What Will I Learn By Reading This
When you have chemotherapy to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. You will learn:
- What fatigue or tiredness is
- How to know if you have fatigue
- Things you can do to help manage your fatigue
- When to call your doctor
It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.
Cellular Immunity Latent Viral Reactivation And Fatigue
Cancer treatments can cause pronounced and prolonged alterations in the cellular immune system, , which may underlie alterations in inflammatory activity and associated symptoms of fatigue. Our group has documented alterations in T cell populations and myeloid dendritic cells in breast cancer survivors with persistent fatigue that are correlated with inflammatory processes, . Other groups have shown more global changes in the cellular immune system in relation to fatigue, including elevations in leukocyte numbers among fatigued breast cancer survivors, , though these effects have not been consistently replicated. One of the few longitudinal studies in this area found that elevated leukocyte counts in the post-treatment period predicted persistent fatigue over a 2â3 year follow-up in breast cancer survivors.
Another potential explanation for elevated inflammatory processes and fatigue in cancer patients is reactivation of latent herpesviruses, . A recent study conducted with breast cancer patients prior to treatment found that elevated cytomegalovirus antibody titers were associated with a greater likelihood of being fatigued, as well as higher levels of CRP. Cancer treatments such as chemotherapy promote viral reactivation and associated increases in inflammatory markers which may have long-term implications for immune regulation and recovery as well as fatigue and other behavioral symptoms.
Supporting Someone With Fatigue
Supporting a partner, friend or family member with fatigue can be very difficult. There are things that might help.
- Ask your loved one what he feels able to do and support him to do those things.
- Ask what he doesnt feel able to do and look into ways you or other people could help with those things.
- Ask if your loved one would like you to go to hospital appointments with him.
- Learn more about fatigue so you understand what your loved one is going through.
- Look into ways to deal with any feelings you might have about your loved ones fatigue, like feeling frustrated or upset.
- Make sure you get enough rest so that you have enough energy to support him.
- Ask friends and family for help.
- Talk to your doctor for support.
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Prostate Cancer And Fatigue
Men who have been diagnosed with prostate cancer may experience fatigue as a serious side effect of both their prostate cancer and its associated treatments. Physically speaking, being fatigued can leave your body feeling drained, lethargic and weak. It can also adversely affect your energy levels as well as your ability to maintain daily normal function. The specific reason for cancer related fatigue is unknown. However when being treated for prostate cancer your body will undergo a number of physical changes and any one factor by itself or combined can contribute to prostate cancer fatigue.
What Exactly Is Fatigue
Everyone describes it a bit differently. Some men say they are dog-tired, drained or weary all the time. Others say they’re completely knackered and exhausted most of the day.
The key is that fatigue goes beyond occasional tiredness. Itâs like your energy has been completely zapped â making it harder to sleep, work, hang out with friends and family, and get on with everyday life. This feeling of being drained can linger for a long time, sometimes even months or years. Simply just being tired, on the other hand, usually goes away after resting up a bit.
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Genetic Testing For Prostate Cancer
You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.
Seeing A Healthcare Provider For Fatigue
When your chief complaint is fatigue, cancer isn’t likely to be the first thing on your healthcare provider’s mind. Fatigue is related to many other conditions, and your healthcare provider will want to rule out the most common causes first.
This will be accomplished through a physical and routine blood work. Your healthcare provider will likely order a few different blood tests, especially tests to check on your thyroid function.
During your visit, your healthcare provider may ask several questions relating to your quality of life and what factors may contribute to your fatigue. Possible questions include:
- How many hours do you work? Are you stressed at work?
- Have you had any major life changes, such as marriage, birth, or death?
- How often do you exercise?
- Do you sleep well? How much sleep do you get?
- How is your diet?
- Do you have a family history of thyroid disease?
It is important to remember that fatigue is not exclusive to cancer. If you are experiencing fatigue, it may be related to a less serious condition or have a lifestyle cause.
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What Can I Do To Combat Fatigue
The best way to combat fatigue is to treat the underlying medical cause. Unfortunately, the exact cause is often unknown, or there may be multiple causes.
Assessment. Evaluate your level of energy. Think of your personal energy stores as a “bank.” Deposits and withdrawals have to be made over the course of the day or the week to balance the amount of energy you store and the amount you need each day. Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors. Be alert to your personal warning signs of fatigue. These may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.
