve tank” on board. Stop at the first sign of fatigue, before you’re depleted, or it may take days to recover. Talk with your doctor about your thyroid function and iron levels as you may need support in these areas. When eating is a challenge, choose only the most calorie dense, colourful and nutritious foods. One wise woman taught me that adding plain yogurt to her food made it more palatable as well as easier to chew, swallow and digest. Guard your sleep and rest time with dedication and ferocity! Recognize that you are in the restoration and rebuilding mode. Exercise can help by cleverly changing your metabolism and giving you more energy. It’s important to “start low and progress slowly” and be consistent. An important proviso is that radiation treatment is a time to maintain rather than gain.
Axillary Web Syndrome or Cording is another common outcome from breast cancer surgery and treatment, seen in between 20 to 80% of women; its incidence depends on what kind of surgery and treatment you’ve had. Cords look like a guitar string that pops up under your skin anywhere from your chest to your armpit, elbow, wrist or palm. Women often see it for the first time when they stretch to put on their seatbelt or coat. A cord is your lymphatic vessel tightened up. They “mate once for life” and don’t heal, so helping them release and get back to work is important. If you have cording, you also have a raised risk for lymphedema down the road. Your breast cancer physio can help you reduce or lose cording with lymphatic manual therapy, myofascial release, and gentle stretching. You can regain full lymphatic function, release your lymph vessels/skin tissue and find full spinal and arm movement in the mix!
Yoga After Breast Cancer (ABC), a PhysioYoga class, will begin on Jan 10th, 2019, Thursday afternoon at 3:00 - 4:15 at The Yoga Room for 6 sessions. It’s our introductory class for women who have had breast cancer at some time in their life. After reading this series of articles (and there are 2 more!), you know that there are lifetime impacts from the breast cancer experience. Each class has an education component, the movement, breathing and restoration followed by handouts/homework. You may be newly diagnosed, recovering from surgery, in the middle of treatment or an old hand……you’re all welcome. Email jgphysio@shaw.ca to register. Space is limited and we’ll do our best to accommodate all who are interested.