Prevalence Of Pain Fatigue And Depression
Overall, at the time of the survey, 660 men reported clinically significant cancer-related fatigue, 802 had clinically significant cancer-related pain, and 481 had depression.
Mean scores for the three symptoms were fatigue 24.0 pain 15.4 and depression 4.5 . Mens scores for each pair of symptoms were strongly, and statistically significantly, correlated .
A total of 2879 men completed the pain, fatigue and depression scales and were therefore included in the symptom cluster analysis. Figure 1 demonstrates combinations of pain, fatigue and depression. A total of 1024 men experienced one or more of the symptoms in the cluster. A total of 127 men were affected solely by fatigue, 260 were affected by pain alone, and 150 were affected by only depression. A total of 278 men experienced two symptoms: fatigue and pain, 161 fatigue and depression, 59 and pain and depression, 58 . Two hundred nine men had all three symptoms. Of the men who reported at least one symptom, almost half experienced two or more .
Prevalence of fatigue, pain and depression and combinations of these in prostate cancer survivors, expressed as number of survivors who completed the fatigue, pain or depression scales and number of survivors who experienced at least one of the symptoms
How Can I Manage Fatigue
Generally fatigue will begin to decrease as time progresses. However, some people will have to cope with it for an extended period of time. Here are some tips on managing your fatigue:
- Eat a nutritious diet
- Set realistic goals for what you want to accomplish each day
- What time of day do you have the most energy? Try to schedule high-effort activities during that time
- Try to get eight hours of sleep each night
- Take time to rest during the day as you need
- Try to be physically active, start slowly and work up to a comfortable level
- Ask for and allow others to help you
Causes Of Prostate Cancer Related Fatigue
The following prostate cancer treatments are commonly associated with the onset of prostate cancer fatigue.
Any type of chemotherapy can potentially cause fatigue in patients. However the side effect is more common with the drugs vincristine and cisplatin. Patients often feel fatigued after undergoing several weeks of chemotherapy but this usually varies from patient to patient. Fatigue can last for as little as a few days, or may even persist throughout the course of treatment.
Radiation therapy can cause fatigue that will gradually increase over time regardless of where the treatment site is located. Fatigue usually tends to last several weeks following treatment but can continue for several months to a year even after the treatment has concluded.
Undergoing more than one prostate cancer treatment at the same time will increase your chances of developing fatigue.
Additional contributing factors to fatigue include:
- Chronic or severe pain
- Poor nutrition
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Low Levels Of Red Blood Cells
Cancer and its treatment can affect your bone marrow. The bone marrow is where your body makes red blood cells which carry oxygen around your body.
A lower than normal red blood cell count is called anaemia. Having too few red blood cells means your blood carries less oxygen and you can have:
- shortness of breath
- tiredness and lack of energy
- an increase in heart rate
- chest pain
Managing Fatigue Or Tiredness
The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.
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What Else Can Cause Fatigue
Many other factors can make you feel tired and fatigued if you have cancer. Some of these include:
- not sleeping well at night or sleeping too much during the day
- treatment may be harder for you to cope with especially if you’re elderly
- your tiredness may make it harder for you to concentrate so everything seems more difficult making you feel even more tired
- travelling to and from the hospital for treatment
- having a lot of visitors when you are staying in hospital
- looking after children
- other health problems such as diabetes, problems with your lungs, heart problems and being overweight
You can ask your nurses to tell your visitors that they can only stay with you for a short time. Don’t feel bad if you have to do this. You need a lot of rest and your friends and family will understand.
What Are The Complications Of Cancer Fatigue
Persistent fatigue can interfere with your ability to participate in lifes activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working.
As many as 1 in 4 people with cancer develop depression. Sometimes, its hard to determine if fatigue leads to depression or vice versa.
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Elevation In Inflammation Marker Il
- H. Lee Moffitt Cancer Center & Research Institute
- Researchers are investigating whether inflammation in the body, a side effect of ADT, contributes to these symptoms in prostate cancer patients. They pinpoint a specific inflammation marker that is associated with increased fatigue in this group of patients.
Prostate cancer is one of the most common cancers among men in the U.S. For many patients, hormone therapy is a treatment option. This type of therapy, also called androgen deprivation therapy , reduces the level of testosterone and other androgens in the body. Lowering androgen levels can make prostate cancer cells grow more slowly or shrink tumors over time. However, patients receiving ADT often experience higher levels of fatigue, depression and cognitive impairment.
Moffitt Cancer Center researchers are investigating whether inflammation in the body, a side effect of ADT, contributes to these symptoms in prostate cancer patients. In a new study published in the journal Cancer, they pinpoint a specific inflammation marker that is associated with increased fatigue in this group of patients.
While the groups did not differ at baseline, researchers noticed a significant increase in fatigue and depressive symptoms in the ADT patients over the 12-month period. They also saw an increase in one inflammation marker, IL-6, in this group of patients.
