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Dr. Elaine Schattner Headshot

Breast Cancer Fatigue Syndrome Is Harmful to Patients

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Breast Cancer Fatigue Syndrome (BCFS) may be setting into our collective consciousness. This newly named, unofficial and insidious condition afflicts individuals who've become desensitized to all things having to do with breast cancer. The list of topics people shy away from, now, includes breast cancer screening and particularly mammography, chemotherapy and new, less-toxic targeted therapies. Issues women face after treatment, like estrogen depletion, feelings of sexual inadequacy, reduced bone density and fear of recurrence are, well, better not to discuss.

Pink distracts us from the real thing -- tumors that kill tens of thousands of ordinary mothers, sisters, daughters and friends in the primes of their lives. At the same time, it serves as a useful surrogate: it's easy to say you're sick of all the silly ribbons or that the tone of breast cancer awareness has become shallow and too commercial. It would be harder and very un-PC to say: "I'm tired of thinking about breast cancer, can we talk about something else now?" So we trash the ribbons and chastise their distributors, instead.

The symptoms of BCFS vary and can be subtle, so much so that some affected persons aren't even aware they have this condition. They may, for example, subconsciously avoid malls in October or, if an awareness ad comes on their TV set, go right then to the kitchen for a snack. Others are more overt in their discomfort with the topic; they might actively complain about the pink spectacle, or speculate that the awareness campaign is a money-making scheme. Others are so fatigued by BCFS that they just stop caring and turn inward, trying as best they can to avoid what's happening around.

The Centers for Disease Control reports that breast cancer ranks first among invasive cancers. It's the most common malignancy among women in the U.S., accounting for nearly one in four tumors aside from those of the skin, according to the American Cancer Society's latest fact sheet. In North America, the death rate from breast cancer approximates 45,000 women per year. According to the World Health Organization, the number of deaths from breast cancer, worldwide, is approximately 519,000 per year.

To be clear, BCFS is entirely different from real fatigue that affects people who have cancer. It's not the same as chemo-brain, which can alter how people with cancer concentrate at work and in their homes. It's not the same sort of distraction that happens in cancer patients due to worrying. Tiredness from anemia is a very real phenomenon from which many cancer patients suffer, either because the disease has infiltrated the bone marrow, where blood cells are formed, or as a side effect of treatment.

This new fatigue syndrome can be quite harmful. If people suffering from BCFS feel tired of breast cancer awareness and become less sympathetic to patients' plights, they may lessen their contributions to cancer charities. With reduced funds, it's harder for cancer researchers to accomplish their work, and for private agencies to provide needed support for patients and their families. People may behave less kindly toward those in their community who have cancer, less willing, for example, to drop by with a meal or mind a patient's daughter during a late-afternoon chemo infusion.

I hope this is just a phase, maybe a retro thing, as if we're trying to somehow reclaim the naivety of the 1960's, when few publicly acknowledged the problems faced by women with breast cancer who, often, felt ashamed of their illness and were reluctant to ask for needed support. To go back to that level of awareness would be devastating, the opposite of progress.

The solution, I think, involves keeping awareness of breast cancer in our minds year-round, starting with this November first. Maybe a less concentrated, steadier campaign of knowledge about all illnesses would be more sustainable in the long term. The worst possible scenario would be for the effort to be so intense that people feel contempt for those with cancer, and turn away.