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Author: Leo Flor

Taking Control Back After Cancer Fatigue Took Over

“I am confident that relief is within my reach with Cancer Fatigue Services by my side.”

My cancer fatigue journey…

Wanting family to enjoy Christmas Holidays, I kept the lump in my breast quiet until the celebration was over. Upon medical examination it was discovered that I had Invasive Lobular, HER2 Positive Breast & Lymph Node Cancers on the right side. My treatment plan was to have a double mastectomy, 6 chemo sessions, 15 radiation & 5 years of hormone therapy. That was the treatment path, and as we know in life things never go to plan. My surgeon was reluctant to remove both breasts; I was taken aback that I had to fight for my rights and choices. In the end it was later determined after testing breast tissue that cancer would have appeared on the left breast as well within a year. Chemo is already a very tough thing to go through, but my body was still in chronic pain from surgery, both of these compounded the unwell feeling that could not be broken. Of course, during chemo, I had to be part of the 1% of the population that went catatonic during my sessions. Resulting in only being able to complete the first two of six suggested. Because of this, radiation was deemed necessary to fully complete in hopes of preventing further spread of cancer. These sessions though short in duration, left a longer lasting impact. From my experience, my face on my left side looked like I had a stroke and blindness. Thankfully, this lasted only during the 15 sessions and not long term. Due to these experiences, I declined the 5 years of hormone therapy out of fear, frustration and exhaustion. There was no recovery time in between treatments and this was not sustainable for me.

This is where chronic fatigue came in. My fatigue responses were at a point where it controlled me and I didn’t control it. My symptoms included; chronic chest pain, loss of range of motion and fine motor skills, cognitive decline, brain fog and inability to problem solve and irritability. As for physical symptoms, I would first taste metal on the tongue, face would swell and turn red and brain fog and pressure to a point of inducing sleep. This could last 20 minutes to 2 hours of loss of consciousness. Sadly, after these bouts the body and mind did not feel rested and in some circumstances felt worse off than before.

Needless to say, that these symptoms meant I was not able to return to work for the past 2.5 years or living as desired. My normalcy was gone. My family bore the brunt of me not always being able to function, taking on responsibilities, things that I once was able to do. Days could be spent on the couch in an awake sleep state, in pain, frustrated, and depressed. To put it in perspective, walking up the stairs, taking the dog for a walk around the block or even getting up to use the bathroom was daunting. The thoughts of making dinner were often overwhelming, as it felt like I was going to pass out from overheating and being completely, physically, drained.

The fatigue overpowered all my senses, mind and body.

This hurt not only myself, but all the relationships around me; my husband, teenager, friends, and extended family. The adverse impact meant loss of friends, family and strained relationships for my husband and teenager.

Losing breasts was expected, but the inability to ‘live’ life like I had formally was over! I was not prepared for this. No one shared this possibility during treatments or was willing to look into why or how to overcome.

Leaving me isolated and alone…

Struggling to combat fatigue, I tried every possible means to find a remedy to be able to return to life formerly known. This included: physiotherapy, massage therapy, seeing a naturopath, counselling therapy, spiritual meditation, relation techniques and Chinese medicine treatments. I embraced every avenue available in hopes of leaving this fatigue behind me and living as wanted and needed. I changed all my eating habits and took supplements based on guidance from a naturopath. I tried Chinese Medicine treatments like meridian massages, cupping and Gua Sha. I went to individual and couples counselling to repair myself and family/spousal relationships. All of these things were positive on some level and painful on another, physically and mentally.

Nothing seemed to negate fatigue.

While scrolling on my phone an ad for Cancer Fatigue Service appeared on Facebook. I was shocked to find this, as my own medical team had thrown up their hands at this point, as they could not understand why I had chronic fatigue or how to help. It was foreign to them. I was alone in my battle to get better. I quickly picked up the phone and called Cancer Fatigue Services.

When I called Cancer Fatigue Services in Toronto, Ontario from Halifax, Nova Scotia, they were receptive and eager to learn about my cancer diagnosis, treatment, and present health concerns. A number of health records, blood tests, questionnaires, and interviews were turned in for examination.

I must admit that I cried because I was so grateful that they considered me as a COMPLETE person. Through a series of in-person and remote testing and care sessions, they assessed my medical conditions, financial circumstances, support systems, and mental, physical, and interpersonal stresses to create a comprehensive personal treatment strategy to combat my cancer fatigue, as a collaborative team. My comprehensive fatigue care plan included all of my test results and proposed a personal combination and timeline of treatments and support strategies to improve and battle my chronic fatigue. Together, we developed a personalized plan that included cardiopulmonary-focused exercise, individual and group counselling, and practical tools to manage fatigue such as meditation, positive self-talk, setting realistic goals, and incorporating meaningful rest.

Given that roadblocks arise often and necessitate adjustments, Cancer Fatigue Services worked with me to make adjustments to my Fatigue Care Plan, demonstrating that it’s a workable approach and that success comes from teamwork!

Although my fight against fatigue is continuing, I am confident that relief is within my reach with Cancer Fatigue Services by my side.

Those suffering with cancer fatigue, understand first-hand their personal journey, struggles and appreciation of having Cancer Fatigue Services on their recovery path. 



Reprendre le contrôle après que la fatigue liée au cancer ait pris le dessus  

« Je suis convaincue que le soulagement est à ma portée avec Cancer Fatigue Services à mes côtés. » 

Mon parcours avec la fatigue liée au cancer…  

Souhaitant que ma famille profite des fêtes de Noël, j’ai gardé le silence sur la boule que j’avais au sein jusqu’à la fin des célébrations. Lors de l’examen médical, on a découvert que j’étais atteinte d’un cancer lobulaire infiltrant, HER2 positif, touchant le sein droit ainsi que les ganglions lymphatiques. Le plan de traitement prévoyait une double mastectomie, six séances de chimiothérapie, quinze de radiothérapie et cinq années d’hormonothérapie. C’était l’itinéraire prévu — mais comme souvent dans la vie, rien ne s’est déroulé comme prévu.  

