Prednisone after Proton Therapy and ADT

Posted by ou14mejc @ou14mejc, Sep 5 2:11pm

It's me again! Thanks for all the suggestions with "after effects of ADT and proton therapy" for bowels and bladder. I appreciate all the replies. Now that proton therapy is over, Prednisone has been prescribed to "shrink the prostate" but husband is going for days without sleep since starting the prednisone. Has anyone else had this issue and if so, what did you do to help with sleep? Thanks for all the help. This is a wonderful way to seek suggestions from all of you who have "been there." Prayers for all of you!

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brianjarvis | @brianjarvis | Sep 6 7:22am

I was not given prednisone after my proton radiation treatments. ADT shrank my prostate some; radiation treatments shrank it even more.

Is your husband having urinary issues - is that why he was prescribed prednisone?

copyman | @copyman | Sep 6 7:39am

Check with doctor if Melatonin would be alright to take. This is an all natural supplement to help with sleep.

ou14mejc | @ou14mejc | Sep 6 10:58am

In reply to @copyman "Check with doctor if Melatonin would be alright to take. This is an all natural supplement..." + (show)

@copyman Thanks! He has taken melatonin before, not sure he's taking it now with all his medications. He has a heart condition, so he has to be careful what he takes. I appreciate the response.

ou14mejc | @ou14mejc | Sep 6 11:00am

In reply to @brianjarvis "I was not given prednisone after my proton radiation treatments. ADT shrank my prostate some; radiation..." + (show)

@brianjarvis Yes....His prostate was "very large," according to his urologist. It puts pressure on his bladder, even after proton and of course he is still on ADT. He goes to MD Anderson in November so hopefully, he can get more answers at that time.

swl1956 | @swl1956 | Sep 6 11:15am

I've been taking Orgovyx and Zytiga with Prednisone for over a year and a half. I too have been experiencing insomnia and fatigue which I believe is mainly caused by the Prednisone. I asked to be switched to Nubeqa which does not require Prednisone, but my doctor suggested I stay the course being it's working well and I have only 4 months left to go on my 2 year prescription. You can try taking the Prednisone early in the morning which may help a bit and avoid caffeine as well which has helped me slightly, but likely as long as you're taking Prednisone, insomnia may continue to be an issue. I believe it unusual to use Prednisone alone after radiation therapies unless Zytiga (Abiraterone) is subscribed?

brianjarvis | @brianjarvis | Sep 6 11:55am

In reply to @ou14mejc "@brianjarvis Yes....His prostate was "very large," according to his urologist. It puts pressure on his bladder,..." + (show)

@ou14mejc Has he tried Finasteride?

Jeff Marchi | @jeffmarc | Sep 6 12:28pm

You have asked this question in two different places, Here’s the response I put in another place.

If he is really having sleep problems, the prednisone could be a direct cause. You might ask the doctor to reduce the dosage to help Resolve that problem. Normally people on abiraterone Must have Prednisone because abiraterone Stops the body from producing cortisol, and the prednisone restores the amount that is missing. Without that prednisone, there is a tremendous amount of fatigue.

You don’t mention if he is on abiraterone, So I’m not sure Exactly why your doctor prescribed prednisone.

surftohealth88 | @surftohealth88 | Sep 6 1:38pm

In reply to @jeffmarc "You have asked this question in two different places, Here’s the response I put in another..." + (show)

@jeffmarc

My laywoman guess is to stop post RT inflammation 🤷‍♀️. This patient has a lot of inflammation going on in both regions - urinary tract and his guts : ((((.
Proton can cause the same RT effects as photon - it is all individual as always.

My husband talked to 6 physicists and his RO (they had some conversations that were not related to his RT, they wanted to meet him) and he was told that proton is not that precise as people like to think since it is very hard to determine what actual energy is needed to start the reaction to make proton particle go the EXACT length and stop at the EXACT place since it is very heavy particle and sometimes it stops too soon and sometimes it passes through and stops in wrong place, and so on . Physicists are actually still working on perfecting proton and as of now it has the best results with tumors that are close to surface of the body, etc.

I just want to reiterate once more that I am totally ignorant of this field and this is how I understood explanation of proton particles. Unfortunately there is just NO perfect method and no treatment that does not produce possible SA now or later and it is all so individual .

ou14mejc | @ou14mejc | Sep 6 2:16pm

In reply to @surftohealth88 "@jeffmarc My laywoman guess is to stop post RT inflammation 🤷‍♀️. This patient has a lot..." + (show)

@surftohealth88 Thank you....I'm just frustrated and trying to find help for him.

oldgreenpaint | @oldgreenpaint | Sep 7 8:26am

In reply to @surftohealth88 "@jeffmarc My laywoman guess is to stop post RT inflammation 🤷‍♀️. This patient has a lot..." + (show)

@surftohealth88

I used proton sbrt and have zero bowel issues but very significant urinary tract discomfort that is still improving 9 months after the last treatment. I traveled to a center of excellence for this, and have been somewhat disappointed on how things went and turned out.

My brother stayed local for his photon sbrt, took the Prostox test and it came back favorable for him. Minor urinary discomfort for him. If I had it to do over again, I would nix the COE and stay local.

No help on the prednisone issue. I fortunately avoided that pathway. I can say for certain that my sleep has been deeply disrupted once ADT was started. That ended with last injection in February 2026. I am still not sleeping well and when I notified the oncology team they were not helpful.