Energy conservation. You can conserve your energy in several ways. Here are some suggestions:
- Plan ahead and organize your work. Change storage of items to reduce trips or reaching. Delegate tasks when needed.
Other ways to combat fatigue include:
Fatigue From Prostate Radiation
Fatigue occurs in about half the men who undergo radiation therapy for prostate cancer. It is probably related to the body responding to the inflammation in the prostate. Usually it is mild, but in some cases it is moderate or severe and interferes with work and other activities. Fatigue is more common in men who already have some fatigue before they even start radiation. It is also more common and intense in patients who are simultaneously receiving testosterone-reducing hormone therapy injections like Lupron for their cancer.
The fatigue from radiation usually takes a few weeks to start, it may worsen for several weeks, and then level off during the last 3 weeks or so of treatment. The fatigue usually improves and goes away during the first 2 6 weeks after RT has ended. These time frames are quite variable from patient to patient. There are reports of some men that may have some chronic fatigue for months afterwards.
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Important Facts About Prostate Cancer
There are some essential facts about prostate cancer that every male over 60 should know.
- Prostate cancer starts almost silently and so it does not show any indication at the first stage. There is no pain or feeling of obstruction in the beginning.
- The symptom only comes out when the growth of the tumor cause blockage at the urethra.
- The symptoms that we discussed here are not enough to confirm prostate cancer as all these signs are pretty similar in men if there is any non-cancerous growth in the prostate or benign enlargement of the prostate gland. Therefore a proper medical screening is a must under an expert medical advisor.
What Is Prostate Cancer
In prostate cancer, normal cells undergo a transformation in which they not only grow and multiply without normal controls, but they also change in their microscopic appearance and can invade adjacent tissues. Prostate cancer cells form into malignant tumors or masses, which then overwhelm surrounding tissues by invading their space and taking vital oxygen and nutrients. Cancer cells from these tumors can eventually invade remote organs via the bloodstream and the lymphatic system. This process of invading and spreading to other organs is called metastasis. Common metastatic locations where prostate cancer cells may eventually be found include pelvic lymph nodes, and bones. The lungs and the liver may also show deposits of, or metastases from, prostate cancer, but that is less common.
Almost all prostate cancers arise from the glandular cells in the prostate. Cancer arising from a glandular cell in any organ in the body is known as adenocarcinoma. Therefore, the most common type of prostate cancer is an adenocarcinoma. The most common non-adenocarcinoma is transitional cell carcinoma. Other rare types include small cell carcinoma and sarcoma of the prostate.
Older men commonly have an enlarged prostate, caused by a benign condition called benign prostatic hyperplasia . Prostate gland cells simply keep growing in number in the prostate gland in BPH. BPH can cause urinary symptoms but is not a form of prostate cancer .
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What Other Factors Contribute To Fatigue
Several other factors could contribute to fatigue, including:
- Tumor cells compete for nutrients, often at the expense of the normal cells’ growth.
- Decreased nutrition from the side effects of treatments can also cause fatigue.
- Cancer treatments, specifically chemotherapy, can cause reduced blood counts, which may lead to anemia, a blood disorder that occurs when the blood cannot adequately transport oxygen through the body. When tissues don’t get enough oxygen, fatigue can result.
- Medicines used to treat side effects such as nausea, pain, depression, anxiety, and seizures can also cause fatigue.
- Research shows that chronic, severe pain increases fatigue.
- Stress can worsen feelings of fatigue. Stress can result from dealing with the disease and the “unknowns,” as well as from worrying about daily tasks or trying to meet others’ needs.
- Fatigue may result when you try to maintain your normal daily routines and activities during treatments. Modifying your schedule and activities can help conserve energy.
- Depression and fatigue often go hand-in-hand. It may not be clear which started first. One way to sort this out is to try to understand your depressed feelings and how they affect your life. If you are depressed all the time, were depressed before your cancer diagnosis, or are preoccupied with feeling worthless and useless, you may need treatment for depression.
How Long Will My Fatigue Last
How long fatigue lasts will vary from man to man. It may get better or worse over time. How long the fatigue lasts will depend on whats causing it.
If your fatigue is caused by your treatment, it may improve when you finish treatment. But some men have fatigue that lasts for many months, or sometimes years. If you have life-long treatment for prostate cancer, this can cause long-term fatigue. Keeping active during treatment might help your fatigue to improve more quickly.
How long the fatigue lasts will also depend on the type of treatment youve had.
Some men who have surgery get fatigue for a few weeks afterwards, but it can last for longer.