Mon chirurgien était réticent à retirer les deux seins. J’ai été bouleversée de devoir me battre pour mes droits et mes choix. Finalement, les analyses du tissu mammaire ont démontré que le cancer serait également apparu dans le sein gauche dans l’année  suivante. La chimiothérapie est déjà très éprouvante, mais mon corps souffrait encore de douleurs chroniques dues à la chirurgie. Ces deux éléments ont intensifié ce sentiment permanent de malaise dont je ne pouvais me libérer.  

Pendant la chimiothérapie, j’ai eu la malchance de faire partie de ce 1 % de la population qui entre dans un état catatonique durant les séances. Je n’ai pu compléter que les deux premières des six recommandées. À cause de cela, la radiothérapie est devenue indispensable pour empêcher toute propagation supplémentaire du cancer. Bien que les séances aient été courtes, leurs effets se sont fait ressentir longtemps. Mon visage, du côté  gauche, était paralysé comme après un AVC, avec une perte de vision. Heureusement, ces symptômes ont disparu à la fin des 15 séances.  

Ces expériences m’ont poussée à refuser l’hormonothérapie de cinq ans, par peur, par frustration et par épuisement. Il n’y avait aucun temps de récupération entre les  traitements — ce n’était pas viable.  

C’est à ce moment que la fatigue chronique s’est installée. Mes réactions à la fatigue étaient telles que c’est elle qui me contrôlait, et non l’inverse. Mes symptômes comprenaient : douleurs thoraciques chroniques, perte de mobilité et de dextérité, déclin  cognitif, brouillard cérébral, diƯiculté à résoudre les problèmes, irritabilité. Physiquement, je ressentais un goût métallique sur la langue, des gonflements du visage, des rougeurs,  une pression cérébrale menant à une perte de conscience pouvant durer de 20 minutes à 2 heures. Malheureusement, après ces épisodes, ni mon corps ni mon esprit ne se sentaient  reposés — parfois même pire qu’avant.  

Autant dire que ces symptômes m’ont empêchée de retourner au travail depuis deux ans et demi, et de vivre comme je l’aurais souhaité. Ma normalité avait disparu. Ma famille a dû prendre le relais pour toutes les tâches que je ne pouvais plus assumer. Des journées  entières se passaient sur le canapé, dans un état de veille-sommeil, douloureuse, frustrée et déprimée. Monter un escalier, promener le chien ou simplement aller aux toilettes devenait éprouvant. Rien que penser à préparer le dîner m’épuisait, au point de craindre de m’évanouir d’épuisement et de surchauffe. 

La fatigue dominait tous mes sens, mon esprit et mon corps.  

Cela m’a blessée, mais a aussi affecté toutes mes relations : mon mari, mon adolescent,  mes amis, ma famille élargie. L’impact négatif a entraîné la perte de liens, des tensions avec mon conjoint et mon enfant.  

Perdre mes seins, je m’y attendais. Mais perdre la capacité de « vivre » comme avant — ça,  je n’y étais pas préparée. Personne ne m’avait avertie que cela pourrait arriver, ni comment y faire face.  

Je me suis retrouvée isolée et seule…  

Désespérée de retrouver une vie normale, j’ai exploré toutes les avenues possibles :  physiothérapie, massothérapie, naturopathie, psychothérapie, méditation spirituelle,  techniques de relaxation, médecine traditionnelle chinoise. J’ai changé mon alimentation, pris des suppléments conseillés par une naturopathe, testé les massages des méridiens, le gua sha, les ventouses. Je suis allée en thérapie individuelle et de couple pour reconstruire ma vie personnelle et familiale. Chaque méthode apportait quelque chose…  mais ne soulageait jamais la fatigue.  

Rien ne semblait pouvoir l’atténuer.  

Un jour, en faisant défiler mon téléphone, une publicité pour Cancer Fatigue Services est  apparue sur Facebook. J’ai été choquée. Mon équipe médicale avait baissé les bras. Ils ne comprenaient pas ce que j’avais, ni comment m’aider. J’étais seule dans ma lutte. J’ai pris mon téléphone et j’ai appelé Cancer Fatigue Services. 

Depuis Halifax, j’ai joint leur clinique à Toronto, en Ontario. Ils ont été à l’écoute, curieux d’en apprendre davantage sur mon diagnostic, mes traitements et mes symptômes  actuels. J’ai envoyé de nombreux documents : dossiers médicaux, analyses de sang, questionnaires, entretiens.  

J’ai pleuré, de reconnaissance. Pour la première fois, quelqu’un me considérait comme une personne complète. Grâce à des évaluations en présentiel et à distance, l’équipe a pris en  compte ma situation médicale, mes finances, mon système de soutien, mes stress mentaux, physiques et relationnels. Ensemble, ils ont créé un plan de soins personnalisé  pour combattre ma fatigue, en équipe.  

Mon plan comprenait tous les résultats de tests et proposait une combinaison de soins, dans un ordre et un rythme adaptés à ma situation. Nous avons élaboré une stratégie  personnalisée incluant des exercices axés sur la capacité cardiopulmonaire, des séances de counseling individuelles et en groupe, des outils pratiques comme la méditation, le dialogue intérieur positif, l’établissement d’objectifs réalistes et le repos réparateur.  

Et parce que les imprévus sont fréquents, l’équipe de Cancer Fatigue Services a adapté mon plan au fil du temps, montrant que c’est une approche vivante — et que le succès naît de la collaboration.  

Même si mon combat continue, je suis désormais convaincue que le soulagement est à ma portée, avec Cancer Fatigue Services à mes côtés.  

Ceux qui souffrent de la fatigue liée au cancer connaissent intimement ce chemin, ces luttes — et la valeur inestimable de ne pas être seul·e sur ce parcours de rétablissement.

