Fatigue in prostate cancer survivors treated with definitive radiotherapy and LHRH analogs.
BACKGROUND
Few studies have dealt with chronic fatigue (CF) in definitive radiotherapy (RAD) patients during and after (neo-)adjuvant androgen deprivation therapy (ADT) for prostate cancer.


METHODS
CF was the primary outcome in this population-based cross-sectional study as evaluated by the Fatigue Questionnaire. We compared the post-RAD levels of fatigue in two groups of > or = 1 year prostate cancer survivors; those with ongoing medical castration (HTcont) and those who had used a luteinizing hormone-releasing hormone analog (LHRHa), but had discontinued the therapy at the time of the survey (HTdis). The prevalence of CF and the levels of total fatigue were compared to comparable parameters in men with prostatic RAD who never had had ADT (Control group) and to men > 60 years old from the general population.


RESULTS
After an observation time of median 18 months since start of radiotherapy about 40% of our > or = 1 year prostate cancer survivors from the HTcont group reported CF, as compared to approximately a quarter of men from the HTdis group and, the prevalence of CF in the latter group being similar to that of hormone-naïve RAD controls and males from the general population. After discontinuation of ADT, age 65 years or below was associated with increased risk of CF.


CONCLUSIONS
Pre-counseling of prostate cancer patients starting (neo-)adjuvant LHRHa therapy must include fatigue, mainly physical fatigue, in particular in men aged 65 years or younger. Future studies of testosterone recovery after ADT discontinuation should also include measures of CF.
Kyrdalen
Anne E
AE
National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital, Norway.
Dahl
Alv A
AA
Hernes
Eivor
E
Hem
Einar
E
Fosså
Sophie D
SD
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects*; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010551:Personality; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors; D016896:Treatment Outcome
D000726:Androgen Antagonists