Husband is getting very sleepy after all meals. His sugar is always below 100 when tested, he takes levothyroxine for low thyroid (waiting for over 2 weeks now on latest blood work and TSH results from PCP. *sigh* He's taking a statin (can't remember the name) and Tamsulosin. Current cancer treatment is three month lupron depot. PSA is non-detectable. Scans in July showed old mets healed, and no new ones.
His fatigue is the same whether we eat low carb or not so I haven't been able to find a correlation with food. Last night we had sirloin and a salad and he was out in 10 minutes. He's not dehydrated as he drinks at 64+ ounces of water each afternoon.
Since starting treatment in 2017 (age 56), he's had a hard time getting up in the morning and that seems to be getting worse as well. During the day, he's having a harder time with working after lunch due to the fatigue and when he works from home, often has to take a nap.
He exercises (treadmill) 4-5 times a week. He's talked about doing some sort of weight training but never gets around to it.
More thank likely it's fatigue from cancer/treatments and no way to reverse it. I'm simply researching ideas on how to help him cope.
Thanks in advance for any ideas.
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Union98
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hi union98 ……. Is your husband diagnosed stage4 , and is he taking meds like Xtandi or similar drugs. Maybe you could put more info / history in his bio part of the site for us to get a better picture.
Just offhand and totally IMHO observation based on your info, plus I’m not a medical doctor …
Since he was DXed in 2017 ( a year before me …. myself late in 2018 ) …. He sounds like he has been doing VERY well with his treatment. Very fortunate , this since you say he s working and sometimes from home ….sounds like he is mobile ( not in a wheelchair. ) and everyday functional ( enough to still be working ).
Statins, of course, make many / most somewhat fatigued and , for many, common SEs of Lupron are mild to heavy fatigue, blurry vision, and swollen legs and feet, just to name a few. He IS 7 years older now as well …. just say’in.
Others here say exercise dispels much of the fatigue, elastic bands a good exercise , plus he’s already working and using a treadmill. Some will probably offer suggestions along those lines.
Just my observation, but he sounds like he is doing “ extremely “ well. In the highest , best level , of most guys here with aPCa. . That’s a really good thing . As you pursue ways to lessen his fatigue, if that’s possible, knowing he is doing so well should bolster your feelings considerably. Good luck is good luck. Good for him , and you, for such great results. Herze hoping he can maintain this luck for many years to come.
Big ehug out to both of you. How lucky your husband is to have you on here advocating for him. Lots of love showing there too.
Thank you for your thoughtful, encouraging response. At one point all the details were in the bio but they've since disappeared. *shrug* And yes, he is doing extremely well and we are very grateful. His first year he did lupron, taxotere and started on Zytiga. Third year he went through the Provenge protocol. Summer of 23, due to skin issues from the prednisone, he decided to stop taking Zytiga. His oncologist (who advocated against stopping) was shocked that his PSA didn't start rising. He stopped playing in live cover bands during 2020 and the pandemic and started to learn piano (in addition to his guitar and bass talents). So he keeps busy. My best to you.
Thank you , hubby sounds like my kinda guy. I’ve worked in a late 60s light show ( called headlights , at Titicut Follies club in Berkeley ) and met my current wife of 45 years while working with a dive bar ( crazy horse salon ) band in Central Texas in the late 70s Yayahahahaya. She was getting divorced from our drummer at the time. Yayaha yayay.
If he gets tired of being tired perhaps he’ll lift weights instead of talking about it. I assume he is on some form of ADT? If so, that will take care of it.
