Background: Fatigue is a common, multifaceted disease- and treatment (tx)-related symptom experienced by pts with advanced PC (aPC). Although fatigue of variable severity has been reported across clinical trials in pts with metastatic hormone-sensitive PC (also referred to as metastatic castration-sensitive PC [mCSPC]) and non-metastatic castration-resistant PC (nmCRPC) treated with ARIs, there is limited real-world insight from the pt’s perspective or guidance on the management of this symptom. This study assessed pts’ experience with fatigue and self-reported management strategies. Methods: In this cross-sectional non-interventional qualitative research study, pts receiving ARIs were interviewed about their fatigue experience and management strategies. All pts were ≥18 years, diagnosed with mCSPC or nmCRPC, currently on ARI tx (enzalutamide, apalutamide or darolutamide) that began ≤24 months (mo) prior to interview and experienced fatigue. Descriptive data extracted were organized into general concepts and presented as number and frequency of reports. Results: Among 143 screened pts, 11 completed the interview (mCSPC, 7; nmCRPC, 4). Most were White, mean age was 63 years and median time since ARI initiation was 12 mo. Pts described their fatigue experience as a physical, emotional or mental feeling that impacted activities of daily living. Pts attributed their fatigue to more than one cause including, but not limited to: a side effect of ARI tx, emotional burden of disease, or physical exertion. Most pts did not feel adequately prepared and indicated they would have liked to receive additional education or support to manage tx-related fatigue. As a result, most pts followed self-initiated management strategies such as healthy diet, rigorous exercise and increased rest, which were reported to be effective for some pts. Conclusions: Pts with aPC emphasized the lack of adequate knowledge and health care provider (HCP) recommendations for managing fatigue. Hence, there is a need to develop recommendations for fatigue management and resources to support HCPs’ counselling methods to ultimately improve pts’ quality of life while on tx. HCPs may play a critical role in developing and disseminating fatigue management initiatives.

^aPts did not talk about the source of all tx strategies reported and could select more than one response. ^bPts had already incorporated management strategies in their daily routine.