What to Expect After Breast Cancer Treatment

As a mom of two, I thought that I understood fatigue, especially since my first son didn’t sleep through the night until he was 14 months old. However, I was completely unprepared for the fatigue that came with my breast cancer diagnosis. This was not exhaustion fixed by napping in the afternoon or going to bed early. It was more than physical fatigue. I was exhausted mentally and emotionally, as well.

I was diagnosed with stage zero breast cancer after a routine annual mammogram at age 41. Suddenly, my days were filled with doctor’s appointments, phone calls, more breast imaging, and no shortage of decision-making.

Since my breast cancer was in a small area, I was offered a choice of surgeries. I could have a lumpectomy, which would remove the small area of cancer in my right breast, or a mastectomy, which would remove one or both breasts. Both surgeries would be effective, and the choice was mine to make.

Every waking moment was spent thinking about this decision. What would make sense for me at this stage in my life? What did I want? What was the right choice? That last question was one of the most tricky to unwind because there was no “right” choice for me. I could pick either surgery, and it would be effective.

I was mentally exhausted from the choices I was facing. This mental exhaustion made it difficult for me to attend to the other areas of my life, like paying bills, supervising virtual school for my two sons, and planning meals. I had used my cognitive decision-making powers on these choices and had nothing left for the rest of my life.

Eventually, I chose to undergo a lumpectomy followed by a month of radiation treatment. The cancer was small and only in one location in my breast, I didn’t have genetic risk factors that would have increased my risk of the cancer spreading or recurring, and my lymph nodes weren’t involved. I also wasn’t ready to say goodbye to my breasts yet. After spending so much energy thinking about the decision, and talking it over with my doctors, it was a relief to have made a choice – and even more of a relief after the surgery was over and the cancer was successfully removed.

In addition to the mental exhaustion I experienced with decision-making, I was also dealing with strong and challenging emotions.

I don’t know that I ever acknowledged my emotional attachment to my breasts before breast cancer. But as my treatment progressed, they were bruised, poked, cut open, and, during radiation, burned. I would look down at what used to be a symbol of my femininity and feel a deep sadness.

Only my husband, my medical team, and I saw the treatment’s true impact on my body. In the morning, I would gaze at myself in the mirror, try to think encouraging thoughts despite the disappointment at my appearance, and then put on my clothes.

I remember one morning, as I was getting ready for church, I put on several dresses. These were my favorite floral dresses to wear, but nothing felt right. I tried on each dress, looked at myself in the mirror, and didn’t recognize the woman staring back at me.

The tears began to flow down my face, ruining the makeup I’d just applied, and I looked helplessly at my husband, Dave. “Nothing works. I hate all of them!”

Gently, he reassured me that it was okay that I didn’t like them. I’d been through identity trauma. I didn’t have to like these dresses anymore. I collapsed into him, trying not to get my mascara all over his white dress shirt, and then went back to my closet.

I chose a simple black dress and paired it with a scarf – finally, something that felt like the woman I was becoming during breast cancer.

That morning at church, people came up to me and asked how I was doing. They said I looked great, which was ironic because underneath the black dress was a purple, bruised breast.

The clothing hid the physical trauma, and my smiles hid the upheaval happening inside.

During that time, I was so emotionally exhausted. I would cry at the drop of a hat or yell at my family for an innocent comment. I wondered if I’d ever feel well enough to be joyful again.

I had never experienced medical fatigue before my breast cancer treatment. People in my life had chronic conditions that exhausted them, and I wish I could say that I was compassionate about what they were experiencing. But, in my naivety, I thought a good night of sleep would resolve their fatigue.

I was wrong. During radiation treatment, no amount of sleep would fix my fatigue. I couldn’t even make it through dinner with my family. I would finish my last bite and listen to the conversation around me. I’d zone out in my fatigue until my husband would look over and say, “Go to bed, honey, it’s okay.”

I would trudge up the stairs and settle into bed. Sometimes I drifted off to sleep right away, and other times I would watch a little TV. Reading a book, my preferred activity, was something I was too exhausted to do during radiation.

I’d wake up feeling a little bit better in the morning, but that didn’t last long. After a half-hour walk with my husband, it was time to rest again.

During my month of radiation, I developed a few ways of coping with physical fatigue. I discovered that if I was careful not to push myself too much, the mental and emotional fatigue were also easier to deal with.

Here are some things I did to manage the little physical energy I had during radiation:

• I said no to evening activities because I was too tired
• I used a timer to limit the amount of time I would do housework
• I went to bed early
• I napped a little, but not so much that it would interrupt my evening rest
• I walked in the morning, because light exercise has been proven to help with radiation fatigue
• I drank lots of water
• I listened to my body and took advantage of the times I felt energetic, but rested when I was tired

After I finished treatment, it took time for the physical fatigue to resolve. One night, I was lying in bed and heard my family watching a movie downstairs. I wasn’t tired and decided to go down and join them. They looked up, worried they had been too loud. Once I told them I wanted to watch together, they were happy I had some energy to join them. I laughed at a funny moment, and my younger son, Dan, looked over at me and said, “I’ve missed hearing you laugh, Mom.”

I smiled and said, “I’ve missed laughing.” I was grateful that the fog of fatigue was beginning to lift.

I didn’t know I would be so exhausted during and after breast cancer treatment, but I’ve realized now that it is part of the cancer process. Cancer treatment is exhausting to our minds, emotions, and bodies. Fighting the fatigue doesn’t make it go away; instead, we can learn to live within the energy we have for each moment.