Fatigue after radiation/chemo for esophageal junction cancer

Good morning, Amelia. Oh golly, I’m sorry you’re having to go through chemo treatments. I’ve been there and it’s not on the list of fun things to do. However, there are positive outcomes afterwards so hang in there.

Unfortunately, fatigue after chemo is pretty common. The worst of it generally hits around 7+days after the end the last day of treatment and lasts maybe a week or so as your blood numbers plummet. Chemo kills off rapidly developing cancer cells. But it’s not discriminatory so it also can impact other rapidly developing cells such as the lining of the mouth and gut, and bone marrow. When it impacts the marrow it can rapidly decrease the red blood cells, white blood cells and platelets.
There is a low period where all the numbers are down which is referred to as a neutropenia or the nadir period. However, when the number of cells start to regenerate you should feel a little more normal…just in time for the next cycle. 😉

Without an abundance of red blood cells there is little oxygen circulating through your body. That causes the fatigue you’re experiencing. Another caution comes with the lowering of white blood cells and platelets. It’s important to avoid infection and illness at this time. Because of the lack of clotting ability be mindful of nose bleeds, cutting yourself with food prep, bumping into things to avoid bleeding issues.
One more note, checking your temperature several times per day during the nadir period is important. Neutropenic fevers can happen which may indicate an underlying infection. So if your temperature reaches 100.4 call your oncologist’s office right away.

There’s not much that can be done mid cycle to restore your energy. That just comes with time. So for now, resting is the most important thing you can do.
I found a pretty good article on nadir if you’d like to read it. It might give you a better understanding about what’s occurring with the chemotherapy.

I hope this is helpful for you. How many cycles of chemo/radiation are in your treatment plan?

Finished 28 rad treatments and 5 chemo treatments, and this Thursday will be two weeks since completed rad. The fatigue started hitting about 3 days after last treatment, and has gotten worse and worse. Hoping it has bottomed out now. I am eating some ... so thankful for that.
Thank you for your feedback

Sheeesh... I went thru my CROSS protocol at 61... cannot imagine doing it at 75! So... you'll be scanned shortly... plans to continue with esophagectomy? We talk to many on our twice-weekly Zoom calls... and a couple are 75 or older, having gone thru surgery. I think one fella had his in November at 79... he's now 80... and coming along.

Be well.
Gary

Waiting on scans, yes, on May 23. Then will discuss surgery. The top surgeon at the university hospital where I am being treated does not specialize in the minimally invasive surgery, and I am already considering other options including Mayo. Is it difficult to get into Mayo? I'm in Virginia and as I said am 75 (76 in Sept) and have cardiovascular disease. In 2020, I had open coronary bypass surgery and did well.
Does Mayo only take extraordinary cases?

I am wondering also if an out-of-state patient is able to have surgery at Mayo, how is follow up oncology care handled? With the patient's local oncologist? In my case, it's a good university hospital, just not providing the minimally invasive surgery.

Very easy to get started with Mayo. Just call the number on the website, and they will be ready for you. That was our experience.

Hi @amelia1, if you would like to request a second opinion for surgery at Mayo Clinic, click this link to get started http://mayocl.in/1mtmR63

You can self-refer or ask your doctor to submit a physician referral.

Follow-up care can be discussed with your cancer team. Some patients prefer to have follow-up care or additional treatments like chemo closer to home.