Clinic’s Perspective: Tim Marnoch, Director of Customer Care & Service

Written by: Tim Marnoch BA, Director of Customer Care & Service

The first thing you should know about me is that I have ALWAYS been a people person. The only consistent comment I received on my school report cards growing up is that “Tim loves to socialize with his fellow students…”

I also LOVE helping people and working as a team. I am a big sports guy, so it brings me joy to see staff working together towards a common goal and achieving great things through collaboration and pushing each other to be our best. 

After completing my undergraduate degree in Political Science from the University of Guelph, I was able to confirm two things: First, I wanted nothing to do with politics! Second, my desire to help coupled with my ability to connect with people easily meant that I was destined to find my footing, professionally, in the customer service space. 

So that’s what I did. I have been working in customer service for 25+ years, spending the last 10 years in the Insurance industry dealing with complex car accident claims.  This allowed me to hone my skills of quick and out-of-the-box problem solving and anticipating potential issues to ensure the best customer experience for all.

My transition to Cancer Fatigue Services has been an enjoyable and eye-opening learning curve as I previously had very little direct experience with cancer and its treatments. My lived experience of being a caregiver to a family member with chronic fatigue helped prepare me for understanding the daily challenges of high fatigue, and the nuances that each individual faces. 

What immediately struck me when joining the Cancer Fatigue Services team was how few resources there are in the medical landscape to help with the ‘ripple effect’ challenges people face during and after treatments, with fatigue being a major challenge for many.  

I was also surprised by how much people tend to normalize or downplay the daily struggles with their fatigue, hoping to not be a burden to their family and friends.  Since joining the Cancer Fatigue Services team and speaking to people daily about their fatigue journey, I am in absolute awe of the determination and resilience shown, which only motivates me to work harder to ensure we can reach as many people as possible to assist with reducing their fatigue symptoms. 

I am very proud of to be part of Cancer Fatigue Services, who have made a major focus of our program to be as accessible to all, regardless of any financial barriers or lack of sufficient coverage currently provided by Provincial Ministries of Health. 

My professional career has been dedicated to helping others in various capacities. I am very comfortable saying that connecting with people through Cancer Fatigue Services and doing my part to help people reclaim their lives by reducing fatigue has been the most rewarding position I have ever held.



Perspective Clinique : Tim Marnoch, Directeur du Service à la Clientèle

Rédigé par : Tim Marnoch, B.A., Directeur du Service à la Clientèle

La première chose à savoir sur moi, c’est que j’ai TOUJOURS été une personne sociable. Le seul commentaire constant sur tous mes bulletins scolaires était : « Tim adore socialiser avec ses camarades de classe… »


J’ADORE aussi aider les gens et travailler en équipe. Je suis un grand amateur de sports, donc voir une équipe collaborer pour atteindre un objectif commun me procure beaucoup de joie. J’aime voir comment la collaboration et l’encouragement mutuel nous permettent de donner le meilleur de nous-mêmes.


Après avoir obtenu mon baccalauréat en sciences politiques à l’Université de Guelph, deux choses sont devenues claires : premièrement, je ne voulais absolument pas travailler en politique ! Deuxièmement, mon désir d’aider les autres, combiné à ma facilité naturelle à créer des liens, signifiait que j’étais destinée à trouver ma place, sur le plan professionnel, dans le domaine du service à la clientèle.


Et c’est exactement ce que j’ai fait. Je travaille dans le service à la clientèle depuis plus de 25 ans, et, au cours des 10 dernières années,dans l’industrie de l’assurance, à gérer des réclamations complexes liées à des accidents automobiles. Cela m’a permis d’affiner mes compétences en résolution rapide de problèmes, parfois de manière créative, tout en anticipant les enjeux pour offrir la meilleure expérience possible aux clients.


Ma transition vers Cancer Fatigue Services a été à la fois agréable et enrichissante. N’ayant que très peu d’expérience directe avec le cancer et ses traitements auparavant, j’ai énormément appris. Mon expérience vécue comme proche aidante d’un membre de ma famille atteint de fatigue chronique m’a aidée à mieux comprendre les défis quotidiens liés à une fatigue sévère, ainsi que les nuances propres à chaque personne.


Ce qui m’a immédiatement frappé en rejoignant l’équipe de Cancer Fatigue Services, c’est à quel point il existe peu de ressources dans le milieu médical pour aider à relever les défis en cascade auxquels les personnes sont confrontés pendant et après les traitements, la fatigue constituant pour plusieurs un défi majeur.


J’ai aussi été surpris de constater à quel point les gens ont tendance à normaliser ou à minimiser leurs luttes quotidiennes avec la fatigue, par peur d’être un fardeau pour leurs proches. Depuis que je suis en poste et que j’échange quotidiennement avec des personnes sur leur parcours de fatigue, je suis profondément impressionné par leur détermination et leur résilience. Cela ne fait que renforcer ma motivation à travailler encore plus fort pour que nous puissions aider le plus de gens possible à soulager leurs symptômes.


Je suis extrêmement fier de faire partie de Cancer Fatigue Services, une organisation qui met un point d’honneur à rendre ses services accessibles à tous, peu importe les barrières financières ou le manque de couverture adéquate de la part des ministères provinciaux de la Santé.
Ma carrière professionnelle a toujours été guidée par le désir d’aider les autres, sous différentes formes. Et je peux affirmer, sans hésiter, que le lien que je tisse avec les gens à travers Cancer Fatigue Services et le rôle que je joue pour les aider à reprendre leur vie en main en réduisant leur fatigue constitue l’expérience la plus gratifiante de ma carrière.

Elevating Survivor Voices Through Connection and Celebration

National Cancer Survivors Day – A Community Recharged

On June 1st, Cancer Fatigue Services (CFS) proudly took part in the 3rd Annual National Cancer Survivors Day Expo in Brantford, Ontario. The day was nothing short of extraordinary.

Representing CFS was our founder, Dr. Scott Adams and exercise therapist, Matthew Dhanushan. This dynamic duo was on-site at our dedicated booth, engaging with attendees and fielding thoughtful questions about cancer-related fatigue. Their approachable style and in-depth knowledge contributed to remarkable connections and almost 100% of the survivors in attendance registering with CFS before the expo concluded.


