Fatigue (Extreme Tiredness)
What causes it: Fatigue is one of the most common symptoms men report with advanced prostate cancer. The cancer itself can cause fatigue through several mechanisms. Cancer cells hijack a lot of your body’s energy and can produce substances that make you feel unwell or tired. Additionally, prostate cancer can induce anemia (low red blood cell counts) if it spreads to the bone marrow or due to chronic illness; anemia reduces the oxygen-carrying capacity of blood and leads to fatigue and weakness. Pain or discomfort from cancer can disrupt sleep, contributing to tiredness. Emotional stress and depression related to cancer can also manifest as fatigue. Often, fatigue in cancer is multifactorial – meaning it’s caused by a combination of physical changes and psychological factors. It’s important to note that cancer-related fatigue is different from just being tired after a long day; it can be more severe and not fully relieved by rest. If you are undergoing treatments like hormone therapy, radiation, or chemo, those treatments further compound fatigue. So a man with advanced prostate cancer might experience fatigue from the cancer itself and from the side effects of treating the cancer – a double whammy. In summary, the cancer’s spread and the body’s fight against it cause a persistent tiredness that is very common in advanced disease
How it affects daily life: Cancer-related fatigue can be profound. You might feel drained from the moment you wake up, even after a full night’s sleep. Unlike normal fatigue, it doesn’t always improve with rest or a cup of coffee. This kind of fatigue can affect your energy levels, motivation, and emotions. You may find you have to cut back on activities or need naps during the day. Tasks that you used to do easily – like taking a walk, doing housework, or even showering and getting dressed – might now take significant effort or require breaks. It can be frustrating to not have the stamina you once did. Some men describe it as a heavy feeling in the body or a constant lack of energy. Because of fatigue, you might withdraw from social activities or hobbies simply because you don’t have the energy to participate. It can also impact your ability to concentrate or think clearly (this overlaps with the “brain fog” we discussed). Importantly, fatigue can have an emotional toll – it’s demoralizing to feel exhausted all the time, and that can feed into feelings of depression or irritability. Also, if you have sudden bouts of fatigue, you need to be careful in situations like driving; fatigue can hit quickly and affect alertness. The impact on daily life is significant, which is why addressing fatigue is a key part of managing advanced cancer.
Ways to manage or reduce it: There are several strategies to cope with fatigue, even if we can’t eliminate it entirely. Medical evaluation: First, let your doctor know about your fatigue. They might investigate treatable contributors – for example, checking your blood counts for anemia (if you’re anemic, treatments like iron supplements, blood transfusions, or drugs like erythropoietin could help). They may also check thyroid function or other labs. Treating pain or depression often helps alleviate fatigue, so managing those conditions is crucial. Energy conservation and planning: Arrange your day to prioritize important activities when you have the most energy. This might mean doing chores or exercise in the morning if that’s when you feel relatively better, and resting later. Use labor-saving devices or ask for help with tasks that are very tiring. It’s perfectly okay to delegate things or accept assistance from family/friends. Rest vs. activity balance: While rest is important, too much rest can actually worsen fatigue over time (due to deconditioning). It’s a balance. Incorporate light to moderate exercise as you are able, because research shows exercise can reduce cancer-related fatigue. Even a short daily walk or some gentle stretching can help maintain your muscle strength and energy. Start small: if you can only manage a 5-minute walk, that’s fine – do 5 minutes today and maybe 6 minutes next week. Listen to your body:If you’re exhausted, it’s okay to take a short nap (20-30 minutes) to recharge. Long naps, however, can interfere with nighttime sleep, so keep them brief. Improve sleep quality: Make sure your night-time sleep is as good as possible. Pain or urinary issues that wake you up should be addressed with proper medications or strategies. Practice good sleep hygiene – a cool, dark, quiet room, and a relaxing routine before bed (avoiding screens and heavy meals late). If hot flashes wake you, consider the strategies in the hot flash section. Nutrition: Eating a well-balanced diet helps combat fatigue. Small, frequent nutritious snacks can keep your energy up. Stay hydrated as well – dehydration can cause fatigue. Mind-body techniques: Some people find that relaxation practices like yoga, meditation, or breathing exercises actually make them feel more energized afterward. It might sound counterintuitive, but these practices can reduce the mental fatigue and stress that add to overall fatigue. Avoid unnecessary strain: This means not over-committing yourself. It’s okay to say no to activities you know will be too draining. Save your energy for what matters most to you. On days when fatigue is overwhelming, give yourself permission to rest.
Encourage physical activity when possible: Being as physically active as you can within your limits is recommended. Engaging in even light exercise can create a positive feedback loop: activity can improve mood and energy slightly, which encourages a bit more activity, and so on. If needed, ask for a referral to a rehabilitation or exercise program for cancer patients – they can tailor safe exercises for you. Support: Sometimes just knowing that fatigue is a common part of cancer can ease the worry (“Is something else wrong with me?”). Talking with others going through similar experiences can also provide new tips.
There’s no one-size-fits-all fix for fatigue, but by combining medical management, lifestyle adjustments, and support, you can often reduce its impact. Keep in mind that fatigue can fluctuate – have patience with yourself on the bad days, and make the most of the better days. With time and treatment of the cancer, some men see their energy improve, especially if therapies like chemo or radiation are completed.