Potential link between fatigue and breast cancer recurrence

For many breast cancer survivors, fatigue may linger long after treatment ends, which can have a significant impact on cognitive function, ability to work, and overall quality of life. A new study from George Mason University’s College of Public Health suggests that this is not just a subjective feeling but a measurable reality.

Ali Weinstein, professor of global and community health and senior scholar at the Center for the Advancement of Well-Being, studied how breast cancer survivors respond to physically and mentally tiring tasks.

Researchers measured changes in both inflammation and participants’ self-reported fatigue, two common symptoms among breast cancer survivors that are believed to be connected, impact quality of life, and may also play a role in cancer recurrence.

The researchers found that women who reported higher levels of fatigue at the beginning of the study experienced more inflammation after the tasks, particularly in levels of TGF-β and eotaxin (indicators of inflammation that are linked to immune function, stress, and mood).

Even women in the control group (who watched a nature video) with high baseline fatigue showed signs of increased inflammation and fatigue, suggesting reactivity even to this relatively innocuous stimulus.

Surprisingly, most inflammation markers and fatigue levels did not change following mentally or physically fatiguing tasks, suggesting that these short tasks do not affect inflammation or fatigue among most breast cancer survivors.

The study, published in BMC Women’s Health, explores three previously unstudied areas among breast cancer survivors:

• how mental fatigue may be connected to inflammation
• responses in the short term to tasks that may induce fatigue
• the effects of physically versus mentally fatiguing tasks

“Studying inflammation in breast cancer survivors is important because past research has shown a link between inflammation and cancer progression or recurrence,” explains Weinstein.

“Fatigue can also strongly influence survivors’ daily quality of life, and we suspect it may be connected to inflammation. We’re working to better understand that connection, particularly with short-term exposures that may accumulate—and increase inflammation—over time.”

The team worked with female breast cancer survivors, each randomly assigned to one of three short activities: a physically demanding walk/run, a mentally challenging computer test, or simply watching a nature video (used as a control). Blood samples and fatigue ratings were collected before the task, immediately after, and again after a 30-minute recovery period.

The researchers highlight the need for more personalized approaches to fatigue management for breast cancer survivors, particularly strategies that consider existing levels of fatigue and the body’s inflammatory response to everyday physical and cognitive demands.