Post radiation exhaustion?

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Regular Member

Date Joined Nov 2009
Total Posts : 212
   Posted 7/30/2010 1:15 PM (GMT -6)   
My father is now about 9 weeks post IMRT treatment (still on Lupron, since Dec. '09). Most everything seems to be looking positive, SP catheter is out and he is peeing normal, blood values (hemaglobin, etc) all look good, PSA .21 at the moment, pain meds are being slowly decreased.

But he does find he gets tired very easy. In particular, the last week+, he is finding he gets completely exhausted, needing to sit down somewhere if he is out running an errand, etc.
Can this still be affects from the treatment? He is a bit depressed at times, so maybe that is contributing to it, but when I talk to him on the phone, its like he's almost too tired to speak...
Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.
Ended IMRT and Chemo (Taxotere) late May
Mid-July - pain finally better controlled with Fentanyl patch
Late July - Superpubic Cath. removed, peeing normal again
July 21 - PSA .21

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 7/30/2010 2:12 PM (GMT -6)   
The fatigue is more likely due to the HT. I took lupron for two years and have been off of it now for 7 months and have much more energy now. Seems to get better every day. The depression can also be a side effect of the lupron due to the suppression of the testosterone. I used to get nausea and diarrhea about two weeks after a shot that lasted for about 5 minutes. I do not know if it was the shot but sure seemed to follow at a regular interval.
I see that your Dad also had chemo. He has put his body through a lot in the last few months so it may take some time for things to improve.
Best of luck to both of you and hope for improvement.
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Two years on Lupron completed 01/2010.
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 were full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones
PSA 05/10 .42 Rising a little as the lupron wears off. Last lupron shot 01/10.
PSA 06/10 .322 Maybe the .42 reported in May was in error?

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/30/2010 2:26 PM (GMT -6)   
Lupron can actually fuel depression or cause such and depending upon the patient can vary some as to side effects and post radiations usually people start recoverying from fatigue probably sooner than this (some might take longer), but could also be the combo of the two. You also added chemo to this therapy that could have a big influence on overall system too.There might be herbs, or drug additives that could boost his fatigue issues, someone else having used such could elaborate. Maybe add D3 vitamin for boosting your system, it is cheap and useful for us patients.

Radiations take time to do all there magic (months and months), I monitored my psa's monthly and at about 9 months out post radiations (includes I did ADT drugs prior and during and after), the lowest psa ever achieved and this is called NADIR psa level in PCa. Important threshold and can even be used as pronosticator to some degree, the lower the better in simplistic terms (undetectable is the goal). So your .21 should still drop is the best guess and should be good to see as a reward for having been put thru the ringer in protocols that we patients end up doing. (Dx-2002)
Youth is wasted on the Young-(W.C. Fields)

Forum Moderator

Date Joined Jan 2010
Total Posts : 7087
   Posted 7/30/2010 2:29 PM (GMT -6)   
My IGRT (post DaVinci, 39 sessions, No HT) left me totally wiped out - at 6 weeks after I still have a lot of fatigue.
Rad. Oncologist says it isn't likely the radiation as much as a really hard year, but more often related to HT. My GP says it is a known and expected side effect he sees in most longer-term radiation patients.

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 7/30/2010 8:37 PM (GMT -6)   
I was on ADT3 and had radiation at the same time. I could not tell for sure which was causing the fatigue however I do know that after my radiation treatments daily I seemed wiped out. I also felt the same fatigue after being on the Lupron Casodex Avodart for a few weeks. I stayed on that course for two years and now that i have been off for a year I have tons of energy again. I think it is most likely a combo of several things causing the issue. I do agree with Bob that Lupron can fuel depression. That is one side effect I never had but I know several men that had a terrible bout with it. Keep us posted often please

peace to you
My PSA at diagnosis was 16.3
age 47 (current)

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
I was on Lupron, Casodex, and Avodart for two years with my last shot March 2009. I am currently (7-22-2010) not on any medication.
My Oncology hospital is The Cancer Treatment Center of America in Zion IL
PSA July of 2007 was 16.4
PSA May of 2008 was.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11
PSA Jan 15th 2010 is .13
PSA April 16th of 2010 is .16
PSA July 22nd of 2010 is .71
Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 7/30/2010 8:58 PM (GMT -6)   
Both radiation episodes in my life thus far has caused chronic fatigue. After I was through with neck/throat radiation 10 years ago, which was pretty gruelling at the time, my radiation and medical oncologist said that if I were to regain 75-80% of my strength after that, I would be doing well. I didnt have any fatigue undergoing the rad at the time, but I was also much younger. about 2 months after it ended, I literally had a physical meltdown, and as it were, the effects of the radiation took hold me in a big way. Ultimately, I went through 6 months of physical therapay, while working full time, and then it was extended another 6 months.

People really react differently to large doses of radiation. I have never been on HT, so I have no opinion of whether its the radiation or the HT or both that is effecting your father.

My most recent radiation (SRT), which ended late last November, is still keeping me in heavy chronic fatigue. That ended 9 months ago, and I still get hard every day around 2-4pm, hits me like a massive invisible wall. The dr. thinks its the whole combined effect on the body, of what I have been through the past 10 years of my life. Each op takes a little more out of me. When I can (if it ever happens) get catheter free, I will still be going to physical therapy, as I am so limited to what kind of physical work or exercise I can do.

I am always amazed at the guys here at HW that say they never felt any thing negative about their radiation treatments, either during or after. I believe them, but
I am always amazed when guys here at HW say they had no effects from radiation. I believe them, of course, but I just don't see how they never feel anything, especially the fatigue part. Its a form of radiation poisoning and it can do a number on your general immune system as well.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19

Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 7/30/2010 11:41 PM (GMT -6)   
I had the fatigue, my Oncologist said it was perfectly normal, had a nap in the afternoon when I was having RT, it will ease off.

Regards Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)
PSA 11th March 09 0.5
PSA 3rd August 09 0.6
PSA 25th November 09 0.6 (I am now 69)
PSA 18th Jan 10 0.6
PSA 27th July 10 0.6
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