Proton treatment - fatigue?

[quietcorner]

Partner is 66 and has Gleason 7=4+3. He began ADT 4 months ago, with 1 month Lupron shot, then Orgovyx. Other than having some ADT mild fatigue, generally later getting up in the morning, sleepiness around 3 pm, and going to bed a bit earlier, things have pretty much been the same. No hot flashes or mood swings.

He began proton tx 4 weeks ago, 18 treatments thus far. He is now complaining of an intense, sudden increase in fatigue. Also, muscle, bone, and joint pain, which he hadn't felt just a week ago. He thought it was the flu, but no fever, digestive distress, nothing.

Is this common? We believed proton tx didn't have as many side effects as photon tx, or at least, fatigue didn't begin until after the tx was pretty much complete. Imagine our surprise, when Googling, to learn that yes, fatigue can start after just a few sessions.

If proton tx fatigue was your experience, how long did it take to resolve?

[Tall_Allen]

Yes, radiation-induced fatigue is common"

prostatecancer.news/2017/11...

The only way to deal with it is exercise.

Proton docs oversell it. It seems to have all the same side effects of all other kinds of radiation, and no greater effectiveness.

[quietcorner in reply to Tall_Allen]

Thanks for the article link, super helpful.

I agree, proton docs oversell the therapy and understate the side effects.

[BanjoPicker]

I had a 4-month Eligard shot after two weeks of Bicalutamide. I was dreading the side effects that I had read about on sites like this. I hired a strength coach based on advice from many commentators including Tall_Allen. The low T side effects kicked in about 3 weeks after the Eligard injection. The main side effect was frequent hot flashes. I credit my new obsession with exercise for limiting fatigue. My strength coach was aware of my reason for exercise and tailored a program that was relatively easy to follow and gave me a sense that I was in control of my disease management.

[wilcoxsaw]

I've had 45 proton treatments to the prostate, experienced no fatigue. The many men I've been in contact with experienced little fatigue after protons. In any case, whether the cause be the protons or the ADT, I agree with tall Alan that exercise is the best remedy. One of the more common side effects of ADT is lack of good sleep and insomnia which certainly can cause the issues you describe.

[quietcorner in reply to wilcoxsaw]

Yes--it's been 2 days since I posted, and I just spoke with my husband, who is out of town having therapy. He went to the gym for the first time in 2 weeks, and he says he feels MUCH better.

[j-o-h-n]

Dr. Gaggle, would you please tell me the difference between protons and photons:

As protons travel through the body, most of the energy is reserved and released where the protons stop—in the tumor.

Photons release energy along the entire path they travel. This fundamental difference is what makes proton therapy preferential for certain tumors.

Thank you Doctor. Dec 20, 2019.

Next question Dr. Gaggle, which one goes better with bananas?

The one that begins with the letter P.

Thank you Doctor. Nov 12, 2023.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/12/2023 6:38 PM EST