Take the Quiz! (below)

Jan Manarite, Your Prostate Cancer.help (3 minute read)

Did You Know?
* Soda/pop doesn’t hydrate you well. ⁸
* New research – caffeinated drinks don’t dehydrate you as much as previously thought ¹
* Alcoholic Drinks dehydrate you ¹⁴
* These foods help hydrate you ^{2, 10} :

• Cucumbers
• Celery
• Tomatoes

• Melons
• Lettuce
• Strawberries
• Yogurt
• More…ask a dietician

My husband, hydration, and the oncology nurse
When my husband was going through various treatments for mCRPC (metastatic castrate-resistant prostate cancer), I remember one of the oncology nurses saying that most advanced/metastatic patients come into clinic “a quart low”.  She said many treatments dehydrate patients a little or a lot, and if a patient has appetite or nausea issues, he’s less likely to drink as much as his body needs. 

The catch-22 was that being low on hydration can cause nausea – and nausea can make a patient refuse to drink.  But – staying hydrated can help prevent nausea.  I didn’t remember anyone explaining this to us before. I was glad that she did.

Ask a man what “quality of life” is to HIM…
I also learned that being low on hydration can cause fatigue.  Men want to keep their energy.  I also learned that mental clarity could be helped/increased by hydration sometimes.  Once I explained these 2 things to my husband, he decided to get his own water bottle, fill it up in the morning, and walk around with it all day.  I’m convinced he felt better.

One day the oncology nurse also told us that my husband may be able to come into the IV treatment room just to get “fluids”.  She told us to call  ahead and ask for the IV treatment room desk, and if they were able to, my husband could come in for ½ bag of saline IV drip.  We did this off and on – my husband always felt better afterwards.  

The nurse would also always check his blood pressure (both sitting and standing) before giving my husband fluids.  He was on blood pressure medication, so we kept a blood pressure machine at home to be able to measure his status whenever we wanted to.

Oncology Dieticians
Although we didn’t have access to one, dieticians are also an excellent source of information on hydration for cancer patients.  Some cancer (oncology) clinics have registered dieticians, noted as RD.  “Dieticians are recognized medical professionals…insurance may cover visits to a dietician.”  ¹³

“Nutritionists, on the other hand, are a self-proclaimed title…and may or may not have training in the field.”

Incontinence & Hydration
Many prostate cancer patients deal with some degree of incontinence, especially after prostate surgery.  Trying to convince someone to hydrate when they’re dealing with incontinence may sound like torture.  But again – the hydration will probably help you prevent some side effects, which might help you STAY on cancer treatment. 

Here are a few tips from St Pete Urology, and the Urology San Antonio:

• Drink most of your water early in the day ¹²
  Drinking water a few hours before bedtime can be problematic, especially if you are struggling with nocturia [getting up at night].  A good practice is to drink most of your water in the morning and afternoon and avoid drinking 2-4 hours before going to bed.
• Drink it in sips ¹²
  When you drink water, you must avoid guzzling one or two cups at a time, which can overwhelm your bladder. Instead, drink water by frequent sipping. It would be best to have smaller amounts of water and liquid throughout the day, sipping slowly over several sittings.
• Pelvic Floor Physical Therapy (after prostatectomy)
  These can help strengthen muscles and decrease leakage.  See 7 difference exercises here – https://www.urologysanantonio.com/pelvic-floor-physical-therapy/post-prostatectomy

***Learn more – Take the Quiz:

1. Our bodies are made up of what % of water? ³
   a. About 60%
   b. About 75%
   c. About 80%
   (Answers below)
   
2. Staying hydrated may help with ^{4, 10}:
   a. Energy (prevent fatigue)
   b. Stamina (prevent dizziness)
   c. Mental clarity (prevent confusion)
   d. Appetite (prevent nausea)
   e. All of the above
   
3. Hydrating is always helpful, but most effective
   a. Before treatment
   b. During treatment
   c. After treatment
   
4. You can be “underhydrated” without being dehydrated ⁷.
   a. True
   b. False
   
5. Being hydrated, or underhydrated can affect blood pressure⁹.
   a. True
   b. False
   
6. Which PC treatments actually recommend hydrating? ^4,5,6
   a. Pluvicto (Lu-177)
   b. Xofigo (radium 223)
   c. PROVENGE (sipuleucel-T)
   d. Other treatments – ask you oncology nurse or doctor
   e. All of the above
   
7. Who has a higher degree of education?  ¹
   a. Nutritionist
   b. Dietician
   c. They are the same
   
8. Oncology Nurses are usually in which doctor’s office?
   a. Urologist
   b. Urologic Oncologist
   c. Radiation Oncologist
   d. Medical Oncologist
   
9. You can usually make a direct appointment with your oncologist’s nurse, especially if the doctor is busy. 
   a. True
   b. False
   

We all know to “talk to our doctors” about cancer issues.  But remember to also talk to your nurses – especially about how you’re feeling.  Remember also to ask about dieticians – hydration is part of your diet.

This article has been reviewed by Fran Fanning, MSN, RN, OCN. It is intended to help you ask your nurses, dieticians and doctors better questions. 
It is not medical advice.

Answers to Quiz:

1. a.  About 60%
2. e.  All of the above
3. a.  Before treatment
4. a.  True
5. d.  All of the above
6. d.  All of the above
7. b.  Dietician
8. d.  Medical oncologist
9. a.  True

References:

1. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/caffeinated-drinks/faq-20057965
2. https://www.aarp.org/health/conditions-treatments/info-2023/how-much-water-should-you-drink-a-day.html
3. https://www.hsph.harvard.edu/nutritionsource/water/
4. https://us.pluvicto.com/about-pluvicto/what-to-expect-when-taking-pluvicto
5. https://www.xofigo-us.com/patient/while-on-xofigo
6. https://provenge.com/target-therapy-advanced-prostate-cancer-provenge/
7. https://link.springer.com/article/10.1007/s00394-018-01889-z
8. https://www.beaumont.org/health-wellness/blogs/6-reasons-to-stop-drinking-soda#:~:text=Your%20hydration,can%20also%20contribute%20to%20dehydration.
9. https://www.healthline.com/health/dehydration-and-blood-pressure
10. https://my.vanderbilthealth.com/10-foods-you-should-be-eating-to-stay-hydrated/
11. https://rutherford.ces.ncsu.edu/2022/08/foods-that-hydrate/
12. https://stpeteurology.com/does-drinking-more-water-help-incontinence/#:~:text=A%20good%20practice%20is%20to,hours%20before%20going%20to%20bed.&text=While%20plain%20water%20is%20ideal,or%20lemon%20to%20your%20water.
13. https://health.clevelandclinic.org/dietitian-vs-nutritionist
14. https://www.healthline.com/health/does-alcohol-dehydrate-you#causes

HYDRATING for Advanced PC Treatments