GREG'S LEGACY

Specialising in the human experience of Living with prostate cancer – warts and all

Posts Tagged ‘Cancer-related fatigue

Cancer And The Domino Health Effects Of Treatment

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Cancer Ribbons

Cancer Ribbons

I have been mentally calculating an audit lately of the personal health effects as a result from my prostate cancer and its treatments. It has become apparent to me, that the results of this audit may make for an interesting article for some readers. What follows is not intended as a “Poor Me” sympathetic seeking diatribe, but rather as a personal example of the domino effect that a cancer diagnosis can have on the health of a patient. I am sure that many long-term cancer patients would also see themselves, and their journey in the same way. My intention in this article is to highlight this issue so that fellow cancer patients, recognise that they are not alone, and to advise new cancer patients of the pitfalls that may await them on their path.

Before I begin, I should point out that prior to the time of my cancer diagnosis, I thought I was a pretty fit soul. I visited and walked Kokoda in 2008 and 2009. I was an avid sailor, diver and fossicker up to my diagnosis, and my previous health apart from skin cancers had been marvellous. In July 2011 I was about to turn a fit and active 64 years of age in September, and I felt bullet proof…….Until late August.

My cancer adventure began in late August 2011 when I experienced urinary problems that lead to my visit to the GP, and then for a PSA test and ultrasound. The results showed a PSA of 4.5 and an enlarged prostate that led to a diagnosis of BPH. (benign prostatic hypoplasia) I was given a prescription for pills to alleviate the urinary pain, and a future date in six months to repeat the tests. I didn’t quite make the six month period as the symptoms became much worse in January and February of 2012. In early March I had my first visit to the urologist, whose examination led to a biopsy; With the results confirming advanced aggressive prostate cancer that threw me into a spin mentally.

I needed to make a choice of treatments available, and through some early research and medical advice decided on, Radiation and Androgen Deprivation Therapy as my primary treatments. I immediately received my first injection of the drug Eligard, that I was to receive every four months for the next two years, plus an oral anti androgen drug taken daily. On the other hand in order to begin my radiation treatments, I first had to attend to my urinary symptoms which involved a surgical procedure carried out in May called a TURP (rebore.) The TURP procedure alleviated the urinary restrictions, but also introduced a series of urinary tract infections that persisted until September 2012. Finally in October I was able to begin the radiation treatment.

So there I was at the end of 2012, having had to cease work with the following health audit results of:

  • Various urinary symptoms, including some incontinence, and infection causing increased frequency, pain, chills and fever.
  • Erectile dysfunction and loss of any sexual libido.
  • Hot and cold flushes, constant mental and physical fatigue.
  • Sleep disturbances and increasing joint stiffness and joint pain.

The following year 2013 found me dealing with the above side effects, and attending to all the medical visits to doctors for blood tests and scans. The year finished with the following health audit:

  • All of the previous years health issues.
  • A new diagnosis of Diabetes type II, which may or may not be attributed to the Androgen Deprivation Therapy but included diet modification and blood monitoring daily.
  • A diagnosis of osteopenia, which is a precursor to osteoporosis or thinning of bone density. This may or may not be attributed to the Androgen Deprivation Therapy.
  • Intermittent urinary bleeding had started late in the year.
  • An instance of mental depression led to mental breakdown with considerations of suicide. This led to several sessions with a counsellor.

Early in 2014 the urinary bleeding events began to worsen, and become more frequent. I had a cystoscopy examination that concluded I had radiation damage to the bladder. In May I began hyperbaric oxygen treatment to treat the radiation cystitis in Townsville General Hospital for two months. Unfortunately this treatment failed, when I was admitted as an emergency with urinary retention, twice during the hyperbaric treatment. The frequency of hospitalisations due to urinary blockages and bleeding increased throughout the year, including several medical procedures to attempt to solve the issue. Finally in November, surgery removed the remains of my prostate gland, lymph nodes and the bladder. Pathology confirmed active cancer cells and tumour were evident in the samples. These had been previously undetected by PSA monitoring. Pathology also confirmed the bladder tissue was quite neucrotic and fragmented. The health audit for 2014 brings us up to date with:

  • Most of the previous two years issues still current.
  • The ill-health and the effects from pain, and mental anguish from instances of urinary bleeding and blockages that required hospitalisations.
  • Uncontrolled urinary incontinence from time to time.
  • The immediate effects of the surgical procedures, and rehabilitation needed.
  • The care and maintenance of the stoma, that was surgically created to replace the bladder function.
Sometimes its the truth

Sometimes its the truth

Looking back over what I have presented here, seems to be pretty much just a summary of events that I have written about in other published articles. That may be the case, but I think it still represents a good example of cancer and the domino effect that cancer causes in a person’s life. When I think about the domino effect, I wonder just how accurate are the mortality rates given for cancer by the statisticians. Could it be that the cause of death in some instances, attributed to conditions other than cancer, be actually a bi-product of the cancer domino effect????? As an example, prior to my surgery in November 2014, I was critically ill with blood loss and urine retention. My doctor at the time, agrees that without surgical intervention I would have died from blood loss by Christmas 2014. If that had been the case, would my death have been registered in statistics as being from my prostate cancer, or from blood loss and urinary retention?????