As emcee for the day, I had the distinct pleasure of guiding the audience through a packed schedule filled with heartfelt stories, a powerful caregiver panel discussion, and emotional tributes from life experience. Many attendees, vendors and fellow speakers shared overwhelmingly positive feedback – not only about the quality of this year’s expo but specifically about the energy and professionalism brought to the stage. Balancing crowd control with comedic moments and emotional authenticity, I aimed to create an atmosphere that felt as cathartic as it was celebratory.

The day was more than an event – it was a testament to the resilience and humour of our community. We also capitalized on valuable networking opportunities, strengthening bonds with local health professionals, advocacy groups, and fellow survivor-led organizations.

To read more about the event and it’s impact, check out Brant Beacon’s coverage here: https://
www.brantbeacon.ca/honouring-cancer-survivors-with-stories-and-support/



Pride in Partnership – Princess Margaret’s 2025 SGDc Pride Event


On June 12th, I was invited to participate in the Princess Margaret Hospital’s Sexual and Gender Diversity in Cancer Care 2025 Pride Event as their emcee, hosted by their remarkable Chosen Family Team. Held in celebration of the 2SLGBTQIA+ survivors and supporters, the event seamlessly wove joy, visibility, and inclusion into every corner of the space.
You can view the event recap here: Instagram Reel and visit the official post from @PMChosenFamily on my role as a Patient Partner here.

Following the event, being asked as a Patient Partner what it means to me was both a highlight and so touching to be able to contribute:

What Does Being A Patient Partner Mean To Me?

“I don’t just want a seat at the table. I want to feel like my chair matters.”
“I want people to know that the moment you include survivors in decisions, the outcomes feel more human and more honest.”

These words encapsulate the purpose behind every conversation we had that day.

From the CFS perspective, the event was another powerful platform for visibility and dialogue. We had meaningful one-on-one discussions with survivors who were curious about cancer-related fatigue and it’s lingering effects. I was so pleased to be able to share information about our services and the allyship that CFS stands for. I was incredibly honoured to receive an open invitation to return as the official emcee for future SGDc events.


Looking Ahead

With summer in full swing, Cancer Fatigue Services continues to move forward with a simple mission: to reduce the burden of cancer related fatigue so survivors can reclaim their energy and thrive. Whether it’s standing behind a podium, beside a booth, or alongside another survivor – I remain committed to showing up, speaking up, and amplifying the voices of our community.

If you’re reading this and wondering where to start your own fatigue recovery, know that our doors are always open.

Stay connected, stay proud, and stay energized.

Peter Laneas
Advocacy & Outreach Communications Manager
Cancer Fatigue Services

From Exhausted to Empowered: How I Took My Life Back

10 years have passed, and I still remember the first time I heard the words “invasive ductal carcinoma”. From my limited knowledge of medical terminology, I knew this meant I had breast cancer – the last thing I expected to hear at the young age of 28.

The following several days were full of assessments, visits with three new specialists, scans, bloodwork, and a chemo prep course – one kind nurse said it was likely akin to being on the amazing race.

Eight short months later (yeah right) – after six cycles of chemo, a double mastectomy, and 25 radiation treatments, along with all the fun side effects – I was considered “cancer free”. My scans might have been saying that, but my body said otherwise. The fatigue from chemo and radiation was like nothing I’d ever experienced.

Life did eventually return to normal, and I was so fortunate it did, since the next several years were filled with wonderful experiences and memories. I had several incredible trips with my boyfriend and my family, added another Schnauzer to my fur babies, and got engaged and married in beautiful Nova Scotia. After this, I started to feel like cancer was finally behind me.

Unfortunately, I was wrong! In October 2020, I suddenly developed symptoms of jaundice. After additional scans and bloodwork, I was diagnosed with stage IV breast cancer with metastases to the pancreas, liver, and bile duct. At the age of 34, I had won the cancer lottery again!

The hardest thing to come to terms with this time was that there would be no moving beyond cancer. My oncologist informed me that after six cycles of chemo, I would continue with antibody treatment every three weeks until it stopped working or became intolerable due to side effects.   

I have been very fortunate that almost five years later, my first line antibody treatment is still working, and I have had three years with no evidence of metastatic disease.

During that time, I continued to hear how healthy I looked and how good I was doing. I struggled significantly with this, since I did not feel this way at all, but didn’t know how to explain it to my doctors or even to my family and friends. I was never outwardly judged, but always felt like people were wondering why I had not returned to work. Even though I was “just” on a maintenance treatment, I still couldn’t do the things I enjoyed previously while I was working full time – walking and playing with my pups, camping, hiking, and boating with my husband. Not only that, but sometimes doing a load of laundry or cooking a meal felt like a real chore. I did not necessarily feel any more tired, but seemed to have a lot of trouble keeping up.

I had amazing support from friends and family, but it was still difficult at times not to feel alone in this struggle. Luckily, once I became involved with Young Adult Cancer Canada (YACC) and attended their virtual and in-person events, I found a new community of people who felt the same way and could relate.

It was through YACC that I was made aware of Cancer Fatigue Services (CFS). In December of last year, I presented for my initial assessment and was finally validated in how I was feeling. When the team further explained cancer fatigue to me and just how complex it was, I began to understand why I’d been feeling so limited.

CFS treated me as a whole, not just my cancer. Not only that, but once they provided me with my personalized care plan, I also finally felt like I had regained some control over my life. I was given a very specific exercise prescription that allowed me to make sure I didn’t overdo it. After my first six weeks, I had gains in my muscle mass and other markers of fitness. More importantly though, despite doing more throughout the day, I had more energy and have been able to enjoy my evenings with my husband and my dogs.  

Since working with CFS and the services they referred me to, my mental health and sleep have improved. There have also been positive changes to my nutrition – and this is coming from someone who worked as a Dietitian for 10 years – we can always learn something new.  

