Lupron & radiation fatigue. Expectations re when it goes away?

Posted by dicka @dicka, Feb 20 1:59pm

Hi, I received a 4-month's dosage of Lupron few weeks ago and immediately began to experience fatigue (as expected). During my RT simulation, the tech informed me to expect even more fatigue and that it would most likely increase over time (26 daily visits). RT starts next week. I'm not complaining, but hoping to hear from the group - will the fatigue go away after the 4 months' dose loses strength? Or when RT ends? Or...?
So, no complaints yet - just trying to establish expectations. Your experience? Thoughts? Comments? Thanks!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

xahnegrey40 | @xahnegrey40 | Feb 20 3:42pm

my exp with ADT ( Orgovyx/Nubeqa) plus 45 EBRT was occasional fatigue but nothing debilitating...even now, nearly 3 months after ending EBRT, I am still having some fatigue side effects ( I assume from the RT and not so much the Orgovyx) ...it is transient in nature and usually requires just getting up and a bike ride or gym or even a walk seem to cancel it out...

As for Lupron and RT, you may experince a bit more pronounced side effect..I would drink as much water as you can each day and try to stay active and not let the fatigue depress you...it is from the drug combo and you just have to play thru it !

jeff Marchi | @jeffmarc | Feb 20 4:29pm

Some people get fatigue from ADT others don’t. Some people get fatigue from RT others don’t.

I never had any fatigue from either of them. Had 40 sessions of RT and went to work immediately after never noticed it. You are having fewer sessions, which means more radiation each time and that might cause a little bit Of fatigue.

The trick with fatigue from ADT is to exercise. Walking fast, running going to the gym and doing weight training, all of these things can actually reduce your fatigue even though they seem counterproductive. Since you haven’t started RT yet, you should give it a try. While I have never had fatigue, I’ve always been very active so that may have offset it.

Colleen Young, Connect Director | @colleenyoung | Mar 3 5:25pm

@dicka, fatigue is a common side effect of cancer treatments. just because it's common doesn't make it easy. But it might help to know you're not alone.

Like @jeffmarc said, everyone is different. You might appreciate these related discussions:
- Fatigue and radiation https://connect.mayoclinic.org/discussion/fatigue-and-radiation/
- Lupron treatment and Fatigue... https://connect.mayoclinic.org/discussion/lupron-treatment-and-fatigue/
- Fight Fatigue. Mow the lawn https://connect.mayoclinic.org/discussion/fight-fatigue-mow-the-lawn/

See all: https://connect.mayoclinic.org/group/prostate-cancer/

@dicka, how many more radiation sessions do you have left? How are you doing?

dicka | @dicka | Mar 3 8:15pm

Thank you @colleenyoung ! I am in tune with your comments and I'll check out the links.

I have no complaints, but was looking for advice from folks who might have been similarly situated. In fact, I have been following @jeffmarc's and @xahnegrey40's advice. 🙂

I have just completed 5 of 26 sessions and met with my oncologist today. The biggest issue I have is that the RT side effects appear to reinforce some of the ADT side effects - more frequent (and burning) urination, more frequent hot flashes, etc. I'll get there!

A positive note that reinforces the comment that everyone is different: I met a man today who had just completed his 26th session (he was proudly displaying his certificate of achievement). He told me the only side effects he had experienced were "a little bit of fatigue" and some weight gain. Nothing else. 🙂

Thanks again for the comments, links and support! Cheers, Dick

jeff Marchi | @jeffmarc | Mar 4 10:35am

In reply to @dicka "Thank you @colleenyoung ! I am in tune with your comments and I'll check out the..." + (show)

@dicka
It’s the 26th sessions that is what’s causing your problem. They give you more radiation than somebody who has around 40 sessions. That frequently results in the Burning sensation you are feeling while peeing. You might try AZO which is available in the pharmacy without a prescription. It doesn’t work for everybody, but it may work.

The hot flashes really aren’t due to radiation. That’s ADT just getting your testosterone down lower.

I had around eight weeks of IMRT radiation and had absolutely no side effects at all. I know other people that were getting radiation at the same time did have some fatigue, They mentioned they had to sit in their cars before they could drive off after treatment. This was 12 years ago and at that time they didn’t use the higher dosage of radiation with each session.

kujhawk1978 | @kujhawk1978 | Mar 5 8:02am

You asked...will the fatigue go away after the 4 months' dose loses strength? Or when RT ends? Or...?

As others have indicated, most likely your experience may be different than...

In part the side effects of ADT muscle and joint stiffness, fatigue, hot flashes, weight gain, genitalia shrinkage..."go away" when treatment ends and T recovers. When will T recover? That depends, which agent did you use, the duration of the treatment, baseline T when starting treatment, age, health, lifestyle...

The two times I've done ADT my T has recovered in the first 3-6 months, after 18 months of Lupron and later 12 months Orgovyx. In both cases, the fatigue, muscle and joint stiffness went away in the first three months, the hot flashes started subsided in in 3-6 months, the weight gain took 6-12 months to get rid of. I did not experience loss of libido nor depression.

As to the side effects of the radiation treatment, I've done SRT, WPLN and SBRT, so, 69 treatments, 155 Gya, zero side effects. Testimony to the quality of my radiation team and the planning and delivery technology.

Will my experience be yours, only way to find out, finish treatment and see. I, as we all are, am a study of one in this very heterogenous disease.

There is some literature which may indicate that lifestyle may play a role in T recovery, aka, exercise...

Kevin