My Dad had another small PSA increase from 0.029 to 0.031. He has two small spots on L2 and T8. He finished Provenge 2 months ago. Recently he started experiencing extremely tiredness, he is walking very slowly and can’t do many of the activities he used to. I never seen my dad crying before but now he tears many days telling me that he doesn’t feel well and can’t do anything. Is this tiredness caused by 3.5 years of Abi, Prednisone and Lupron? He has been taking this same treatment all this time and never complained about any side effects ever. Why all of the sudden such a severe tiredness and mobility issues? Or is it caused by the two new spots on his spine? Are there any pills that he can take to help him have more energy and a better life? Any advice is greatly appreciated. Thank you so much.
Extremely tiredness : My Dad had... - Advanced Prostate...
Extremely tiredness
Fatigue, depression and muscle loss are common side effects. I am sorry to say that but exercise is much better than any drugs.
I’m in the same boat …. 6.25 years of lupron - xtandi and I could barely lift my head sometimes. Way too tired , too sleepy, too exhausted. Started sleeping 16-18 hours a day.
My oncologist put me on an estrogen transdermal patch and it perked me up considerably. You could say dramatically even. Estrogen can be hard to get from a lot of doctors …..mine included. But after I was about to enter a narcoleptic trance they figured “ what could it hurt ? “ . Like everything else in our aPCa 4b world , estrogen has negative things as well , even bigger boobs, more “ additional weight gain ( than even ADT ) , moody, extremely sore / painful touch sensitivity to nipples, more. This is something to give some thought and talk it over with your oncologist/ palliative care team. For me it is well worth it ….. being awake / alert is a blessing.
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Thanh you so much for your reply, sorry you had to go through same issues, glad to hear that estrogen made a difference, I will inquire about it. Thank you again.
Estrogen made a mild / modest improvement in me, other guys on here rave about using it and get much better results than I’m getting. They are taking larger daily amounts than I am as well. It’ll all depend upon your particular doctors .
You are a great advocate for your father , he is lucky to have you in there helping him.
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Hello, I've just read up about your dad, I see that he is about 4 years into the treatment. I'm just wondering if he is at a point many of us reach, before we pick back up again. Unfortunately the symptoms you describe are not uncommon, is he at his lowest point just before his Lupron jab ? For me, even now I fade rapidly about a week before I am due the jab.
Gentle exercise to begin with is always good for the head, a walk in the fresh air, then gradually the stamina will increase.
I hope he picks up, his PSA is still very low.
I wish you well.
Yes , imho, nice addition. Definitely an important aspect to consider as well.
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I am sorry to hear of his problems. There is a wide differential diagnosis here and his symptoms may or may not be related to PCa. A full assessment is needed.
Has a doctor taken a fresh history from him about the recent deterioration and undertaken a full physical examination including neurological exam and cognitive tests? If not these should be done.
Has he had basic blood checks done? These include liver function, full blood count, renal function, CK (muscle enzyme), thyroid function (TSH) for under active thyroid, HbA1c and fasting blood glucose, urine check for proteinuria.
Next, has the possibility of a depressive illness or early dementia been considered? Depending on the initial assessment, his doctor(s) may need to undertake a mental and cognitive health examination.
I hope this helps to get you started.
Thank you so much, all these are great points, we are having a full examination appointment tomorrow. Thank you again.
Shows that even on Lupron, a small PSA can be accompanied by metastases. I had a spine met for years that I eliminated with heat while on Lupron and lycopene, also PSA <0.06. Apply very hot shower to the pain spots, and try heat pad. Also tomato juice frequently. As for energy, I drink coffee.
That's very interesting about hot shower or heat pad , I do the same thing and it calms down the pain. I read heat can kill cancer cells.
Thank you so much.
Sorry to hear. Fatigue is the most common side effect of these drugs, particularly Lupron and others of its class. Exercise is indeed the best remedy, but of course the trick is to overcome the overwhelming need to sleep and sit. Also accompanying depression, for which there are some options for of course.
Exercise is truly the medicine for this though. Like so many challenges, testosterone suppression side effects are best met by going straight at them with exactly what we want least to do.
