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.

Treatment of fatigue

Make sure you get enough sleep.  For example, you may need to sleep an hour longer each night than you are used to.  A 20 minute nap during the afternoon may be helpful.  It may be helpful to cut back on your work hours or cut back on other stressful activities.

Daily exercise can be helpful.  A randomized study instructed men who were receiving prostate radiation to briskly walk for 30 minutes on at least 3 days a week.  These patients used a heart rate monitor to keep their heart rate at 60 – 70% of maximum, i.e. at about 100 – 110 beats per minute for a 60 – 70 year old.  The men who exercised had significantly less fatigue than patients who did not exercise, and it helped prevent the fatigue from developing.  So, try to walk 2 miles at least 3 times a week, starting right from the beginning of your radiation.  If you aren’t able to walk easily then maybe you can get on an exercise bicycle or do some water aerobics.

Eating healthy can also help: more vegetables, more fresh fruit, healthy protein sources like DHA enriched free-range eggs, using olive oil instead of other oils, avoid sugar and soda pop, eat less junk food and less fast food.

Some vitamins and supplements are useful for energy.  A Vitamin-B complex may help.  A multivitamin every day is also a good idea.

There are also some supplements that are specifically designed to make your mitochondria work better and improve your energy level.  Two examples of these are:

• Mitochondrial Energy Optimizer with BioPQQ, by Life Extension Foundation at 1-800-544-4440. Cost is $70 – $95 for a 120 tablet bottle which lasts 1 month.
• Youthful Energy, by Juvenon at 1-800-588-3666.  Cost is $39 – $45 for a 120 tablet bottle which lasts 1 month.

There are also prescription medications that can help, such as Provigil 200mg every morning.  Provigil is also used to help treat the sleepiness from sleep apnea syndrome and narcolepsy, so it may be particularly helpful if you are sleepy.

For more information you can also consult the NCI patient information about fatigue.