Tuesday, February 7, 2023

Extreme Fatigue After Prostate Removal

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Talking With Your Health Care Team About Fatigue

How long does fatigue last after prostate surgery?

Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:

  • What is most likely causing my fatigue?
  • What should I keep track of and share so we can develop a plan to help me feel better?
  • What types of exercise do you recommend for me?
  • How much rest should I have during the day? How much sleep should I get at night?
  • What food and drinks are best for me?
  • Are there treatments or medicines that could help me feel better?

Side Effects Of Radiation Therapy To Your Prostate

Some people have side effects from radiation therapy. The type and severity of side effects varies from person to person. Your healthcare provider will talk with you about what to expect based on your medical history and specific treatment plan.

This section explains the most common side effects of radiation therapy to the prostate. You may have all, some, or none of these. Most of these side effects will go away several weeks to months after you finish radiation therapy. If you have any of these side effects, your healthcare provider will give you more information and help you manage them.

What Are The Complications Of Cancer Fatigue

Persistent fatigue can interfere with your ability to participate in lifes activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working.

As many as 1 in 4 people with cancer develop depression. Sometimes, its hard to determine if fatigue leads to depression or vice versa.

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Life After Treatment: Alan Weiners Story

When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.

The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.

Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.

I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.

Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.

Prostate Cancer And Fatigue

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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.

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How Long Does Cancer Fatigue Last

Everyones experience with cancer fatigue is unique. For some people, fatigue lasts a few weeks. Others may feel exhausted for years. You may feel better when your cancer treatments stop, but often fatigue lingers.

  • Bone marrow transplants can cause prolonged fatigue that lasts up to a year.
  • Radiation therapy fatigue often gets worse as treatments progress. Fatigue should lessen a few months after you stop treatment.
  • Surgery tends to cause temporary fatigue that goes away after you recover.
  • Systemic treatments can cause fatigue that comes and goes. These treatments include chemotherapy, immunotherapy and targeted therapy. You may be exhausted while taking the medications and feel better during the recovery phase . When treatment resumes, you feel exhausted again. You should have more energy when you finish the treatment.

Impotence After Prostate Surgery

In the past, up to 70 per cent of men who had their whole prostate removed because of cancer had some difficulty achieving an erection afterwards. This is because the prostate lies next to the nerves and blood vessels that are important for erections, and these nerves and vessels can be damaged during the operation. Newer surgical techniques that aim to spare the nerves associated with erectile function have reduced the risk of impotence.

While there is a still a significant risk of erectile dysfunction after prostate surgery, there is often a gradual improvement in erectile function over time. Some men only have short-lived erectile dysfunction and others continue to improve for up to 3 years.

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What You Need To Know About Prostate Surgery

What is prostate surgery for?

The prostate is a gland located underneath the bladder, in front of the rectum. It plays an important role in the part of the male reproductive system that produces fluids that carry sperm.

Surgery for partial or complete removal of the prostate is called a prostatectomy. The most common causes for prostate surgery are prostate cancer and an enlarged prostate, or benign prostatic hyperplasia .

Pretreatment education is the first step to making a decisions about your treatment. All types of prostate surgery can be done with general anesthesia, which puts you to sleep, or spinal anesthesia, which numbs the lower half of your body.

Your doctor will recommend a type of anesthesia based on your situation.

The goal of your surgery is to:

  • cure your condition
  • minimize pain before, during, and after surgery

Read on to learn more about the types of surgery, risks, and recovery.

The goal of prostate surgery also depends on your condition. For example, the goal of prostate cancer surgery is to remove cancerous tissue. The goal of BPH surgery is to remove prostate tissue and restore the normal flow of urine.

What Else Can Cause Fatigue

Urinary Incontinence after Radical Prostatectomy | Prostate Cancer Staging Guide

Many other factors can make you feel tired and fatigued if you have cancer. Some of these include:

  • not sleeping well at night or sleeping too much during the day
  • treatment may be harder for you to cope with especially if you’re elderly
  • your tiredness may make it harder for you to concentrate so everything seems more difficult making you feel even more tired
  • travelling to and from the hospital for treatment
  • having a lot of visitors when you are staying in hospital
  • looking after children
  • other health problems such as diabetes, problems with your lungs, heart problems and being overweight

You can ask your nurses to tell your visitors that they can only stay with you for a short time. Don’t feel bad if you have to do this. You need a lot of rest and your friends and family will understand.