However, the turnaround can be stunning. Even a little goes a long way. A trainer or other professional can really help also, if it’s practical for you. Great luck to you both!
The triple shot of abi, Prednisone and Lupron is a lot for body and mind to handle. 3 years is a long time to be on those meds. The side effects are brutal already they were for me when I was on all 3 for 16 months.
you have not included your dads age which would help me make some suggestions. I notice you are treating the psa and not the symptoms. If he has bone mets he is treatable but not incurable. I like some others treat the symptoms and not the progression. Example, my psa climbed from 1 to 9 in about a year and local oncologist says I need chemo. I still have my prostate intact so my numbers may run a little higher. I feel great, very minimal side effects from adt but I suspect that could be from supplements I take to mitigate the side effects af adt. I won’t risk going from what I have now to possibly chemo induced neuropathy to lower my psa. Now if pain shows up that will be different because pain is a powerfull motivator. What I am saying is that all we can do is manage quality of life as we can do nothing to cure this disease and I am more interested in how well I live not how long I live. I have 3 doctors on my team to treat my cancer, two understand what I am sating and one doesn’t which is why second and third opinions are important. Your father should feel incredibly blessed to have you advocating for him. I pray that you will find the answers to help him live a good life. If you are interested you can research curcumin, berberine, magnesium and gut dysbiosis on prostate cancer treatment as well as how they effect the individual side effects of adt. You can also research how prednisone with abi doesn’t actually fight the cancer and in time can actually fuel the cancer. It purpose is to mitigate the side effects of abi which in most cases can be done with individual drugs. I say most cases because that is what the studies have shown. Forgive me for not using paragraphs, It is just that I know it drives some people crazy and I just can’t help myself. Gos bless.
No paragraphs? Oiiii that's driving me crazy....
Good Luck, Good Health and Good Humor.
j-o-h-n
Driving you crazy? I think that ship left port long ago.lol God bless.
No, not at all, thank you for all the info, I really appreciate it God Bless🙏
Yep on the "Motor Vessel", MV Doña Paz Ferry on December 20, 1987 and definitely could use a God Bless.
Good Luck, Good Health and Good Humor.
j-o-h-n
Thank you so much for all the info provided. Very helpful, thank you again.
Agree with all the other posts... exercise, rule out things unrelated to PCa. When I was on Lupron, Ritalin helped considerably with mental acuity and motivation to exercise. This was the trial that sent me down that path: clinicaltrials.gov/study/NC...
Thank you, I will look into Ritalin
You could question the taking of 5 mg prednisone twice a day. The recommended dose for castration-sensitive patients is 5 mg prednisone once a day. See:
dailymed.nlm.nih.gov/dailym...
Thank you, he already is on 5mg Prednisone twice daily.
Your dad's PSA is very low, so his response to abi and Lupron shows he is castration-sensitive. This means he need take only 5 mg a day of prednisone, according to the information sheet I linked to above.
You may want to research switching to dexamethasone. Prednisone can begin to fuel cancer after a while. My MO just switched me after a second opinion fron Sam Denmeade at JHUH. God bless.
This is what I was thinking to do, it’s a minor switch from Prednisone to Dexamethasone, but maybe it would help. I heard it’s only helping for short time but I will take anything. Thank you.
Some people get no benefit and some can get quite a bit of benefit. We won’t. Know unless we try. I do feel that the switch may be making it harder for me to fall asleep at night. D has a much longer half life than P.
Thank you
My question too...... how old is your dear Dad?
Keep posting!!!
Good Luck, Good Health and Good Humor.
j-o-h-n
Hi John, always love your posts, my dear dad is 87.
Simonspo, I’m also was wondering your fathers age, the bio does not say . I’m soon to be 83 and age and fatigue do add a factor. In my opinion, I fight fatigue by forcing my self to exercise ,do chores, keep moving, it works. Go to a pain doctor if necessary but don’t let him give up.
Husband getting extremely tired on Zytiga
low hemoglobin
Psa down on no intervention 
Oligometastatic PCa
