Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
How Does Radiotherapy Contribute To Fatigue
The cancer itself may contribute to your sense of fatigue as well. While radiotherapy seeks to eradicate cancer by destroying cancer cells with radiation, it also increases the level of fatigue a person feels.
Lets take a moment to think about how radiation therapy works. A team of experts use technology to provide a lethal dose of radiation to a targeted area of cellular tissue. In those living with cancer, radiation leads to cellular death at the target site. As a result, the immune system responds to repair the damage. In this case, the remnants of cancerous tissues are removed from the body.
Unfortunately, some healthy cells near the target area may also receive this dose of radiation. Although technology has advanced light-years in terms of focusing radiation on a specific area, the destruction of healthy cells will naturally lead to an increase in fatigue. For instance, radiotherapy for prostate cancer may result in fewer healthy cells affected than treatment on another area, such as the lungs.
Now, everyone responds to radiation therapy differently, and the exact type of cancer will affect your sense of tiredness as well. For example, if treatment destroys too many red blood cells, a person may develop anemia. Anemia, as a medical condition, is associated with increased fatigue. Meanwhile, larger cancers, requiring a prolonged dose of radiation, will lead to excessive tiredness too.
Possible Risks And Side Effects Of Brachytherapy
Radiation precautions: If you get permanent brachytherapy, the seeds will give off small amounts of radiation for several weeks or months. Even though the radiation doesnt travel far, your doctor may advise you to stay away from pregnant women and small children during this time. If you plan on traveling, you might want to get a doctors note regarding your treatment, as low levels of radiation can sometimes be picked up by detection systems at airports.
There’s also a small risk that some of the seeds might move . You may be asked to strain your urine for the first week or so to catch any seeds that might come out. You may be asked to take other precautions as well, such as wearing a condom during sex. Be sure to follow any instructions your doctor gives you. There have also been reports of the seeds moving through the bloodstream to other parts of the body, such as the lungs. As far as doctors can tell, this is uncommon and doesnt seem to cause any ill effects.
These precautions arent needed after HDR brachytherapy, because the radiation doesnt stay in the body after treatment.
Bowel problems: Brachytherapy can sometimes irritate the rectum and cause a condition called radiation proctitis. Bowel problems such as rectal pain, burning, and/or diarrhea can occur, but serious long-term problems are uncommon.
To learn more, see the Radiation Therapy section of our website.
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What Have I Learned By Reading This
You learned about:
- How to know if you have fatigue,
- Things you can do to manage your fatigue,
- When to contact your doctor
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.
How Can I Handle Fatigue
The fatigue you feel from cancer and radiation therapy is different from other times you may have felt tired. Itâs an exhaustion that doesnât get better with rest and can keep you from doing the things you normally do, like going to work or spending time with family and friends. It also can seem different from day to day, which makes it hard to plan around it. It can even change how well youâre able to follow your cancer treatment plan.
Let your doctor know if youâre struggling with fatigue. They might be able to help. There are also things you can do to feel better:
- Take care of your health. Be sure youâre taking your medications the way youâre supposed to. Get plenty of rest, be as active as you can, and eat the right foods.
- Work with a counselor or take a class at your cancer treatment center to learn ways to conserve energy, reduce stress, and keep yourself from focusing on the fatigue.
- Save your energy for the activities that are most important to you. Tackle them first when youâre feeling up to it.
- Keep a balance between rest and activities. Too much bed rest can make you more tired. But donât over-schedule your days without giving yourself breaks.
- Ask for help from family and friends. If fatigue is interfering with your job, talk with your boss or HR department and ask about taking some time off from work or making adjustments in your schedule.
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Risk Of Other Health Problems
Evidence suggests that having hormone therapy might increase the chance of developing heart disease, stroke and type-2 diabetes. There is also some research that suggests having hormone therapy can increase your risk of getting blood clots and anaemia. But more research is needed to help us understand the links between these conditions.