Clinician’s Perspective: Matthew Dhanushan, Clinical Exercise Physiologist

Written by: Matthew Dhanushan BSc, CEP

Before joining the Cancer Fatigue Services team, my professional path was grounded in work physiology and sport performance. With a bachelor’s and master’s degree in Fitness Science from York University, much of my early academic and professional work focused on understanding the physical demands of jobs and relating it to human capabilities for injury prevention and risk reduction. I spent years analyzing how different tasks—like lifting, pulling, carrying, etc.—translate into real-world physiological demands, which helped me develop a strong applied lens for interpreting human performance.

This same lens has proven surprisingly relevant in the oncology space. Whether someone is carrying a firehose up stairs or simply bringing in groceries from the car, every activity demands energy—oxygen, metabolism, and endurance. When these systems are impaired, even basic daily tasks can feel overwhelming. This is one of the areas where cancer-related fatigue (CRF) becomes such a critical, yet under-addressed challenge.

When I started working at Cancer Fatigue Services, I’ll be honest—I didn’t know much about oncology. Beyond some chronic disease coursework in school, I had little exposure to the world of cancer care. I knew cancer-related fatigue was a common symptom, but I didn’t realize the scope or depth of its impact. I’ve since come to understand just how pervasive and debilitating cancer-related fatigue can be—and how limited the resources are to help people navigate it. It’s a common experience among cancer survivors, yet there are many challenges with accessibility of these resources to help address the problem.

What motivates me today is the opportunity to be part of a truly innovative solution. Our team is leading Canada’s first dedicated medical care service for cancer-related fatigue. One of the biggest problems in healthcare is inequitable access and a lack of resources, and being a part of Cancer Fatigue Services has given me the opportunity to help address this issue by improving access and striving to provide compassionate care. Even more compelling is the fact that the most effective intervention to cancer-related fatigue is also one of the most misunderstood: exercise. It seems paradoxical—how could someone exhausted from cancer and treatment benefit from physical activity when it’s often exhausting to even move? But the science is clear: exercise is the most evidence-based treatment for CRF, outperforming medications, injections, and even rest in many cases.

This role has given me new purpose. I’m driven by a commitment to help people reclaim their energy, their confidence, and their lives. My goal is to educate, empower, and make a meaningful difference for those facing the invisible weight of cancer-related fatigue.

We’re not just treating fatigue—we’re striving to restore hope.

A Canadian Advocate’s Reflection on the 2025 TCF Summit in Las Vegas

As a Canadian cancer advocate, attending the 2025 Testicular Cancer Foundation (TCF) Summit in Las Vegas was a moving experience. Held from April 25-27 at the Four Seasons Resort, the summit brought together survivors, caregivers, medical professionals, and advocates from across North America, fostering a vibrant community in the fight against testicular cancer.


Building Bridges Across Borders
From the outset, the summit emphasized connection. Friday’s activities, including a friendly golf outing at Angel Park and a welcome event at Flight Club Bar & Restaurant, set a warm and inclusive tone. These gatherings underscored the importance of camaraderie and shared experiences in the journey toward healing and advocacy.


Empowerment Through Education
Saturday’s sessions were a testament to TCF’s commitment to education and empowerment. Keynote speakers like Dr. Gina Wheeler discussed holistic wellness post-cancer, while Dr. Matthew Campbell provided insights into advancements in oncologic care. Dr. Pablo Santamaria addressed hormonal health after testicular cancer, and Dr. John Lin shed light on the epidemiological trends. These presentations highlighted the multifaceted nature of survivorship and the importance of comprehensive care.


Stories That Resonate
The personal narratives shared by survivors were particularly impactful. Stories of resilience and vulnerability resonated deeply, reminding us of the human faces behind the statistics and the strength found in shared experiences.


Innovative Advocacy Initiatives
Sunday’s “Stressticles Activation,” sponsored by SAXX, exemplified creative approaches to advocacy. This interactive campaign promoted early detection and self-exams in an engaging manner, demonstrating how innovative strategies can effectively raise awareness and encourage proactive health behaviours.


The Call to Action
Returning to Canada, I am invigorated by the knowledge and connections gained at the summit. The event reinforced the importance of cross-border collaboration in cancer advocacy and the need to continue fostering communities that support survivors and promote education. I am committed to integrating these insights into my work, striving to enhance support systems and awareness within our Canadian context.


For more details on TCF, please visit www.testicularcancer.org.

Written by:
Peter Laneas
Advocacy & Outreach Communications Manager
Cancer Fatigue Services

Clinician’s Perspective: Luana Pereira, Registered Social Worker and Psychotherapist

Written by: Luana Pereira, MA Clin. Psych., MSW, RSW

When sharing reflections about working in oncology, I must say that my first perspective around cancer came from being a family member. My mom was diagnosed with breast cancer in her mid 40’s, I was 14 years old. As a teenager, I felt the impact of sudden changes and uncertainty. I witnessed losses and strength, I also felt powerless when life took a turn in our home.

Many years later, during my bachelor in Psychology I was drawn to study Health Psychology and ended up conducting qualitative research with women who underwent mastectomies. No surprises here – I guess I was trying to understand, from a new perspective, my mom’s experience.

After my graduation I was mostly working in private practice, but I decided, again, to be involved in cancer care. I started working in a public hematology/oncology hospital in Brazil, this time with children and teens. That was extra though, and it made me learn so much about cancer-related trauma, meaning-making and how we, as professionals, can help a very challenging situation feel more manageable. In my role, I was caring for patients, families, and the healthcare team at the same time, they were all suffering. Having my peers around to debrief and support each other on hard days was essential.

I decided to go back to school for my masters in Clinical Psychology and dove into research one more time, listening to the impact of cancer for individuals who were still developing – physically and emotionally. I found that, even for children, making sense of their experience through narrative or playing, helped them process this potentially traumatic event in early life.

