Here's my clinical history...

I've had three separate radiation treatments:
SRT 39 IMRT 70.2 Gya
WPLN 25 IMRT 45 Gya
SBRT 5x 40 Gya

SRT was done as a monotherapy, the other two in conjunction with ADT, either Lupron or Orgovyx.

I did not experience any fatigue with the SRT, just the hassle with the full bladder requirement those of us wo have done that know so well and the fact that for eight weeks you couldn't take any extended vacations! When my radiation team said not to drink coffee or alcohol because of the bladder irritation, I smiled and said...

The WPLN was in conjunction with Lupron . I had been on Lupron for seven months before I started with the WPLN radiation (that was to allow me to complete the six cycles of chemotherapy and recover). I didn't do any scientific analysis but qualitatively, I did not notice an uptick in fatigue other than what I was already experiencing from the Lupron.

The SBRT and start Orgovyx were pretty much simultaneous in terms of start time. Again, qualitative, not scientific, but I did not experience any fatigue from the radiation and the side effects of Orgovyx though it dropped the T quickly, were slow in coming.

I am not saying no to the fatigue from radiation, just my experience.

Keep in mind my wife says I'm too honery to have anything bother me.

Like you, I exercise frequently, most every day at the gym riding the indoor bike, lifting weights and swimming. If not, riding my bike outside, 25-25 miles, I did that even while on treatments.

Kevin