Research shows that hormone therapy can cause:
- an increase in weight, particularly around the waist
- an increase in cholesterol levels
- changes in insulin.
Talk to your hospital doctor and GP about how often you should have general health checks. You may be weighed and have your blood pressure checked regularly. You may also have blood tests to check for diabetes and to measure your cholesterol levels. Your GP may suggest you have these checks about every six months. Or you can ask for them yourself at your GP surgery.
If you already have heart problems or diabetes, talk to your doctor before you start hormone therapy. They will work with you to manage these conditions.
While the risk of getting these conditions may be worrying, its important to remember that hormone therapy helps men to live longer by controlling the cancer.
What can help?
A healthy lifestyle can help reduce your risk of heart disease, stroke and type-2 diabetes. This includes:
- eating a healthy diet
Read more about diet and physical activity.
Are There Side Effects Of The Combination Approach
There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects, both of which are common with any radiation treatment given to the prostate. But at MSK, we routinely use sophisticated planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications.
In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation that the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and after a few months dissolves on its own within the body, causing no harm or long-term effects.
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If Youre Having Radiation Therapy To The Pelvis
Radiation therapy to the pelvis can cause side effects such as:
- Bladder problems
- Fertility problems
- Changes in your sex life
You might also have some of the same problems people get from radiation to the abdomen, such as nausea, vomiting, diarrhea, or constipation.
Bladder problems
Radiation to the pelvis can cause problems with urination, including:
- Pain or burning sensations
- Blood in the urine
- An urge to urinate often
Most of these problems get better over time, but radiation therapy can cause longer-term side effects as well:
How To Cope With Digestive Issues
Chemotherapy and radiation therapy can both cause nausea, vomiting and diarrhea. There are several medications, however, that can prevent and alleviate these digestive concerns. Additionally, making certain dietary changes can help ensure that you get the nutrients you need when dealing with digestive issues.
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If Youre Getting Radiation Therapy To The Head Or Neck
People who get radiation to the head and neck might have side effects such as:
- Soreness in the mouth or throat
- Dry mouth
- Jaw stiffness
How to care for your mouth during treatment
If you get radiation therapy to the head or neck, you need to take good care of your teeth, gums, mouth, and throat. Here are some tips that may help you manage mouth problems:
- Avoid spicy and rough foods, such as raw vegetables, dry crackers, and nuts.
- Dont eat or drink very hot or very cold foods or beverages.
- Dont smoke, chew tobacco, or drink alcohol these can make mouth sores worse.
- Stay away from sugary snacks.
- Ask your cancer care team to recommend a good mouthwash. The alcohol in some mouthwashes can dry and irritate mouth tissues.
- Rinse your mouth with warm salt and soda water every 1 to 2 hours as needed.
- Sip cool drinks often throughout the day.
- Eat sugar-free candy or chew gum to help keep your mouth moist.
- Moisten food with gravies and sauces to make it easier to eat.
- Ask your cancer care team about medicines to help treat mouth sores and control pain while eating.
If these measures are not enough, ask your cancer care team for advice. Mouth dryness may be a problem even after treatment is over. If so, talk to your team about what you can do.
How to care for your teeth during treatment
Radiation treatment to your head and neck can increase your chances of getting cavities. This is especially true if you have dry mouth as a result of treatment.
External Beam Radiation Therapy
After completing external beam radiation therapy , urinary and bowel side effects may persist for two to six weeks, but they will improve over time. You may need to continue some medications.
Some patients report continued, though lessening fatigue for several weeks after treatment. Other minor problems may include dry itchy skin, a sensation of heaviness in the perineum, anal and rectal irritation, and flare-up of hemorrhoids. However, patients are usually well enough to continue with normal daily activities.
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What Can You Do To Pump Up Your Energy
Eating well before, during and after treatment is key. Keeping active with an exercise program could also help you improve more quickly. To help you get going, talk to your doctor or care team about having a nutrition and workout plan created that will work just for you.
Below, read more on how each treatment can take its toll.