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Questions About Fatigue To Ask Your Doctor Or Nurse

You may find it helpful to keep a note of any questions you have to take to your next appointment.

  • Is my prostate cancer treatment likely to cause fatigue?
  • How long might my fatigue last?
  • What can I do to improve or manage my fatigue?
  • What physical activity is suitable for me?
  • Is there a local support group for men with prostate cancer-related fatigue?
  • How can I access a local exercise programme?
  • What other support is available to me?
  • Who can I speak to for advice about work?

Ways To Manage Fatigue

Tell your health care team if you feel extremely tired and are not able to do your normal activities or are very tired even after resting or sleeping. Keeping track of your levels of energy throughout the day will help your doctor to assess your fatigue. Write down how fatigue affects your daily activities and what makes the fatigue better or worse.

You may be advised to take these and other steps to feel better:

NCI’s Fatigue PDQ® summary has more information on how fatigue is assessed and treated. View the patient or health professional version.

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During Your Radiation Treatments

When its time for your treatment, your radiation therapists will bring you to the treatment room and help you onto the treatment table. Youll be positioned exactly how you were during your simulation. Your radiation therapists will do everything they can to make sure youre comfortable during your treatment. Then, theyll leave the room and start your treatment.

Breathe normally during your treatment, but dont move. Your radiation therapists will be able to see you on a monitor and hear you through an intercom during your whole treatment. Tell them if youre uncomfortable or need help.

Neither you nor your clothes will be radioactive during or after treatment. Its safe for you to be around other people.

Extreme Fatigue After Surgery Heres How To Fix It

Did you ever wonder why you feel so tired and lethargic after surgery? A common misconception is that this is a result of being anesthetized. Surely being artificially put to sleep drains your system and causes tiredness? Surprisingly no extreme fatigue after surgery is the result of other factors including:

Sleep deficit and pre-surgery nerves Blood loss during the procedure Medication administered during surgery Loss of minerals and nutrients during the procedure

As you can see, there is a myriad of reasons. It is therefore important to fix this problem and ensure that you have a quick recovery, with minimal fatigue. In the below sections we look at different ways of combating this problem:

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Considerations When Opting For Surgery

Before agreeing with any surgery, knowing its benefits and risks is vital. It is even more important when the surgery is not urgent, like in the cases of proctectomy.

Thus, one should ask a doctor about various treatment options, prostate surgery recovery, and what to expect after prostate surgery.

Sometimes prostate surgery is one of the options. Thus, it is important to ask a doctor if it would be better to have some watchful waiting.

If one goes for prostate removal, one should know about the benefits, prostate surgery complications, the side effects of living without a prostate, how long prostate cancer surgery is, its impact on sex life, etc.

Additionally, one should inquire about all the surgical options available and consider the risk and benefits of each of the options.

Quite often, doctors may also help in making the decision. Here good communication with a healthcare provider is the key.

Are There Differences Between Orp Lrp And Ralrp

According to a 2010 of different surgery types for prostate cancer, the outcomes for open radical prostatectomy , laparoscopic , and robotic-assisted prostatectomy are not significantly different.

But people who choose LRP and RALRP may experience:

  • less blood loss
  • shorter hospital stay
  • faster recovery time

Also, people who choose RALRP report faster recovery in continence and decreased hospital stay, in comparison to LRP. But the overall outcomes still depend on the surgeons experience and skill.

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How Long Will My Fatigue Last

How long fatigue lasts will vary from person to person. It may get better or worse over time. How long the fatigue lasts will depend on whats causing it.

Fatigue caused by your treatment may improve when you finish treatment. But some men have fatigue that lasts for many months, or sometimes years. And life-long treatment for prostate cancer 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.

Surgery

Some men who have surgery get fatigue for a few weeks afterwards, but it can last for longer.

Radiotherapy

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. Fatigue usually starts to improve several weeks after treatment ends. But it could take up to a year for it get better.

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.