I had the same problem, How how I solved it for myself was first cut out all sugar and refined carbs and at meal time always have at least a half a cup of fermented sauerkraut or Kimchi along with digestive enzyme and probiotic capsules along with Tudca. Learned to eat slow and chew more as if my mouth is a blender. lol. Digestion takes a lot of energy. Gut biome is very important factor stated in articles. I also sprinkle Black Papaya Seed powder on my Avacodo or over other food I find it tasteless- Said to be good for digestive system and cancer. Just started taking Gum Mastic( pistacia lentiscus ) articles say has many therapeutic actions including prostate cancer. Now if I fall asleep it's before a meal not after. lol One last thing I do drink Fresh farm organic Kefer not that flavored sugery crap at the store. Not every day maybe 5 oz - 3 times/ week. I slack off for aweek. For me it really get's my digest system moving. I know dairy not good but I find kefer to be of value. Magnesium Citrate at night. Best
two weeks for TSH results? 'd be screaming. I give them 2 days tops. Obviously you know TSH levels will exacerbate the situation. He really needs to be lifting weights. It's critical. Lupron is muscle wasting. There is no way around it. He doesn't have to go all Arnold either. But he should do heavy weights for the largest muscles (Thighs) and if he prefers lighter weights, just do more sets and reps. The point is to do every weight lift set to the point of failure without losing from. In about 12 weeks, he should start to feel better. Also consider asking his PCP to give him a shot of vitamin B12 in the arse once a month. That will help too.
His PCP was very responsive when associated with a group, now he's on his own and won't allow staff to post results to the portal before he has a chance to review them. . .which means they never get posted. I keep asking my husband if I can call them but he hasn't given me permission and it's his ultimately his choice. . . *shrugs* I will try to convince him to think more seriously about the weights. . .and maybe suggest the b12 with the oncologist who is more responsive. Thanks!
"As part of the 21st Century Cures Act, in April 2021, new federal rules went into effect mandating that healthcare providers make all test results and clinical notes immediately available to patients. " In other words, the doctor is violating the law by withholding the information. Certainly his choice but I would find a new PCP. I see all of my scans, test results, everything. This allows me to formulate questions for my doctor before I see him, usually the next day. I will also at times, medical message my docs with what questions I have for the visit. They like that because they can prepare and have answers. Of course in cases like scans or some complex bloodwork, you as a patient need to educate yourself to a near their level as possible, so not to waste your time or theirs but a TSH test? It's either high, low or normal. If your husband doesn't care, then I guess I'd let it go. I hope you get what you need and solve the problem but his extreme tiredness is in no way normal. Perhaps he could try several tiny meals rather than 3 bigger ones.
Hmm. He also has trouble sleeping at night. I believe he might have started taking his tamsulosin earlier in the day to see if it would help with his insomnia and since this is a drug that can cause both drowsiness AND insomnia, it may be he's getting the drowsiness now. I'll mention this to him and see what he things. Thanks!!
Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2
Debra L Barton 1 , Heshan Liu, Shaker R Dakhil, Breanna Linquist, Jeff A Sloan, Craig R Nichols, Travis W McGinn, Philip J Stella, Grant R Seeger, Amit Sood, Charles L Loprinzi
Background: Safe, effective interventions to improve cancer-related fatigue (CRF) are needed because it remains a prevalent, distressing, and activity-limiting symptom. Based on pilot data, a phase III trial was developed to evaluate the efficacy of American ginseng on CRF.
Methods: A multisite, double-blind trial randomized fatigued cancer survivors to 2000mg of American ginseng vs a placebo for 8 weeks. The primary endpoint was the general subscale of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) at 4 weeks. Changes from baseline at 4 and 8 weeks were evaluated between arms by a two-sided, two-sample t test. Toxicities were evaluated by self-report and the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) provider grading.
Results: Three hundred sixty-four participants were enrolled from 40 institutions. Changes from baseline in the general subscale of the MFSI-SF were 14.4 (standard deviation [SD] = 27.1) in the ginseng arm vs 8.2 (SD = 24.8) in the placebo arm at 4 weeks (P = .07). A statistically significant difference was seen at 8 weeks with a change score of 20 (SD = 27) for the ginseng group and 10.3 (SD = 26.1) for the placebo group (P = .003). Greater benefit was reported in patients receiving active cancer treatment vs those who had completed treatment. Toxicities per self-report and CTCAE grading did not differ statistically significantly between arms.
Conclusions: Data support the benefit of American ginseng, 2000mg daily, on CRF over an 8-week period. There were no discernible toxicities associated with the treatment. Studies to increase knowledge to guide the role of ginseng to improve CRF are needed.
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