Feeling fatigued after prostate cancer treatment

Have you been feeling downright exhausted or tired? Mentally, physically, spiritually? That’s probably fatigue talking.

What exactly
is fatigue?

Everyone describes it a bit differently. Some tāne say they are, drained or weary all the time. Others say they're completely exhausted most of the day.

The key difference is that fatigue goes beyond occasional tiredness. It’s like your energy has been completely zapped — making it harder to sleep, work or hang out with friends and whānau.
Fatigue can have a draining impact on with everyday life. It's not usually the kind of sleepiness that you can push through by getting a good night of sleep, or with a cup of coffee. This feeling of being drained can linger for a long time, sometimes even months or years. Simply just being tired, on the other hand, usually goes away after resting up a bit.

People describe this type of fatigue as ‘whole-body tiredness’.

How common is fatigue during prostate cancer?

Almost everyone diagnosed with cancer experiences fatigue, as cancer itself is a lot on the body. Fatigue is so common, that about 3 in 4 tāne with prostate cancer go through it.

What causes excessive tiredness?

It’s tricky because a number of things can bring on fatigue when you're going through prostate cancer treatment.

For example, it’s common to feel quite worn down due to:

  • not having enough sleep or rest

  • eating poorly and not getting the right amount of exercise

  • stress, anxiety or depression

  • aches and pains from treatment

  • body or hormonal changes from treatment

Take time to listen to your body and better understand where your exhaustion may be coming from. Work with your doctor or care team to understand what you can expect before, during and after treatment and how to best manage your energy supply going forward.

How do certain prostate cancer
treatments bring on fatigue?

Treatment can have a large impact on your tinana and hinengaro, and just might be the reason why you feel exhausted.

All prostate cancer treatments can cause fatigue, but some can make it worse:

  • chemotherapy

  • hormone therapy

  • radiation therapy

  • more than one treatment at the same time

What can you do to
pump up your energy?

Eating well before, during and after treatment is key. Keeping active with an exercise program could also help improve your energy levels more quickly. To help you get going, talk to your doctor or care team about having a nutrition and workout plan created that will work just for you.

Below, read more on how each treatment can take its toll.

Hormone Therapy

There are many types of hormone therapy. Depending on which kind you have, and how long you’re on it, the fatigue can vary.

Short term:
If you’re on hormone therapy for a few months, you might find the fatigue gets better soon after treatment.

Long term:
If you’re on hormone therapy for a while, and the fatigue is hard to deal with, talk to your doctor. You may be able to take a break from therapy if the cancer isn’t growing. This break will give you a chance to lessen the fatigue effects and get some relief.

Hormone therapy can also affect your everyday abilities and desire to move around. It’s important to work through it and stay physically active, to keep up your strength. Proper rest, nutrition and exercise will also be key — according to your doctor or care team’s guidelines.


During chemo, your energy levels will probably be up and down. Your doctor will tell you how many rounds of chemo you’ll have, and how many weeks your sessions will last, but fatigue can make this time challenging. As you have more sessions, the fatigue can start to feel worse.

But after finishing a whole course of chemotherapy, most tāne find their energy levels improve. Even with this improvement, however, it can feel like the fatigue is lingering on for a while.

Surgery (radical prostatectomy)

After surgery, you might be exhausted and not in the mood to move around.
And that’s completely understandable — your tinana has just been through a lot.

To help you heal faster, and to reduce fatigue, your doctor or care team will probably want you doing some light activity, like walking, soon after surgery. Moving can give you an energy boost, keep your mind active and also help with constipation. Constipation (not being able to poo easily or empty your bowels) is uncomfortable and can be stressful for your body.

After surgery, fatigue can last a few weeks or even a bit longer.

Radiation therapy

Both types of radiation therapy (external beam radiation and brachytherapy) can cause fatigue. Those tired and drained feelings can start while you’re getting therapy but sometimes it doesn’t happen until afterwards.

Some tāne find it lasts for weeks but it can go on for months.

High-Intensity Focused Ultrasound (HIFU) and Cryotherapy

HIFU and cryotherapy are shorter treatments that can both cause some level of fatigue. After the procedure, you might feel tired after but you should soon get back to normal energy levels. Check with your doctor for more details.


Different types of immunotherapy can leave you very tired afterwards. They can also make you feel sick to your stomach and feel like you need to throw up. Staying hydrated and getting enough rest is critical. Immunotherapy has limited availability for prostate cancer treatment in New Zealand. Check with your doctor for more information.

Active Surveillance

People on active surveillance often don’t have many physical problems — but they may still deal with anxiety, stress and depression. These issues can make it harder to stay active and take care of yourself — and put you at risk for fatigue. If you’re feeling exhausted all the time, it’s also possible there’s something else going on. Talk to your doctor about fatigue and what you can do to regain energy.

Watchful Waiting

On its own, watchful waiting does not cause fatigue. Since the cancer isn’t being actively treated, your
is not being put through the stresses of treatment or recovery. Still, cancer itself can bring about stress, anxiety and depression, making it tough to eat well, feel rested and keep up your energy.

Talk to your doctor, care team
or hauora provider about fatigue

If you’ve been feeling excessively tired, whether physically, emotionally or spiritually, let your doctor, care team or hauora provider know. They can guide you towards getting proper rest, nutrition and exercise, and any other help you may need. 

What's next?

Now that you've read up on Feeling fatigued after prostate cancer treatment , here are some related articles to explore as you continue to build your knowledge and understanding of this topic.
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