Radiotherapy fatigue: My husband had... - Advanced Prostate...

Advanced Prostate Cancer

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Radiotherapy fatigue

JanJames profile image

My husband had radiotherapy for bone mets to his spine recently, apparently it was a lot of radiation even though it was only 5 treatments, his whole spine was treated.

it seems to have worked well in controlling the pain but he is extremely fatigued. he has had radiotherapy in the past which has not affected him as much.

We cannot be sure that it is a reaction to the radiotherapy or something else, does anyone have any experience of this.

15 Replies

Radiation-induced fatigue usually correlates with the number of treatments,and the size of the area covered. Here are some tips for dealing with it:

Calboo profile image
Calboo in reply to Tall_Allen

Great Article on fatigue!

Am on 9th sesion of radiotherapy and fatigue is one of the consequences. Some stomach problems and also get very sleepy sometimes. Docs day it’s from radiotherapy however, also taking Zytiga (abiraterone) with prednisone at same time. These have some pretty undesirable side effects but tolerable. Am 79. If fatigued, rest a lot. You don't realize what fatigue is till you have it. Not the same as just being tired. Grin and bear it!

I had the same treatment. Fatigue was overwhelming at times but I simply dozed or slept when I needed to. A large reclining chair became my best friend. It took about 4-6 weeks to get through it. The pain relief was amazing and well worth the inconvenience of the fatigue.

A friend of mine does a lot of exercise daily. He did swim about four miles before the radiation and did jogging five miles in the evening after the radiation each day. He had no fatigue whatsoever.

So exercise helps. Even Yoga can help against radiation induced fatigue:

in reply to GP24

No fatigue with Rt . That’s amazing!

I had 42 treatments and then 4 years later had 30 more for PCa. I was 63 and 67 years old, but I did have some fatigue. I remember that the X-ray missed it's spot and I my colon released e-coli into my blood stream. I was in sepsis and had to go the the hospital for antibiotic injections. I checked my temperature and it was way over 100. Also with my kidney problems my hemoglobin count went down to 9.6 and so I was given shots of Procrit which brought it up. I was tired with the low hemoglobin. But all is well again! Have a GREAT week and just keep asking questions.

in reply to JimVanHorn

It’s Amazing that you survived that .. wow!

JimVanHorn profile image
JimVanHorn in reply to


Fatigue is normal. Slow down. It’s your body telling you that. I had brachytherapy and 25 sessions of IMRT in 2003. Drink plenty of water and to help with urination, take a Sitz Bath and pee away. Be sure and discuss with your RO.

Gourd Dancer

About the worst thing you can do for radiation-induced fatigue is to slow down or take it easy. The OP had radiation to his spine, not his prostate - so peeing should not be a problem. For someone who has had prostate radiation, fluids should be RESTRICTED.

Complete opposite of my instructions in 2003 is all I can say. Of course that was 15 years ago, and changes happen.

Then again, maybe Mayo has it wrong also.

You incorrectly read Mayo's page - it is about cancer fatigue, not radiation-induced fatigue.

Not only does vigorous exercise fight radiation-induced fatigue, it actually helps the radiation work better during the therapy.

Fluids stimulate the kidneys and cause more urine output. Because the urethra is inflamed by prostate radiation, flow is often restricted. If too much urine accumulates in the bladder, it can burst. Fluids (especially alcohol, caffeine and fruit juices) should be restricted - only drink when you're thirsty. (Of course, this does not apply to spine radiation.)

Tall Allen, we agree on my things dealing with Advanced Prostate Cancer, however, on this we disagree. I am not going to argue with you. I can only tell you what I was told by two Radiation Oncologists and emphasized by their Urological RNs. I will never forget these words. “Do not stop drinking water; no coffee, tea, or anyone other stimulants. Drink water. At least 3 quarts a day. Most people think if they conserve fluids, they will not have frequent urination. This is wrong! It is how you end up in the Emergency Room at 3 am waiting to be catheterized. Take Sitz Baths and pee away in the bath. It won’t hurt you. You will find yourself 3 or four a day in the tub. She sure your waterworks function.

Whether it is radiation or chemotherapy, cancer cells die. Where do they go? The answer is absorbed into the body to be expelled as waste. With a swollen and inflamed prostate, ureter, urinary track not ridding the dead cellular material causes problems.

Further, one difficulty in urinary is constipation and a very full colon. Out of the blue, during my radiation days, my Gastroenterologist also reinforced 3 quarts of water a day. Even today, he will say, constipation is bad, drink 3 quarts of water a day. However, don’t believe me, talk to your Physicians that specialize. I, like others, have given you their experiences and thoughts; however that is no substitute for a solid conversation with your pro.

Just a quick search brought two more links specific to prostate radiation:

Gourd Dancer

LOL@ "I am not going to argue with you." followed by 3 paragraphs of argument. I really don't mind. If you misunderstand this, there are probably others who can benefit from this discussion.

First - I would refer to the two articles YOU cited (which are the same). They both say: "Exercise each day to maintain your strength." That is the point. Not only does it maintain strength, it fights fatigue. I will quote from my article, since you probably didn't read it.

"(2) Exercise. In a small randomized controlled trial, Monga et al. found that an 8-week structured cardiovascular exercise program prevented fatigue, while improving depression, cardiovascular fitness, strength, flexibility and sense of well-being. Hojan et al. found that those high-risk patients randomized to supervised moderate intensity physical exercise had significantly less fatigue compared to controls. Their levels of inflammatory cytokines were lower, as was their functional capacity, blood counts, and quality of life. Steindorf et al. compared outcomes among 160 women undergoing radiation for breast cancer who were randomly assigned to 12-week muscle resistance training or muscle relaxation training. Resistance exercise resulted in significantly lower radiation-induced fatigue and better quality of life. Segal et al. showed that the combination of cardiovascular and resistance exercise in men with prostate cancer decreased fatigue, with longer lasting improvements attributable to resistance training. Windsor et al. found that even moderate walking throughout the duration of EBRT treatments prevented fatigue and improved physical functioning."

As for drinking water when one has prostate radiation therapy - I have heard many RNs tell patients to drink plenty of water. This is just plain wrong. It's important to get info from ROs, not RNs. If your RO did really say that to you, I feel sorry for his patients. patients wind up catheterized in the ER because of urinary retention - having too MUCH water in the bladder, not too little. The danger is that the bladder can rupture, especially with 3 quarts of water a day and restricted flow from urethritis! I don't believe an RO said any of this ( he would have failed basic physiology if he believed any of what you wrote), but I do believe some incompetent RN said this.

Dead cells are solid waste and are primarily excreted in the feces. Patients undergoing prostate radiation are usually told to take a stool softener so they don't strain and make hemorrhoids bleed. You might have been spared a lot of nocturia.

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