ADT and Fatigue...

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gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 3/7/2011 8:40 AM (GMT -6)   
For those of you who were on ADT, did you suffer from really bad fatigue? Did it get better when (if..) you went off ADT?

My father's main treatment was IMRT and ADT. His rad treatments ended in May/June 2010. He has been on ADT for about 16 months. Things in general are going well, his PSA went undetectable since this past October (can't seem to get my signature to update...) but he is exhausted all the time. It seems like he has something like ADS (http://www.prostate-cancer.org/education/sidefx/Strum_ADS.html)...

I'm wondering if his doctor should try him on a mild anti-depressant to help with his energy levels...

Thx
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

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/7/2011 10:11 AM (GMT -6)   
Hi Gibson,
 
My HT treatment was similar to your Dad's and I was on the HT for 24 months. The last six months were the worst for me. I had the fatigue and the weight gain in spite of a regular workout routine. Still, it was tolerable. I have been off of the HT now for about 12 months. My strength and endurance returned slowly. Seems it came back as my T levels rose. As for anti depressants and fatigue I do not know if there is a connection. I would suggest mild exercise such as walking a mile a day and maybe some stretching. Seems to do wonders for one's attitude in general.
 
Best to you and your father.
Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3806
   Posted 3/7/2011 10:42 AM (GMT -6)   
fatigue has been an issue for me.  i did nine months on lupron and my last shot was six months ago.  my testosterpone level was 6 last month but it should start rising soon.  and like the other poster said the side effects increased with each shot.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3806
   Posted 3/7/2011 10:43 AM (GMT -6)   
>>I have been off of the HT now for about 12 months. My strength and endurance returned slowly.<<
 
Don have you been able to lose weight?
 
thanx,
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/7/2011 11:02 AM (GMT -6)   
Hi Ed,

So far not successful with getting the weight off. I went from 174 lbs to 194 lbs the last six months of my Lupron. I confess my workouts were not as intense due to the fatigue. I went back to work recently and it entails a lot of travel and that interrupts my work out routine. But I will keep trying.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3806
   Posted 3/7/2011 11:05 AM (GMT -6)   
Don -- do you think you are able to lose weight....you know like before you started HT?  man i want to lose some weight but i'm not going to starve myself just to spin my wheels.
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 3/7/2011 11:08 AM (GMT -6)   
Thanks Don. It sounds like you are indeed similar to my father in terms of the fatigue, timing, etc.
I think he is scheduled to get his last 6 month Lupron shot this May. So hopefully things should slowly start improving energy wise in 2012.
If I am reading your signature correctly, it looks like your PSA has stayed down even after going off ADT. Good to see!
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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3748
   Posted 3/7/2011 11:29 AM (GMT -6)   
When ADT is used as an adjunct to radiation treatment, it's very difficult to choose between the benefit of such treatment and the major side-effects endured by the patient.. Since there is major disagreement as to the benefit, making the choice is that much harder...

They got the first Eligard injection into me without too much of a fight..Getting the second one in will be more difficult..
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/7/2011 12:08 PM (GMT -6)   
Ed, I am doing my best to get the weight off. Getting back into the exercise and trying to eat a little less but not starvation. It seems to be harder to get off than it used to be. But then it seems that way with everything. tongue
 
Gibson, just got a blood draw today and follow up with oncologist next week. Will let you know how it goes. Doc says expect a rise this long after HT.
 
Don

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3806
   Posted 3/7/2011 1:39 PM (GMT -6)   
thanx for the info, Dan.  one more thing:  do you happen to know you testosterone level?
 
thanx again.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/8/2011 8:44 PM (GMT -6)   
Ed,
I have not had it checked in a good while. It nadired below 50. I know a lot of folks here quote 20 as "castration level" but my doc said it was low enough below 50 and that agrees with some other medical papers I have read. The last I checked was about six months after my last Lupron shot (4 month intervals on the Lupron) and it was around 100. I could tell it was rising as my beard was growing again and the hair on my chest was returning. Hair on legs and arms has stayed away for some reason.
 
Don

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 3/8/2011 9:28 PM (GMT -6)   
I had a lot of fatigue in June/July about 9-10 months after I started HT. At that time I had my annual physical and blood tests showed that I was anemic with a low hematocrit. I was given medication to counter this condition and within about a month my strength returned. Since then I have felt more or less normal and don't have any physical issues at this point that I would attribute to HT, except for loss of libido. I also had some bone density loss and was put on Fosamax.

For many years I have done aerobic exercise, including running and cycling, as well as a light routine with weights for strength, and I have continued both moderate aerobic exercise and light strength training while on HT. I have not gained any weight since going on HT, in fact I weigh about ten pounds less today than in August of 2009 when I started.

Sancarlos
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy, 11/2009 + IMRT on Novalis, 45 gy, 3/2010 + ADT3 (Lupron + Casodex+Avodart)

PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0 ; 12/2009 -- 0.56 ; 5/2010 -- 0.15
8/9/2010 -- 0.06 ; 11/2010 -- 0.013; 3/25/2011-- 0.005

Post Edited (Sancarlos) : 3/8/2011 8:34:24 PM (GMT-7)


mgl
Regular Member


Date Joined Feb 2007
Total Posts : 122
   Posted 3/9/2011 6:32 AM (GMT -6)   
been on HT for 5 months , so far no fatigue , but I try to exerise more now than before HT. Time will tell
Toss and turn alot during sleep

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3806
   Posted 3/9/2011 3:20 PM (GMT -6)   
Don -- you know i think my whiskers are getting thicker and i've noticed that i have been thinking about women more.  hmmmmm....could it be cool ?
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/9/2011 8:16 PM (GMT -6)   
Yeah, Ed. I have been having those same thoughts just more bark than bite right now. tongue
 
Don

richard0460
Regular Member


Date Joined Feb 2011
Total Posts : 49
   Posted 3/10/2011 12:41 AM (GMT -6)   
Hi Gib
I just got off Lupron after three months and am still on Casodex and Avodart until March 30 when I get seeds. I found the fatigue went away interestingly enough by doing intense exercise: I started working out 6 days a week one to two hours a day: tennis, weights, walking, cycling and I felt so much more alive, but I still had that awful Lupron malaise feeling which is hard to describe and I had terrible crying spells. What helped the most with the malaise with THC chocolate (marijuana) believe it or nay. He's been off ADT now for almost a year. He may be a candidate for Testosterone Replacement therapy which will definitely make him feel better. Dr. Libowitz has been using this as a cancer suppressor surprisingly with advance PC patients and it makes them feel great. Some get PSA rises but a lot do not. He's at compasssionateoncology.org. Nothing gives back more positive energy than well managed testosterone replacement. I used it before I found I had PC.
Richard
diag Sept 10
ADT
Seeds March
Gl 7 3=4
T1c PSA 4.9
Current PSA .09
T less than 20

gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 3/10/2011 7:05 AM (GMT -6)   
Thanks Richard. My dad has been going to the gym a few times per week, and is also working a bit (consulting), so is keeping active. But yeah, gets that exhaustion and the odd emotional spell. I guess we'll see what happens in 6 - 8 months when the Lupron will be out of his system. As for test. levels, I guess we have to see if they come up on their own, and if not, what his doctor wants him to do.
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
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