I’m 57 and finished 10 rounds of Chemo about eighteen months ago. I continue on my required Lipton injections. PSA remains undetectable but I’m over due for s body scan. Anyway, so far so good.
But over the last 3 months I feel like my brain performance is suffering. I’m significantly less capable of focus. Planning out a slide presentation at work is a ridiculous chore. In parallel my mood swings are very very bad.
At this point, despite being stage 4 and starting this journey in very bad shape - I really had planned on a “business as usual” strategy for my job and lifestyle at LEAST until I become hormone resistant. And in all honesty I really have convinced myself that I had 5+ years until that stage.
But rather suddenly I’m worried about even holding my job for even another 6 months.
Has anyone had this happen to them? Any tips or improvements I can make?
Or has anyone else successfully gotten their MO to sign off on disability for brain fog? I’m otherwise feeling great and PSA is undetectable, so I’m worried he won’t.
If I am fired for performance, I lose out on my company’s extremely generous disability plan.
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BigM62
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vit B12 isn't supposed to be great for prostate cancer but having a B12 deficit can cause harm to one's brain. I take an acid reducer (omeprazole) for GERD so, following Dr Oz's advice, I take a B12 supplement.
I’m specifically worried about LTDI which is disability insurance through my company. But in general SSDI isn’t automatic for stage 4 bone Mets. It requires organ Mets and/or hormonal resistance. Thankfully I’m not in either category. When I DO become hormone resistant, I already plan to go on SSDI.
I'm wondering if your mood swings are not just "in parallel" with your brain fog, but are part and parcel of it.
Depression and demoralization can be big contributors to what we perceive as "brain fog". These things interfere with our ability to concentrate. We start out trying to solve a problem but in a few minutes, or even in a few seconds, we get overwhelmed by thoughts of sickness, death, discouragement, and futility.
Can we overcome this? I think there's a good chance that we can at least partially, and perhaps fully, if we try really, really hard. I suggest that you get yourself a cup of good strong coffee (or whatever you like), pull up your slide presentation, and get to work on it. Make a plan. Write an outline if that helps (it helps me a lot whenever I have to do something too big to think out all at once.) Then get started on the first section. Your mind will wander into other things, maybe negative things. Stop it. Point your finger at your head and tell yourself - Back On Task! If you can get the first part of the task done, maybe an outline and the first few slides, your mood will go way up. You will have proven to yourself that you've still got it! It's going to be harder than it used to be, but you can do it. You've proven that you can do it. Now it's just a matter of more time, more work, and maybe more coffee.
I believe that physical exercise can help a lot - to clear the head, to renew your energy, and to make you feel better about yourself. It's the same with mental work. When you force yourself to do it it clears some of the negative thoughts from your head, renews your concentration and, very importantly, makes you feel better about yourself.
All great advice for condition described. Best of luck to you. I was pulled out of service as a RR engineer until I got meds adjusted and was clear minded again.
Contacted local management and explained problem. Contacted medical department in Texas (working in calif). Corporate Management investigated and found 2 at risk incidents on the 3 tattle tail systems of train. Local management and med. dept. helped me get back to work with close watch stipulations and time off with any medication change. Off about a month and then back to work. Of course corporate management wanted me to retire, but needed med. ins. Retired after 2 mo. back to work after longer time off acct. med condition.
Maybe get a lawyer who specializes in SSDI. They receive a percentage set by law. Quite reasonable with what you have on the line. Was paid out of the back pay for my wife. Her representatives were actually called advocates. Best thing we did. I protested. She persisted. She was right.