If youre having radiotherapy to treat your cancer, you may have external beam radiotherapy, or a type of internal radiotherapy called brachytherapy. Both types of radiotherapy can cause similar levels of fatigue. Men on radiotherapy often find that their fatigue gets worse over time, and sometimes doesnt start until after their radiotherapy has finished. Some men find that their fatigue improves when their treatment finishes, but for others, it can last for several months.
If your cancer has spread from your prostate to other parts of your body , you may be offered a short course of radiotherapy for advanced prostate cancer to treat symptoms such as pain. Your fatigue may be worse for a week or two after your treatment finishes.
High-intensity focused ultrasound and cryotherapy
How Can I Manage Fatigue
Generally fatigue will begin to decrease as time progresses. However, some people will have to cope with it for an extended period of time. Here are some tips on managing your fatigue:
- Eat a nutritious diet
- Set realistic goals for what you want to accomplish each day
- What time of day do you have the most energy? Try to schedule high-effort activities during that time
- Try to get eight hours of sleep each night
- Take time to rest during the day as you need
- Try to be physically active, start slowly and work up to a comfortable level
- Ask for and allow others to help you
Symptoms Of Prostate Cancer
Prostate cancer may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the tumour grows and causes changes in the body such as changes in bladder habits. Other health conditions can cause the same symptoms as prostate cancer.
The signs or symptoms of prostate cancer include:
- more frequent urination , especially at night
- a strong or sudden urge to urinate
- difficulty starting the flow of urine
- weak or slow urine stream
- interrupted urine stream
- being unable to empty the bladder completely
- having difficulty controlling the bladder , which can cause urine to leak and dribble
- blood in the urine or semen
- burning or pain during urination
- discomfort or pain when sitting, caused by an enlarged prostate
- painful ejaculation
- trouble getting an erection
- pain or stiffness in back, hips or pelvis that doesn’t go away
In rare cases, prostate cancer can cause paraneoplasticsyndrome. This is a group of symptoms including high blood pressure, fatigueand weight loss that may happen when substances released by cancer cellsdisrupt the normal function of nearby or distant organs or tissues.
In some cases, prostate cancer can cause serious problems.These cancer-related emergencies are uncommon but need to be treated right awayand are usually a sign of advanced cancer:
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Individual And Mean Change In Evening And Morning Fatigue
The first HLM analyses examined how evening and morning levels of fatigue changed from the time of the simulation visit to four months after the completion of RT. Two models were estimated in which the function of time was linear and quadratic. For both evening fatigue and morning fatigue , the goodness-of-fit tests of the deviance between the linear and quadratic models indicated that a quadratic model fit the data significantly better than a linear model .
The estimates of the quadratic change model are presented in . Because the model had no covariates , the intercept represents the estimated amount of evening fatigue at the time of the simulation visit. The estimated linear rate of change in evening fatigue, for each additional week, was 0.078 and the estimated quadratic rate of change per week was 0.003 . It is important to remember that it is the weighted combination of the linear and quadratic terms that define each curve. displays the trajectory for evening fatigue from the time of the simulation visit to four months after the completion of RT. Evening fatigue increased over the course of RT and then declined after the completion of RT. It should be noted that the mean fatigue scores for the various groups depicted in all of the figures are estimated or predicted means based on the HLM analyses.
Trajectories of evening and morning fatigue over the 25 weeks of the study.
What Should I Do If I Have Prostate Cancer Symptoms
If you are displaying one or more signs of prostate cancer, be sure to promptly consult with a physician. Even benign prostate conditions like prostate enlargement warrant timely medical attention, so dont delay seeking treatment. And, like most other malignancies, prostate cancer is usually more easily treated when it is detected at an early stage.
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Worried About Having A Dre
Its natural to feel worried or embarrassed about having tests, but some men find the idea of having a DRE upsetting. For example, if youve been sexually abused as a child or an adult, you might feel very upset about having this test. Theres no right or wrong way to feel about this, and it is your choice whether or not you have tests for prostate cancer.
It might be helpful to talk to a counsellor about your experience, thoughts and fears. Or you could contact a charity for people whove been sexually abused, such as the National Association for People Abused in Childhood or SurvivorsUK. If you do decide to have a DRE, explain your situation to your doctor as they can talk through the test with you and help to reassure you.
When I had the DRE I thought, For a few seconds of discomfort, I can live with it. Yeah its uncomfortable, but it could save your life. A personal experience