Knowing when to contact the care team is a key part of supporting someone with prostate cancer. Dr. Andrew Hahn discusses red flags that care partners should be aware of, including increasing weakness, falls, and changes in daily activities. Dr. Hahn also outlines common treatment side effects, such as changes in mood, sleep, and energy that care partners should watch for when a loved one is on hormone therapy.
Dr. Andrew Hahn is a Genitourinary Medical Oncologist and an Assistant Professor of Genitourinary Medical Oncology at The University of Texas MD Anderson Cancer Center. Learn more about Dr. Hahn.
Related Resources
Transcript
Katherine Banwell:
You just mentioned symptoms and side effects. When is it time to call the care team?
Dr. Andrew Hahn:
It’s a good question. I think every case is a bit different. What I would say is if you’re starting to really get concerned about the safety of the patient at home, that’s a clear indication to reach out to the team care.
Understand the focus on hormone therapy initially. There are things that we as providers don’t understand as well. We see a patient in clinic. We look at their labs. We ask them questions. It’s a quick visit. I don’t know if you had a fall two weeks ago. I don’t know if you tripped over your cat or what happened at home or where that bruise came from. I don’t know those things. So, I think when patients with prostate cancer on hormone therapies are starting to look weaker, their transitions are slower when they’re starting to have falls, these are red flags that should be escalated up to the care team.
I think even sometimes symptoms that are perceived as nuisances, things such as hot flashes or difficulty sleeping, if it’s really impacting a man’s life and you feel like it’s impacting their ability to live their day-to-day life, that’s a time to reach out as well. When you get to more specific therapies, if we’re talking about things such chemotherapy, you have a fever, you can call the care team, but also just come straight into the nearest emergency room near you.
The care partner can help with that. With other medicines such as lutetium Lu 177 vipivotide tetraxetan (Pluvicto), with dry mouth, the PARP inhibitors with diarrhea, GI symptoms, and fatigue, these are all different indications to watch out for and to raise flags to the care teams. And now, care is evolving as our tools are evolving. There is sometimes good, sometimes bad. But it’s easier to at least send initial messages into the care teams so the care partner can reach out and say – if it’s not a red flag, you can send a message through a MyChart type of application that can be escalated up. I think that can be helpful as well.
Katherine Banwell:
What changes in mood and behavior or even daily life should care partners be prepared for during and after prostate cancer treatment?
Dr. Andrew Hahn:
I’m going to focus on advanced disease for men receiving hormone therapy because it’s different in a localized space. But during treatment and day-to-day, it can look different. Fatigue is very common. Men have to push through that fatigue to do the normal activities of daily living. They should be able to do those. They should be able to exercise, but they’re going to have a change in their energy levels. They’re probably going to need time to rest occasionally, not maybe go as hard as they previously were going.
I would say that from a mood perspective, about one in four men will experience depression or anxiety that they have not previously experienced or maybe rarely experienced before their testosterone levels were lowered. That can be really big. That needs to be brought up at visits with the care team. Medicines can help with depression and anxiety. Experts can help. Even changes in the medicines that we’re prescribing I’ve had make a big difference in our patients.
It’s just as effective as the different medicines. There’s a lot that can be done. It needs to be brought up. Difficulty sleeping is about one in five, one in four patients. Sometimes medications can help with that depending on the scenario. But these can all really impact the day in and day out of a man living with prostate cancer.
The final one I’ll say, they’re going to notice that they probably aren’t quite as physically strong as they were, and their bodies will change some. They will lose some muscle mass. Oftentimes, they will gain some fat mass. Exercise can help with that. It is part of just what their partner is going to be going through.