Hubby’s Exhausted

Abiraterone and prednisone can cause this problem. One guy I was working with Would wake up in the morning and have to go back to sleep for three hours because he was so exhausted.

What happens with abiraterone and prednisone Is that the Abbie reduces the cortisol and makes you have a lot of fatigue, The prednisone restores the cortisol. The problem is that Prednisone doesn’t increase cortisol enough for everybody. The recommended dosage of prednisone is 5mg or 10 mg. Some doctors start off with 10 mg but most start with five.

I had the guy I was working with talk to his doctor about increasing his prednisone to 10 mg, The doctor agreed, and a lot of the fatigue problems went away.

I was at an online conference and one of the doctors was talking about his problems with prostate cancer. He was on abiraterone And had a lot of fatigue. He increased his prednisone to 7 1/2 mg and it helped a lot, but in his case, it caused his blood sugar to increase too much and became prediabetic so he had to cut back down.

Most people do not have this problem, but I’ve just mentioned it to make you aware of it.

Ask your doctor about increasing the prednisone, It can really help.

@jeffmarc Excellent- Thank you! Always appreciate your insight!

Everything @jeffmarc wrote, plus some people (like me) just don't react well to steroids. An advantage of moving from Abieraterone to one of the -lutamides is that you no longer need to take Presnisone with it.

@anything4him The problem with prednisone longer than a couple of weeks is that it is producing your cortisol. Therefore your body shuts down production. Any longer term use of prednisone and body has an extremely difficult time restarting cortisol. The additional side effects of prednisone are also hard to ignore. Moon face, tissue paper skin, swollen neck, weight gain, bone density, cholesterol issues, A1C, gastric issues and fatigue. Corticosteroids are the devils tic tac. I would really research what you might get yourself into. I had to take steroids for 6 months due to PMR. Go over to the PMR sections of connect and see all the issues. Google how harmful are corticosteroids. Good place to start.

@northoftheborder Thanks!
Aren’t those meds for when you become resistant to the current ADT meds he’s on?
Currently he’s responding very well to his meds - they’re just a lot to handle. I’ll read back up on that.

@anything4him
I switched to Nubeqa (Darolutamide) After being on Zytiga (abiraterone) for 2 1/2 years. I didn’t fail Zytiga, It just caused too many problems with my heart. Switching to Nubeqa At that point is the optimal time to do it because when zytiga fails to work for you, you are a little less likely to have the lutamide be successful in keeping your PSA down. Switching to Nubeqa In that situation is successful for about 60% of people In keeping their PSA undetectable.

So the thing to do is not stay on Zytiga Too long, Switched over to the lutamides while it is still keeping your PSA suppressed.

It did give me 2 1/2 years more time with an aggressive cancer case.

Here is an article about optical sequencing of the drugs
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30688-6/abstract
cid=c2dca8aa74&mc_eid=99575fc699

Lovely to hear from you again - but not good that hubby is getting tired.
Quite common. I'm full of beans in the morning, but pretty worn out by about 3pm.
But 8pm, I'm shuffling around the house like a pensioner.

Walking is always the best exercise, though - but make sure it's in the morning, before his body realises that he's not 20 anymore.

It's a well-known fact that activities that can exhaust a prostate cancer patient the most include doing the dishes, helping make the bed, hanging out laundry, cooking & clothes shopping.
So make sure he's spared of these damaging activities.

@anything4him

isnt Jeff a great asset here !!!!!!...very knowledgeable about PC and drugs.. MAYO Clinic should give him a stipend for all the good advice he gives here..certainly helped me in my early days of panic and crisis!

@tuckerp Thanks for the info! I will definitely start doing more research and will ask about it at our next Mayo appointment.

@jeffmarc Thank you Jeff! I’ll be reading this tomorrow- or tonight if I can’t sleep haha. Appreciate it!