“Fatigue from ADT isn’t just about being tired; it’s an all-consuming exhaustion that seeps into your bones and soul.” – Anonymous.
Anyone undergoing ADT can relate to this quote: "There have been times when just going to the bathroom in the morning felt like climbing Mount Everest." Since 2015, I’ve been on what seems to be a relentless journey battling cancer. In 2016, I had my prostate removed, only to face a relapse in 2019. In 2020, I underwent Androgen Deprivation Therapy (ADT) and radiation. By 2023, my condition had progressed to stage IV, and in 2024, additional tumors were discovered, prompting a second, more aggressive round of ADT, including a six-month treatment plan with Lupron. The road has been anything but easy, and I’d like to share my experiences and some insights I’ve gathered along the way.
The Daily Struggles
One of the most challenging aspects of ADT for me has been dealing with severe fatigue. It’s not just the tiredness you feel after a long day; it’s an all-encompassing exhaustion that makes breaking through the inertia seem nearly impossible. Despite being completely worn out, sleep doesn’t come easily. I often find myself tossing and turning until the early hours of the morning, despite heading to bed around 8:30 PM.
I used to be an active person, always busy with projects around the house. Now, I have to pace myself, avoid leaning over too much, and be cautious with heavy lifting to prevent dizziness. Naps, something I never used to need, have become a daily necessity. While the fatigue is significant, it's manageable with the right approach.
This constant fatigue is coupled with nausea, brain fog, and hot flashes. The discomfort of nausea significantly impairs my concentration and cognitive function, making tasks that require mental focus incredibly challenging. One aspect that restricts my movements outside of my house is the fear of sudden nausea or vomiting and not having quick access to a bathroom. I regret the number of social functions I've had to decline because of this.
The brain fog, in particular, has been debilitating, affecting my working memory. It’s frustrating to forget what I was doing in the middle of tasks, like building a gazebo for the backyard. Remembering measurements and steps is a constant challenge, but I've learned to adapt by taking things one step at a time.
Struggling to find the right words in conversation can be difficult, leading to pauses or interruptions. It can be disheartening, but I've learned to be patient with myself and find alternative ways to communicate.
Hot flashes, with their sudden onset, can be uncomfortable and distracting, making it hard to concentrate on tasks. Night sweats disrupt my sleep, adding to the fatigue. The hormonal changes also impact my mood, leading to emotional swings that can be challenging to manage.
Support and Understanding
Thankfully, I’ve been upfront with my friends and family about my physical limitations. Their understanding and support have been invaluable, especially when I need to bow out of activities due to my symptoms. This openness has fostered a deeper sense of empathy and patience in my relationships, something I am incredibly grateful for.
Finding Positivity and Resilience
While the journey with ADT is undeniably tough, I find solace in the knowledge that I’m not alone. The support from my loved ones and the insights from recent studies help me manage my symptoms better and maintain a sense of positivity. Each day brings its own set of challenges, but with resilience and the right support, I’m learning to navigate this difficult path.
I've found that there are things I can do to help with coping, most of which are intuitive and beneficial even when not on ADT.
Fatigue:
Exercise Regularly: Light exercises such as walking, yoga, or resistance training significantly reduce fatigue and increase energy levels. Studies show that both resistance and cardiovascular exercises can help combat fatigue associated with ADT.
Proper Sleep Hygiene: Maintain a regular sleep schedule and create a restful environment to improve sleep quality.
Balanced Diet: Eating nutrient-rich foods, including plenty of fruits, vegetables, and lean proteins, can help sustain energy levels throughout the day.
Nausea:
Small, Frequent Meals: Eating smaller meals more frequently can help manage nausea. Opt for bland, easy-to-digest foods.
Ginger and Peppermint: Consuming ginger or peppermint in teas or candies can soothe the stomach.
Hydration: Drink plenty of fluids to stay hydrated, which can help reduce nausea.
Hot Flashes:
Cool Environment: Keep your living space cool, use fans, and wear lightweight, breathable clothing.
Cold Packs: Applying a cold pack to your neck or wrists can provide immediate relief during a hot flash.
Medications: Medications such as venlafaxine, gabapentin, or oxybutynin have been shown to help manage hot flashes. However, consult your doctor before starting any new medication.
Brain Fog:
Mental Exercises: Engage in activities that stimulate your brain, such as puzzles, reading, or learning new skills.
Routine: Keeping a consistent daily routine can help manage cognitive symptoms.
Adequate Rest: Take regular breaks to rest your mind and avoid overexertion.
By incorporating these strategies into my daily routine, I am beginning to notice a big difference. Although I’m not a fan of walking for its own sake, I’ve turned to resistance training, which has proven quite helpful. I’m starting to regain some muscle mass and endurance. My meals have become more aligned with a Mediterranean diet, which I find delicious and varied. Not wanting to add any more drugs to my system beyond the prescribed meds, I find a cool compress to work wonders. It doesn’t hurt that I have a pool I can jump into to cool down – thank goodness. To address brain fog, I engage in puzzles, solitaire, and rummikub daily. My working memory and short-term memory are gradually improving.
If you’re undergoing ADT or know someone who is, remember that understanding and compassion can make a world of difference. Reach out, share your experiences, and lean on those who care about you. Together, we can face the challenges of cancer treatment and emerge stronger.
References:
1.“Managing the Side Effects of Androgen-Deprivation Therapy” by Dr. Matthew Smith published on February 16, 2010.
2. Tyler F. Stewart, MD, presented “Managing the Side Effects of ADT” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
“Taking Androgen Deprivation Therapy (ADT) for Prostate Cancer “ by Author: Marisa Healy, BSN, RN. https://www.oncolink.org/cancers/prostate/treatments/taking-androgen-deprivation-therapy-adt-for-prostate-cancer
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