This study was supported by the National Institutes of Health and a Miles for Moffitt Milestone Award.
How Can I Tell If I Have Cancer Fatigue
- Think of your personal energy stores as a “bank.” Deposits and withdrawals have to be made over the course of the day or the week to ensure a balance between energy conservation, restoration and expenditure.
- Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors.
- Be alert to the warning signs of impending cancer fatigue tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety or impatience.
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When Should I Call My Doctor
Although cancer-related fatigue is a common, and often an expected side effect of cancer and its treatments, you should feel free to mention your concerns to your health care providers. Fatigue may be a clue to an underlying medical problem. Other times, there may be treatments to help control some of the causes of fatigue.
Finally, there may be suggestions that are more specific to your situation that would help in combating your fatigue. Be sure to let your doctor or nurse know if you have:
- Increased shortness of breath with minimal exertion
- Uncontrolled pain
Can Sleep Be Improved To Reduce Cancer Fatigue
Sleep is an important part of wellness. Good sleep can improve your mental and physical health. Several factors contribute to how well you sleep, and there are things you can do to improve your sleep, including:
- Doing relaxation exercises, meditation or relaxation yoga before going to sleep.
- Avoiding long afternoon naps.
- Going to bed only when sleepy. Use your bedroom only for sleep and sexual activities.
- Setting a consistent time to lie down and get up.
- Avoiding caffeine and stimulating activities in the evening.
- Establishing a relaxing pre-sleep routine.
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Who Is At Risk For Advanced Prostate Cancer
The exact cause of prostate cancer isnt clear. Your risk of developing this particular cancer increases after you reach age 50.
Certain groups are more likely to develop aggressive forms of prostate cancer, including African-American men and men who carry certain inherited genetic mutations such as BRCA1, BRCA2, and HOXB13.
Most men with prostate cancer dont always have a family history of the disease. But having a father or brother with prostate cancer more than
- PET scans
- bone scans
You probably wont need all of these tests. Your doctor will choose the tests based on your symptoms and physical exam.
If any of the images reveal abnormalities, it doesnt necessarily mean that you have cancer. Additional testing may be necessary. If they find a mass, your doctor will probably order a biopsy.
For a biopsy, your doctor will use a needle to remove samples from the suspicious area. A pathologist will then analyze the removed cells under a microscope to see if theyre cancerous. The pathologist can also determine if you have an aggressive form of prostate cancer.
How To Manage Fatigue When You Have Prostate Cancer
Fatigue for someone who has prostate cancer is much more than just feeling tired and its not something that can be remedied with a good nights sleep. Fatigue can be completely debilitating and many men cite it as one of the worst things about having prostate cancer
Fatigue with prostate cancer is often caused by a combination of elements. Treatments like chemotherapy and radiation therapy can zap energy, coupled with the stress and anxiety of having cancer, its little wonder that many prostate cancer patients suffer from the symptom.
However, its possible to manage fatigue according to Prostate Cancer UK. Ensuring that you try to live as healthily as possible eating well, sleeping well, drinking plenty of water, and gentle exercise can help to lessen the effects of fatigue. Conserving energy when youre feeling fatigued and only doing the bare minimum will help ease feelings of exhaustion.
Planning ahead will help you ensure you dont overload your schedule. Lean on those around you for support and if fatigue is affecting your job, ask your boss if you can work from home or change your hours so youre working at a more suitable time. Prioritize what needs to be done and what can be left or delegated to others. Look for ways to make chores or tasks easier sitting down instead of standing or tackling jobs in segments rather than doing it all at once.
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What To Do If Youre Experiencing Symptoms Of Prostate Cancer
If youre having symptoms that could be a sign of prostate cancer, your healthcare provider can help. They can check for some of the more common causes of these symptoms. And they can help you figure out if you may need more testing. Some testing options include:
PSA testing: This is a screening blood test for prostate cancer.
Rectal exam: This is the best way to feel the prostate gland. A healthcare provider briefly inserts a finger into the rectum to check the size and shape of the prostate. This isnt everyone’s favorite part of a visit to your provider, but its an important part of the prostate exam.
Prostate biopsy: This is a small procedure that collects cells from the prostate for testing. The cells are then analyzed with a microscope to see if they look cancerous.
Imaging studies: An ultrasound or MRI can look for areas of the prostate that might be suspicious for cancer.
Common Symptoms Of Chronic Fatigue
If you suffer from a chronic illness, then its highly likely that youll experience fatigue from time to time. Fatigue is different than just feeling tired, and generally its not something that can be fixed with an early night or by resting for a little while.
With tips from the pros at prevention.com, weve put together a list of six ways that chronic fatigue can affect sufferers on a daily basis.
You feel extremely exhausted.