 

Lee aka Popeye

 

Cancer Fatigue Issues According to Me

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Chronic Fatigue Blues

Chronic Fatigue Blues

In this article I would like to offer some personal views regarding fatigue and cancer. I present this subject here as I believe it is a major issue for any cancer patient. Since my diagnosis in March 2012 (and in hindsight much earlier than then) I had been and still do, experience varying degrees of fatigue over varying periods of time. This personal experience gives me some understanding and experience to be able to discuss fatigue and cancer from my point of view and from other information available.

I bet that if the question was asked of cancer patients ……How do you rate the effects of fatigue on your quality of life???  The replies would almost be a unanimous 10, where 1 would be no effect and 10 the worse. This should not be surprising, as studies have demonstrated that fatigue is a significant issue long into cancer survivorship. Between 70% and 90% of cancer patients will experience cancer fatigue and in some cases prior to diagnosis, then throughout the treatment period and extending into months post treatment. More than 50% of cancer patients will continue to experience fatigue symptoms for many years post curative treatment.

So what is my cancer fatigue like.

Cancer fatigue is very different from the everyday tiredness experienced by most people. I think of cancer fatigue as exhaustion of the body and the mind that is not relieved by sleep or rest. It is caused by both the disease itself when cancer cells produce toxins and by treatments such as drugs, chemotherapy, radiation, surgery and the like. As an example of cancer fatigue I will attempt to give a personal view of my experience with this side effect.

There is an old John Denver song I love that just about sums it all up with the lyrics….”Some days are diamonds….Some days are stones.”  My fatigue comes and goes with just a few warnings of its arrival and no advice as to how long it will stay on each visit. It tends to hang about for at least a day or two but has been known to settle in for a few weeks. Each fatigue event slowly subsides and there begins a period of recuperation from the effects, a bit like climbing out of a hole in the ground. Then sometimes the fatigue will return before you actually get out of the hole and you tumble back down.

I have discovered a few small warning signs that indicate my bad periods. The return of bad disturbed sleep, a weakness in the legs leading to an increasing difficulty climbing stairs or slopes. These always herald the return of cancer fatigue and back down the hole I go.

  • The weakness in the legs slowly spreads to hips, back and arms.
  • My IQ seems to dwindle as I become muddle-headed and forgetful. I find it an effort to even talk and when I do sometimes my speech is slurred.
  • I find I cannot multi-task, I have to concentrate and focus on one thing at a time.
  • I seem to make many mistakes when trying to organise or complete a set task.
  • The time it takes me to complete any task is multiplied by ten from normal .
  • I become clumsy and accident prone.
  • I can become breathless to the point it seems a real effort just to breath.
  • I keep my jacket handy as I can feel cold at odd times even though it is summer and I live in the tropics…….Very strange this one.
  • I can drop off to sleep at the drop of a hat at any time or any angle, doesn’t matter if I am in the car, sitting at the desk, in a shopping centre or entertaining visitors.
  • Everything seems such a huge effort with no relief.
  • Negative thoughts increase and I need to monitor these carefully.
How am I doing today chart

How am I doing today chart

So how do I or you manage this side effect of cancer fatigue

Management is the key word here and part of the answer, is to advise your medical team of the problems and symptoms you may have. Some of the tactics I advise are as follows but please remember I am not a doctor so you should seek medical advice:

  • I wrote a previous article promoting the regular use of citrus juice and pulp mixed with cold water that I use daily. The citrus juices I recommended were lemons and limes. I still hold the view that this has been extremely beneficial to me personally in keeping my energy levels up.
  • Doctors may be able to prescribe drugs to lessen fatigue issues when it is found they are related to a diagnosed causal effect of symptoms, or to lessen the effects of treatment drugs.
  • Stay as active as you can and follow some routine daily exercises such as walking.
  • Practice good nutrition and a balanced diet. Possibly work with a dietician to achieve this.
  • Ask for help in achieving routine chores if you need to.
  • Be flexible and set realistic goals.
  • Shift your focus from thinking about your fatigue, distract yourself and do something else eg listening to music.
  • Consider learning and practicing medication, yoga or tai chi.
A program shutdown

A program shutdown

“Some days are diamonds……Some days are stones……Some times the hard times won’t leave me alone.

Some times the cold wind, blows a chill through my bones……Some days are diamonds……Some days are stones”.

Lee aka Popeye

Further Reading.

http://en.wikipedia.org/wiki/Cancer-related_fatigue

http://www.cancervic.org.au/about-cancer/types-treatments-trials/fatigue_and_cancer

http://www.cancerresearchuk.org/cancer-help/coping-with-cancer/coping-physically/fatigue/what-is-cancer-fatigue

http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/fatigue/fatigue-landing

http://www.irishhealth.com/article.html?id=20944