Hormone Therapy
There are many types of hormone therapy. Depending on which kind you have, and how long youâre on it, the fatigue can vary.
Short term:If youâre on hormone therapy for a few months, you might find the fatigue gets better soon after treatment.
Long term:If youâre on hormone therapy for a while, and the fatigue is hard to deal with, talk to your doctor. You may be able to take a break from therapy if the cancer isnât growing. This break will give you a chance to lessen the fatigue effects and get some relief.
Hormone therapy can also affect your everyday abilities and desire to move around. Itâs important to work through it and stay physically active, to keep up your strength. Proper rest, nutrition and exercise will also be key â according to your doctor or care teamâs guidelines.
Chemotherapy
During chemo, your energy levels will probably be up and down. Your doctor will tell you how many rounds of chemo youâll have, and how many weeks your sessions will last, but fatigue can make this time challenging. As you have more sessions, the fatigue can start to feel worse.
Surgery
Radiation therapy
Immunotherapy
How Long Does It Take To Recover From Radiation Treatment
Theres no doubt radiation therapy can make the difference between life and death for cancer patients, but unfortunately it often comes at a cost.
Radiation therapy is associated with harsh side effects, many of which dont emerge until months or years after treatment. Acute side effects occur and disappear within 14 days of treatment, but long-term effects like bone degeneration, skin ulcers, and bladder irritation take much longer to manifest.
The complications of radiation therapy are frustrating, painful, and often embarrassing, but using ongoing therapy, such as hyperbaric oxygen therapy , can accelerate your radiation therapy recovery in a natural way and stop your symptoms from defining your quality of life.
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Tips For Boosting Or Saving Energy
Taking shortcuts on some things or getting help from other people can help you to feel less tired.
Some research into treating tiredness shows that it is important to balance exercise with resting. The amount you do depends on how much you’re used to exercising. Pick the time of day when you are feeling least tired.
If you’re feeling very tired there are some things you can do to help depending on your circumstances:
- Drink plenty of water.
- Eat a balanced diet.
- Have short naps if you need to.
- If you’re working, see if you can reduce your hours or work from home if possible.
- Ask family and friends for help with things like shopping, housework, gardening, and collecting the children from school.
- Don’t forget to do things that you enjoy this may take your mind off things a bit and make you feel more relaxed.
- Speak to an occupational therapist or social worker if you have problems with your mobility.
- Write a list of shopping and go when the supermarket is not busy or have food delivered.
- Do household tasks sitting down, where possible.
- Play games that you can do sitting or lying down, if you have children. For example, board games, reading books and drawing pictures.
Medicines Other Than Chemotherapy May Add To Fatigue
Patients may take medicines for pain or conditions other than the cancer that cause drowsiness. Opioids, antidepressants, and antihistamines have this side effect. If these medicines are taken at the same time, fatigue may be worse.
Taking opioids over time may lower the amount of sex hormones made in the testicles and ovaries. This can lead to fatigue as well as sexual problems and depression.
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How Can I Combat Cancer Fatigue
The best way to combat fatigue is to treat the underlying cause. Unfortunately, the exact cause may be unknown, or there may be multiple causes. There are treatments to reduce certain causes of cancer fatigue, such as anemia or hypothyroidism. Other causes must be managed on an individual basis.
The following are tips you can use to combat cancer fatigue:
- Conserve energy.
- Manage your stress.
Can Sleep Be Improved To Reduce Cancer Fatigue
Sleep is an important part of wellness. Good sleep can improve your mental and physical health. Several factors contribute to how well you sleep, and there are things you can do to improve your sleep, including:
- Doing relaxation exercises, meditation or relaxation yoga before going to sleep.
- Avoiding long afternoon naps.
- Going to bed only when sleepy. Use your bedroom only for sleep and sexual activities.
- Setting a consistent time to lie down and get up.
- Avoiding caffeine and stimulating activities in the evening.
- Establishing a relaxing pre-sleep routine.
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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.
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.
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