I’m 58 . Good job finishing chemo . I’ve yet to have that pleasure.. hope it works well for you . I’m amazed that anyone of us can keep working throughout this nightmare . I couldnt do it. Two years with tubes out of kidneys assured me disability until my three year review that I missed and they dropped me . Saying I was no longer qualified because i have no visible signs of cancer . Good luck getting any doctors to sign anything saying that you’re disabled . Mine did not . Banner corporation would not send me medical records to Sadi even though they offered them good money to do so . I had to get the lady that has been handling my test drug to actually fax my info to Ssdi . Within weeks I was re-instated with back pay . I think if you Had mets to,an organ you are qualified . I had tumors on bladder and shutting down urethra . The young man told “ you’re not qualified anymore . “ he’s is crazy and wrong . Someone above him read my bio and saw my light . Ssdi for me is sub-subsistence living . Without it we would have sunk by now financially . My Doctors look at me and say “ you look great!” They can’t acknowledge my inabilities to function in public or at work . Being happy with less is key ..... I retired a couple years before I found out I had APC . Looking back I had the APC running me down and that’s why I retired ,felt no energy ,probably had low t ,was depressed . Drs said that I had had pc in me for “ Years “ for it to get to that point of shutting me down . If At some point daily life and happiness is more important than money and income then you can quit . Being broke ain’t no joke . Hopefully you have savings or a nest egg so you can retire early . Why wait for a Cr resurgence to retire ? I couldn’t work efficiently at any job that I had ever worked before . I’m running at about 40 % of my original stamina and aptitude. Good luck to you . We are all different . Yet the same .. Take care ..I do understand your predicament .. Peace ..Scott
I had to terminate my employment as a physician due to fatigue and cognitive impairment due to my prostate cancer treatments including ADT, Xtandi, and chemotherapy. I filed a claim which was approved by my disability insurance company and I am now receiving benefits. My physician had no problems with filling out the necessary paperwork. The entire process was rather painless, and was accomplished in approximately two months. Dealing with my own prostate cancer has become a full-time job.
Thank you! This was the info I was looking for. I am an executive so a drop in cognitive functioning and ability to be efficient is very noticeable in a work environment but I’m worried will be determined as subtle by the doc and insurance.
How much time did you spend discussing with your doc before he agreed to sign off? Or was it a single request and he said yes?
I had another periodic check in yesterday and described to my MO my issues. He seemed to take it seriously and ordered a bunch of additional tests for iron and vitamin deficiency. I assume that is a standard first step to seeing if there is any improvement to help me function better without going the route of stopping work when I am still young and (at least at this point) still in my early period before PSA going back up.
Each visit with Dr. Drake I mentioned my fatigue, cognitive impairment, and short term memory loss. I was already on partial disability as I could not maintain my previous workload. When I became castrate resistant and went on chemo, I told him that I could not continue work as a physician. I filed a claim and gave him the necessary paperwork and he returned it in a timely fashion.
Do you feel confident you will regain strength with lessened fatigue at the conclusion of ADT? I am hopeful but uncertain. Last injection after 3 years of Lupron/Casodex 11/19!
You know, there are so many posts on this site that I know I miss valuable information sometimes. But for some reason, I landed on yours and read it. This is exactly where I stand now in terms of having great difficulty at work and the expectations of my performance being lowered. To be honest, I'm looking at the possibility of disability and am just beginning to gather my medical reports for Social Security. This is not where I had planned on being in terms of my health and anticipated recovery. But it is what it is and I'm happy just to be alive and have some options. I wish you luck, my friend!
At least you are aware of the fog - this happens to a lot of patients on ADT. I found that I had to be better organized and deliberately spent a few seconds before taking any actions or decisions.. I SLOWED down my world a bit and felt that things were easier to manage, with the bonus of reduced frustration.
The idea of exercise and sufficient rest is another point, made by others, that I agree with strongly.
I was diagnosed Stage 4 last year this time, at age 52. I was also worried about getting on LTD. Brain fog, fatigue, pain from stress, made it difficult to work and perform at my professional level.
I took the plunge and applied for LTD, had all the paperwork properly signed, by all the various Drs, and LTD was approved.
Similar to many of us here at St4, you have plenty of real medical evidence and reports, scans, X rays, etc. Insurance companies reject claims, due to lack of evidence. You have evidence. At the end, it comes down to your treating Dr. If he is willing to sign the forms, that say you are not able to work, then you should have a very good chance to get approved.
Thank God, my employer had a good benefits plan, and I am very grateful I am on it. I don't need to tell you, that we are on a time crunch life here. Don't wait.
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Cure definition 
help adt off early will cancer grow 
Here is some Hope for you
I’m frustrated (damned if we do and damned if we don’t question doctors)