It was difficult to be present in so much pain and grief, but I felt that I was making a difference, and it was more rewarding than draining. I also learned to take care of myself to be able to be fully available for my patients. I could see how vicarious trauma, compassion-fatigue and burnout could easily take a tool.

Fast forward, living in Canada I had the privilege of working at the best hospitals in Toronto, and I find myself today as an oncology social worker, working primarily with breast cancer. I guess life has come full circle. I have the knowledge and clinical experience to care for these patients, and I don’t feel as powerless as I did before, as a teenager watching my mom go through this life-changing experience.

My clinician perspective now allows me to witness my patients suffering, growth, their unique journeys, and to support them, but also to learn from them. Cancer changes you in so many different ways: your body, your identity, your relationships, your plans… Together, we find meaning, identify needs, explore coping strategies, boost resilience, navigate uncharted territory, and reframe hope.

Often, at the end of a session, patients sigh and I can see their relief. They also ask me “how can you spend all day listening and talking about cancer, fear and grief?” I usually respond by saying that working with them gives me so much meaning; being allowed in and walking by their side is an honour; seeing them coping better with extremely hard situations is rewarding; and being reminded every day about the things that matter the most in life is a privilege.

Finally, as I can’t offer a patient’s perspective, I usually encourage people that I see to connect with peers, if they are interested. It could be a casual conversation, a support group, an activity. There is something very powerful and unique about sharing lived experiences and supporting one another – it’s a layer of support that we, as professionals, families, or friends, will never be able to provide. Holding space for these connections when facilitating a support group is also a part of my job that I love. There are many opportunities out there to feel validated, understood and seen – don’t hesitate to reach out.

Welcome to the Team!

We are pleased to have recently welcomed two new members to the Cancer Fatigue Services dream team!

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Peter: Championing Health, Equity & Empowerment Through Advocacy and Storytelling

Peter Laneas

Peter has been living beyond cancer and has dedicated over 15 years to advocacy, having overcome cancer twice. His lived experience provides a unique and valuable perspective to our team, allowing us to test ideas and assumptions in an effort to refine and deliver the best healthcare experience possible. He is an inspirational and passionate speaker on key social issues, including intimate partner violence, LGBTQ+ concerns, and cancer survivorship. We are incredibly fortunate to have Peter’s objective viewpoint and expertise in supporting those we aim to help.

Peter will co-facilitate the support groups we have organized for individuals experiencing cancer-related fatigue, With his blend of knowledge, experience and humour, facilitating these discussions is something that comes naturally to him. (See a young Peter on this panel of young adults talking about living with cancer.)

“People without cancer will never understand how complex survivorship is post-treatment.”

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Dr. Martin Chasen: Cancer Care Trailblazer, Bridging Science and Compassion

Dr. Martin Chasen

Dr. Chasen’s experience, expertise and most importantly his values align very well with the mission of Cancer Fatigue Services. The excitement and enthusiasm Dr. Chasen has shown in the work he is doing echoes in the highly positive feedback we have received from individuals who have seen him for their comprehensive fatigue assessments, counselling and care plan delivery encounters. Dr. Chasen uses a whole-person approach and communicates openly with those living with and beyond cancer, also recognizing the vital role of caregivers in their journey.

Once we started talking to Dr. Chasen, we knew that we were aligned in our mission. Serendipitously, we learned that he played a key role in establishing the Cancer Nutrition Rehabilitation (CNR) programs in Montreal and Ottawa which sounds very similar to the same type of multidisciplinary, person-centred care model we aspire to create here at Cancer Fatigue Services. 

Listen as Dr. Chasen discusses the goals of the CNR program and the role of the multidisciplinary team (3:47 – 5:02). The video also talks about how we can show the government that money can be saved in the long run by providing better support for individuals who are living post cancer treatment (13:40 – 15:11). Collecting evidence to justify improved government support for this vulnerable population was already one of Cancer Fatigue Services’ endeavours!

This quote from Dr. Chasen in the video sounds like it came from a foundational visioning session for Cancer Fatigue Services!

“The role of the multidisciplinary team is to have the patient in the centre of all the action and the professionals around the patient each contributing what they are experts at to the benefit of the patient. The patient is actually the leader of the team.”

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We are honoured and privileged to welcome Peter and Dr. Chasen to the team!

When you are ready, they are ready to support you and will be delighted to welcome you to our clinic.

Contact us with any questions and feel free to use our booking calendar to schedule your Free Consultation.




References:
Current Oncology: Cancer nutrition and rehabilitation – its time has come!

Caring for the Caregiver: Why Taking Care of Yourself Matters

Being a caregiver for someone who is living with or after cancer can be both rewarding and exhausting. Whether you are caring for a spouse, parent, child, or friend, the role often requires significant physical, emotional, and mental energy. While it is natural to focus all your attention on the well-being of the person you are caring for, it is essential to not neglect your own health and well-being. Self-care for caregivers is not only crucial for your own health but also for your ability to provide effective care. In this article, we will explore the importance of taking care of yourself as a caregiver and provide practical tips on how to do so.

Why Self-Care is Essential for Caregivers

Caregiving is a demanding role, often leading to stress, exhaustion, and burnout. According to research, caregivers are at a higher risk for health problems such as anxiety, depression, sleep disturbances, and chronic conditions like heart disease. When caregivers do not take time to care for themselves, they may become overwhelmed and less effective in their caregiving duties. This can lead to a cycle of stress that ultimately affects both the caregiver’s health and the care recipient’s well-being.

Moreover, caregiving is a marathon, not a sprint. Whether the person you care for is recovering from treatment or living with cancer-related fatigue, caregiving can go on for months or even years. Without proper self-care, caregivers may experience burnout, which not only harms their own health but also diminishes the quality of care they provide. In this way, looking after your own needs is an investment in your ability to continue caring for others over the long term.

