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Extreme fatigue and loss of appetite

Just joined today, excited to be part of this community and hoping for some support!

My Dad (75) has aggressive localized prostate cancer and has had two TURP surgeries. He is now under ADT (hormone therapy) regime with a three-monthly injection. We are now taking care of him at home and have hired a live-in carer.

However, even though he is not in pain, his overall condition has not improved even several weeks after his discharge from hospital. Other patients his age and treatment usually recover more quickly.

The most distressing part of his condition is his extreme fatigue (his own words). He literally can't get out of bed, and needs the nurse to help him use bathe and use the toilet. He is constantly lethargic and sleepy; standing, walking, even talking with people for more than a few minutes is almost impossibly tiring. He has trouble eating anything but small amounts of food. Dad is trying to maintain minimum nutrition levels, which at around 1500kcal/day should stave off any more weight loss - he has already lost 10kgs since his first operation. However, the inactivity is slowly eating away at his muscle mass.

For a former research scientist who has been fiercely independent his whole life, I imagine the loss of function and heavy dependence on others is also taking a heavy toll on his morale. I am trying to get him to agree to a psych exam to see if depresssion is a factor (he is reluctant).

Or, perhaps it's a cortisol deficiency caused by an adrenal abnormality, but his ADT drugs are not the type usually associated with this.

Do you have any suggestions to help us overcome the extreme fatigue, and point to possible treatments?


  • SunshinedaffSunshinedaff Posts: 1,368 ✭✭✭✭✭


    Hi, welcome to our lovely community, so glad you've found us . I am very sorry to hear about your Dad, especially how much he is struggling with the extreme fatigue.

    I saw you had posted on the @Untire_App thread also, I hope you find their response and suggestions helpful.

    I don't have much knowledge regarding prostate cancer and the treatment, however I am sure Rob ( @RobertA ) and others will be able to share some insight with you from going through their own treatments.

    Encouraging your Dad to speak to a Dr regarding his low morale is important. Do you have any other cancer support network around you? In the UK, there is Macmillan Cancer Support, who are brilliant at providing support to families. It may be possible to arrange for some counselling/chat with someone.

    The toll cancer has on our mental health can be extremely devastating. For the large part we concentrate on the physical aspects of dealing with the cancer, and then it is a while later we realise the mental and emotional impact it has caused. It is very distressing for everyone.

    You are most welcome to come and chat here anytime about anything, everyone here is very friendly and supportive.

    Please keep in touch with how your Dad is doing.

    Chat soon,

    Lou x

  • RobertARobertA Posts: 1,262 mod

    @aritokyo @Sunshinedaff

    Hi Aritokyo

    I have written to you on the Untire thread and I hope that you have found some of my own experiences helpful.

    ADT has quite a number of side effects which can include fatigue, loss of muscle mass, weight gain, loss of libido, impotence, osteoporosis and depression. These are huge issues for a man, even at our age (I am 74). I coped pretty well until my radiotherapy was finished and then I just fell into depression. I was lucky because I had a caring and understanding doctor who recommended me to MacMillan Cancer Care. They provided me with a specialist cancer counsellor and slowly but surely, she helped me to find a way through the fog. She has done so much for me and I still see her once a month for a chat.

    I am not suggesting that your Dad is necessarily depressed, but Lou is so right in that whilst the medical people tend to concentrate on our physical wellbeing, we also have mental challenges which need to be supported. Please persuade your Dad to consider this. I used to think it was a weakness to seek help, but in the end I had no choice and it was the best thing I could possibly have done at that time. It helped me to find the energy and strength to keep going and realise that I still have a life to enjoy.

    I am pleased you have found our community. We are all here to help, support and encourage one another and you are so welcome.

    If you or your Dad would like to speak to me privately, I will be pleased to hear from you.


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