Hormone therapy

Chemotherapy

High-intensity focused ultrasound and cryotherapy

What Is The Cause Of Fatigue And Why Do Men With Prostate Cancer In Particular Suffer From It

Radical prostatectomy or radiotherapy for treatment of prostate cancer

There are three main components that contribute to fatigue: The first is the disease itself and its progression. The second is the psychological well-being, which understandably is impacted by a cancer diagnosis and the accompanying fears and worries. It is normal that a reactive depression can occur, although it can vary. Thirdly, the type of therapy plays a role chemo-therapy, for example, can further negatively impact the functional well-being.

In the case of prostate cancer, a relevant factor is that part of the basic treatment is aimed at lowering testosterone, as this hormone significantly drives the growth of prostate cancer. But testosterone also promotes the production of red blood cells. Now, when men receive hormone treatment for prostate cancer, the lowering of testosterone, often causes anemia, leading to further tiredness and weakness. On top of this basic treatment, other anti-cancer drugs are usually given and some of them can aggravate this fatigue. The exhaustion can considerably impair the quality of life to such an extent that some of the patients discontinue the therapy because of it. However, there are alternatives that usually allow patients to continue their daily lives without being adversely affected by their therapy.

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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.

Dealing With Fatigue At Work

There are laws that protect anyone who has cancer or has had cancer. Even if you no longer have cancer, you are still protected against discrimination.

If you live in England, Scotland or Wales, then the Equality Act protects your rights. If you live in Northern Ireland you have protection under the Disability Discrimination Act.

Under these laws your employer has a duty to make reasonable adjustments to where and how you work, to make sure you get the same chances as the people you work with. For example, a reasonable adjustment could be:

  • giving you time off to go to medical appointments
  • allowing extra breaks if you feel tired
  • changing your job role to remove tasks that cause problems
  • providing suitable toilet facilities.

You can find out more about your rights at work during and after cancer treatment from Macmillan Cancer Support.

What else can help?

If your employer learns more about prostate cancer and its treatment, they might be more understanding. You could show them this website or order our fact sheet, Fatigue and prostate cancer.

Take a look at your company policies and employee handbook. Talk to your occupational health service for advice.

Go to your employer with suggestions about what would help you. For example, taking extra breaks, working from home, flexible hours, or changing your job role or duties for a while.

If you are self-employed or looking for work, you can get more specific information from Macmillan Cancer Support or Disability Rights UK.

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Chronic Fatigue Does Not Need To Be A Given

Always tired, drained, listless this is how many cancer patients feel. This extreme exhaustion, also called fatigue, is particularly common in men with prostate cancer. Three out of four patients with prostate cancer suffer from these symptoms and far too often accept them as a seemingly logical consequence of their disease and the accompanying treatment. We talked to Frank Verholen, Vice President and Head of the Genitourinary Division at Medical Affairs Oncology at Bayer, as to why this should not be the case and what actions can patients take.

Chronic Fatigue In Adult Cancer Survivors

National Advisory Unit on Late Effects after Cancer Treatment

Oslo University Hospital

Kristin Valborg Reinertsen , specialist in oncology and senior consultant. She completed her PhD in 2011 on long-term effects after treatment for breast cancer.

The author has completed the ICMJE form and reports no conflicts of interest.

Regional Advisory Unit for Palliative Care

Oslo University Hospital

Jon Håvard Loge , specialist in psychiatry and in child and adolescent psychiatry. He heads the Regional Advisory Unit for Palliative Care, South-Eastern Norway Regional Health Authority. He is professor II at the Department of Behavioural Sciences in Medicine. He was head of the National Advisory Unit on Late Effects after Cancer Treatment from 2011 to 2014. He has worked with late effects after cancer treatment since the mid 1990s with particular focus on chronic fatigue in cancer survivors.

The author has completed the ICMJE form and reports no conflicts of interest.

Department of General Practice/Family Medicine

Institute of Health and Society

University of Oslo

Mette Brekke , specialist in general practice and professor. She also works as a GP at the Kurbadet group practice, Oslo.

The author has completed the ICMJE form and reports no conflicts of interest.

National Advisory Unit on Late Effects after Cancer Treatment

Oslo University Hospital

Cecilie E. Kiserud , PhD and senior consultant in oncology. She heads the National Advisory Unit on Late Effects after Cancer Treatment.

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