Everyone experiences feeling tired and worn out from time to time but chronic fatigue takes this a step further. People will often avoid doing things they enjoy because they dont have the energy to go out or even get off the sofa. Getting through a day at work or school will leave them feeling extremely exhausted as though they have gone through their energy reserves and have nothing left.
You cant get a good nights sleep.
You would imagine that fatigue could be solved with sleep, but patients who suffer from chronic fatigue often have trouble falling asleep or wake constantly throughout the night. This lack of sleep only adds to the problem and makes the fatigue worse. Even if you do get to sleep, many find that they dont feel any better when they wake up.
You cant concentrate.
Simple tasks zap your emotional energy.
You cant balance.
Youre constantly in pain.
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How Long Can Fatigue Last
Cancer related fatigue is different from tiredness which is usually short term and you feel better after you stop, sleep or rest. Cancer fatigue doesnt usually go away with sleep or rest. It can be severe and last a long time.
Fatigue can last for different amounts of time depending on whats causing it. Most people start to feel better after treatment finishes. But it can take several weeks or months before you feel like your old self. In some people it may take a lot longer.
Supporting Someone With Fatigue
Supporting a partner, friend or family member with fatigue can be very difficult. There are things that might help.
- Ask your loved one what he feels able to do and support him to do those things.
- Ask what he doesnt feel able to do and look into ways you or other people could help with those things.
- Ask if your loved one would like you to go to hospital appointments with him.
- Learn more about fatigue so you understand what your loved one is going through.
- Look into ways to deal with any feelings you might have about your loved ones fatigue, like feeling frustrated or upset.
- Make sure you get enough rest so that you have enough energy to support him.
- Ask friends and family for help.
- Talk to your doctor for support.
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Neuroendocrine Alterations And Cancer
Hypothalamic-pituitary-adrenal axis dysregulation and fatigue
Alterations in the HPA axis have been proposed as a mechanism underlying cancer-related fatigue, either directly or through effects on inflammatory processes. The HPA axis is an important regulator of cytokine production and has potent anti-inflammatory effects. These effects can occur via alterations in glucocorticoid production and/or decreased sensitivity of the glucocorticoid receptor to hormone ligation. Preliminary evidence suggests alterations in both pathways among patients with cancer-related fatigue. In terms of cortisol production, breast cancer survivors with persistent fatigue show alterations in diurnal cortisol slope, with elevated levels of evening cortisol relative to non-fatigued controls. Fatigued breast cancer survivors also demonstrate blunted cortisol responses to psychological stress that are correlated with elevations in stimulated cytokine production and may underlie elevated inflammatory activity. However, studies have not shown alterations in total daily cortisol production or 24-hour urinary free cortisol in breast cancer survivors with post-treatment fatigue, . In ovarian cancer patients, higher levels of evening cortisol and reduced cortisol variability are associated with fatigue before treatment onset, and normalization of cortisol profiles in the following year is associated with reductions in fatigue.
Autonomic nervous system dysregulation and fatigue
Recurrent Prostate Cancer Symptoms
Prostate cancer that returns after treatment is considered recurrent. When it returns to the area around the prostate, the disease is classified as a local recurrence. If the cancer is found in another part of the body, the recurrent cancer is considered metastatic. If the cancer metastasizes outside the prostate, it most likely develops in bones first. Metastatic prostate cancer most often spreads to the liver, bones and lungs.
After initial treatment for prostate cancer, PSA levels are expected to drop dramatically. The first sign of recurrent prostate cancer may be a rise in the PSA level. Other symptoms of recurrent cancer may depend on whether and where the cancer has spread. Symptoms include:
- Blood in the urine
- Difficulty breathing
Patients should discuss any symptoms with their doctor and ask about scheduling regular PSA tests after treatment.
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What Other Factors Contribute To Fatigue
Several other factors could contribute to fatigue, including:
- Tumor cells compete for nutrients, often at the expense of the normal cells’ growth.
- Decreased nutrition from the side effects of treatments can also cause fatigue.
- Cancer treatments, specifically chemotherapy, can cause reduced blood counts, which may lead to anemia, a blood disorder that occurs when the blood cannot adequately transport oxygen through the body. When tissues don’t get enough oxygen, fatigue can result.
- Medicines used to treat side effects such as nausea, pain, depression, anxiety, and seizures can also cause fatigue.
- Research shows that chronic, severe pain increases fatigue.
- Stress can worsen feelings of fatigue. Stress can result from dealing with the disease and the “unknowns,” as well as from worrying about daily tasks or trying to meet others’ needs.
- Fatigue may result when you try to maintain your normal daily routines and activities during treatments. Modifying your schedule and activities can help conserve energy.
- Depression and fatigue often go hand-in-hand. It may not be clear which started first. One way to sort this out is to try to understand your depressed feelings and how they affect your life. If you are depressed all the time, were depressed before your cancer diagnosis, or are preoccupied with feeling worthless and useless, you may need treatment for depression.