Practical Ways to Care for Yourself as a Caregiver

Taking care of yourself as a caregiver does not mean taking a break from your responsibilities—it means finding balance and ensuring that your physical, emotional, and mental health are prioritized. Here are some practical ways you can maintain your well-being while caregiving:

  1. Prioritize Physical Health

Your physical health is the foundation of your ability to care for someone else. If you neglect it, you will find it harder to meet the physical demands of caregiving. To prioritize your physical well-being:

  • Get enough sleep: Caregivers often sacrifice sleep to provide care, but this can lead to increased stress and health problems. Try to establish a regular sleep routine, and ask for help when needed so you can get rest.
  • Exercise regularly: Physical activity reduces stress and increases energy. Even a short daily walk can make a difference in your physical and mental well-being.
  • Eat nutritious meals: Caregivers may skip meals or rely on unhealthy fast food due to time constraints, but eating a balanced diet is crucial for maintaining energy levels and overall health.
  1. Take Breaks and Ask for Help

It is easy to fall into the trap of thinking you need to do everything yourself. However, no one can be a caregiver 24/7 without risking burnout. It is important to take regular breaks, even if they are short. This might mean taking a walk, reading a book, or simply enjoying a few minutes of quiet time.

  • Share the responsibility: If possible, reach out to family members, friends, or professional caregivers to help share the load. This can provide you with much-needed respite and allow you to recharge.
  1. Manage Stress

Caregiving can be stressful, and stress that goes unmanaged can take a toll on both your physical and mental health. Here are some strategies for managing stress:

  • Practice mindfulness: Techniques such as deep breathing, meditation, or yoga can help calm the mind and reduce stress. Taking a few minutes each day to center yourself can have a lasting impact on your well-being.
  • Stay organized: Caregiving often involves managing medical appointments, medications, and daily routines. Keeping a schedule and making use of tools like calendars or reminder apps can help reduce feelings of chaos and stress.
  • Seek emotional support: Caregiving can be an emotional rollercoaster. Talking to a therapist, counselor, or support group can provide an outlet for your feelings and help you process your emotions.
Yoga On The Beach
  1. Make Time for Social Connections

Caregivers often become isolated as they focus their energy on their loved one. Maintaining social connections, however, is vital for mental and emotional health. Regularly connecting with friends, family, or other caregivers can provide support, reduce feelings of loneliness, and remind you that you are not alone in your journey. Even if you do not have time for long visits, brief phone calls, virtual chats or even exchanging a handful of text messages can help you maintain your social circle.

  1. Set Boundaries and Manage Expectations

It is essential to set boundaries with your time and energy. This includes learning to say no to requests that are beyond your ability to manage. You do not have to be available all the time, and you do not need to feel guilty for setting limits. Similarly, understand your limitations—there is no shame in acknowledging that you cannot do it all. By managing expectations and setting realistic goals, you can avoid the stress of overcommitting.

Why Self-Care Benefits Your Loved One

Taking care of yourself not only helps you but also benefits the person you are caring for. When you are physically healthy, mentally sharp, and emotionally balanced, you are better equipped to provide high-quality care. You will have the energy and patience needed to assist with daily tasks, make decisions, and provide emotional support. In turn, the person you care for will experience less stress and feel more secure knowing that you are well-supported.

When caregivers neglect their own well-being, they become overwhelmed, irritable, or emotionally distant, which can strain the caregiver-care recipient relationship. By practicing self-care, you cultivate a more positive and nurturing environment for both yourself and your loved one.

Conclusion

Being a caregiver is an incredibly important role, but it is also one that requires careful attention to your own well-being. By prioritizing self-care, you not only improve your own health but also enhance the quality of care you provide. Remember, taking time to care for yourself is not selfish—it is necessary. By finding balance, managing stress, and seeking support, you can continue to be a compassionate, effective caregiver while maintaining your own health and happiness.



References:
American Cancer Society Journal: Cancer caregiving predicts physical impairments: Roles of earlier caregiving stress and being a spousal caregiver
Cleveland Clinic: Caregiver Burnout

The Cancer Fatigue Services Difference

Cancer-related fatigue is common, but it is NOT normal.

It is arguably the most burdensome and prevalent (or common) symptom reported by people living with and after cancer. Most people accept cancer-related fatigue as part of their ‘new normal’ because they do not think there is anything that they can do about it. We created Cancer Fatigue Services to challenge this false narrative, relieve fatigue, and restore hope for you and the thousands of people needlessly suffering from this treatable but widely unaddressed health issue.

Cancer Fatigue patients of all demographics

Cancer-related fatigue is complex.

Without dedicated support, you and other individuals experiencing cancer-related fatigue are forced to: 

  1. Guess the causes of your fatigue, potentially resulting in the misuse of your precious time, energy, and financial resources; 
  2. Coordinate, schedule and attend appointments with multiple healthcare professionals who do not communicate with one another and may have conflicting opinions;
  3. Independently organize and understand the overwhelming number of tests and expert opinions resulting from these appointments;
  4. Make your own combined fatigue treatment plan by doing research to identify which treatments are most likely to improve your fatigue and the best order to do them in;
  5. Monitor your progress, overcome obstacles and setbacks, and keep yourself on track throughout your treatment plan; and,
  6. hope it will work.

—  OR  —

You can book an appointment with Cancer Fatigue Services!

Just reading that list is exhausting, which is why we have carefully created a complete healthcare service that simplifies and supports every aspect of your fatigue-related care.

We deliver compassionate, personalized, accessible, and affordable multidisciplinary healthcare for people living with cancer-related fatigue. Cancer Fatigue Services is different – from our peer-led, person-first concierge healthcare model to our use of cutting-edge technology (download our Clinic Information Pack).

Here are a few of the many ways that we can make a difference in your life:

1. Concierge Healthcare Support

Our Customer Care & Clinical Care teams start working for you on day one. The Customer Care Team directly supports and simplifies your care experience by helping you organize and track your fatigue care-related appointments and paperwork, both within our clinic and across our fatigue care partner and affiliate network. Your care is further supported by our Clinical Care Team, who initiates and handles most of the administration and paperwork to support your referral to external healthcare providers for fatigue care-related purposes. These teams work together seamlessly to ensure your precious time and energy are protected, allowing you to stay focused on your recovery.

