Small Windows of Hope: Understanding the Meaning of Fatigue Experienced by Cancer Patients

The purpose of the study was to describe the experience of early stage breast cancer women who were living with cancer-related fatigue. Using a phenomenological approach based on the work of Merleau-Ponty, the researcher completed six interviews in which women described the experience of being tired each day.

Interviews were transcribed verbatim and analyzed using a hermeneutical approach developed by Pollio and applied to nursing research by Thomas. Each interview was examined within the context of all the interviews to identify themes noted in all transcriptions. Dealing with the prevailing and profound fatigue that entrenched these women‟s lives was overwhelming. There was an overarching sense of living in the “Shadow of Death,” which served as the contextual ground. This sense of looming in the “Shadow of Death” reflected that these women survived cancer and cancer therapies; however, fatigue rendered their bodies, minds and lives changed…..an irreversible change.

Living with fatigue was described by the women as “part of weaving the fabric of my life,” yet the tapestry was never complete and had many imperfections. These flawed threads in the tapestry emerged as four figural themes: “Being Alone in my Cave,” “Coming Out of the Cocoon,” “It‟s a Lost Fight” and “Who am I Now?”

They described living in two worlds: one being hard and demanding, regardless of how hard they worked to overcome their fatigue; the second world served as a safe refuge, a cave, that allowed them to “peer through the window of hope” into the outside world. As fatigue improved they initiated “coming out of the cocoon,” but realized their bodies were entrapped with many losses.

Losses were described as “permanent visitors” which led to feelings of loneliness and despair with their life being relegated to a non-participative role with family, friends and work. Regardless of effort, their recalcitrant body was unable to overcome the fatigue. With fortitude, they confronted a search for the “old me” to realize every fabric of their life had changed, never to return to the “old self” which left them to peer into the outside world while searching for small “windows of hope.”