2. A Peer-Led and Person-First Approach

Too many people feel unheard and fall through our healthcare system’s cracks – particularly those living with more complex health concerns. Cancer Fatigue Services is committed to ensuring that your care is well supported by people who ‘get it’ and will advocate for you and your healthcare needs. Mr. Peter Laneas (CFS Marketing & Outreach Communications Manager) has been busy living after cancer for almost 20 years, following his passions as a wellness advocate and an experienced peer supporter! Peter is an integral part of our care team who works tirelessly on the front line and behind the scenes to ensure your needs are met, your progress is well monitored and supported, and your concerns are heard and addressed. 

3. Accessible Care

We are aware that just the thought of leaving the house can be a source of stress for people living with cancer-related fatigue. That is why we built our care model with flexibility and convenience in mind. Our clinic is conveniently connected to the Sheppard-Yonge subway station (located on Lines 1 and 4) and is just 3 minutes (<1 km) away from highway 401.  Parking is offered complimentary for all OHIP-covered visits. After your Comprehensive Fatigue Assessment, the rest of your care can be delivered virtually. Our virtual care options ensure that daily changes in your energy levels or geographic location are not barriers to accessing the care you need.

Download our Transportation Options & Tips info pack to learn more.

4. Affordable Care

Financial constraints should not hinder anyone’s ability to live well with and after cancer. Cancer Fatigue Services is committed to ensuring that every individual has access to the fatigue care they require, regardless of their financial circumstances. We are working hard to eliminate the financial barriers preventing people from accessing high-quality fatigue care in three ways. 

  1. Our assessment, treatment planning, and counselling services are covered by OHIP for eligible people. 
  2. Our enhanced assessment and intervention services are eligible for private insurance coverage through most benefits plans. 
  3. Finally, we help people with limited financial means find low- and no-cost fatigue treatment options through our Compassionate Coverage for Care Program.

5. Cancer-Fatigue Focused

While many different forms of fatigue exist, we only treat cancer-related fatigue. This specialization ensures our physicians and therapists stay current with cutting-edge research and novel support approaches for people living with cancer-related fatigue, allowing them to translate the best available evidence into practice to increase the effectiveness and reduce the time it takes to see results.

6. Comprehensive & Innovative Fatigue Assessments

We get answers fast by assessing all the treatable and non-treatable causes of cancer-related fatigue. This appointment lasts between 50 and 75 minutes (depending on the complexity of your case) and evaluates all medical, physical, mental, emotional, demographic, and social factors that may contribute to your fatigue. Results are typically ready within 48 to 72 hours of completing your comprehensive fatigue consultation.

Our fatigue assessments are based on the leading national and international guidelines for cancer fatigue management. However, achieving the best results possible requires doing more than the minimum. That is why we offer enhanced fatigue assessment services that evaluate critically important aspects of your physical health that are likely causes of fatigue for many people, but that have not been included in the guidelines…at least yet! 

We are the only fatigue clinic in North America to offer Cardiopulmonary Exercise Tests, advanced bioelectrical impedance analysis, and strength testing. Cardiopulmonary Exercise Tests are the gold standard for assessing the function of your cardiovascular system and how its primary components (e.g. your lungs, heart, peripheral skeletal muscles) work together to deliver oxygen to support energy production. The combination of bioelectrical impedance analysis and strength testing provides important information about the health and function of your skeletal muscles – which is where most energy production in the body takes place. Together, these tests provide critical insight into the health and function of the primary systems responsible for energy production in the body – making them essential elements of our comprehensive fatigue assessment. 

Download our Cardiopulmonary Exercise Testing Brochure or Information Pack to learn more.

7. Personalized Exercise Therapy

Over 30 years of research has found that exercise training is the most effective single treatment strategy for cancer-related fatigue. However, a special approach to exercise training is needed to treat complex health issues like cancer-related fatigue.

Everyone knows that regular exercise is generally ‘good for you’. However, a generic approach to exercise training is less effective at addressing fatigue because it is not specific to that individual. An effective exercise prescription for cancer-related fatigue considers the specific injuries and dysfunction within specific organs and body systems contributing to each individual’s fatigue. Like all medical treatments, it is essential that you receive the correct type and dose of exercise to ensure it is safe and effective. Exercise Therapy refers to a special medicalized approach to regular exercise training that is: 

  • precisely prescribed and tailored to your physiology and functional capacity using the results of gold-standard assessments like Cardiopulmonary Exercise Tests;
  • targeted to cause specific physiological adaptations within the body to address the unique causes of your fatigue (e.g. improving the efficiency of oxygen delivery to your skeletal muscles; increasing skeletal muscle mass [the number and size of skeletal muscle cells]; increasing the number, size and function of the mitochondria and related enzyme activity within skeletal muscles to boost energy production capacity within the body;  improving glucose control; reducing stress chemicals in the blood; boosting immune system function); and,
  • medically supervised to optimize your safety and benefits.

Our exercise therapists have the experience necessary to get you results quickly and safely by delivering exactly: 

  • what you need – the right type and dose of exercise; 
  • when you need it – the right sequence and schedule of exercise;  
  • where you need it – at our clinic, a community gym, or your own home (including helping you find affordable home exercise equipment); and,
  • how you need it – from weekly supervised care to self-monitored exercise prescription services.

Download our Exercise Therapy Information Sheet to learn more.

8. Ongoing Physician, Therapist and Care Team Support and Monitoring

We are not your typical specialist clinic. We will not leave you wondering, “What is next?” or “Now what?”! We are your fatigue recovery partners. We are in this with you and will continue supporting you as long as you need us. Our team is actively involved in every step of your fatigue care, from your initial screening appointment to your final fatigue-related treatment and through to at least 12 months after your final appointment/treatment. Your fatigue may be unpredictable, but you can count on our team.

Contact us today to discover how Cancer Fatigue Services can help you.

The Cancer Fatigue Services Team