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Advanced Prostate Cancer
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Persisting adverse body composition changes 2 years after cessation of ADT for localised PCa.

New Australian study below [1].

"Twenty-seven cases and 19 controls completed the study. Median duration of ADT was 2.3 years".

"Two years after cessation of ADT, total testosterone remained lower.., fat mass ... and insulin resistance ... remained higher in cases, whereas lean mass ... and physical component of QoL remained lower than controls".

"Two years after ADT cessation, metabolically adverse changes in body composition, increased insulin resistance and reduced QoL persisted."

"This may be related to incomplete testosterone recovery." No kidding!

Dr. Stephen Freedland has said that one must recognize that cessation of ADT is usually a continuation of very low testosterone [T] for a significant period of time. Men beginning ADT often have T levels that are not a lot higher than the hypogonadal cutoff of 350 ng/dL, & sometimes much lower. T often does not recover to its previous high.

The solution is to immediately begin T restoration therapy, but I suppose that most would view that as risky. Anyway, ADT has long-term consequences - even after it has ended.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/297...

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It's true that some would regard T replacement therapy as risky. There are always risks. But as this study shows, there are very likely, very serious risks associated with doing nothing. "Metabolically adverse changes in body composition" means, among other things, elevated risk of strokes and heart attacks. "Increased insulin resistance" sets the stage for diabetes - a terrible killer. "Reduced Quality of Life" is remarkable because so few studies even bother to look. I note they seem to have limited it to "physical" quality of life, probably because it is easier to measure.

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Patrick---Using myself as an example--since my time on ADT was about the same as the study--I can attest to some and not to another. As to T: My T went past my average T levels of 1993--and I expect tomorrow's number from the blood tests today will be near 500, when in 1993 it was 320. So how did my T get so high? I had to do a Quick study---and my data points to my high level daily use of D3[20,000 IU], and 45 minutes of sunbathing 3 times a day. So In my personal opinion, If you want to jack your T up without supplementation, when coming off ADT---D3 may be the answer.

As to insulin resistance, I can report, that even while now PSA undetectable, my Blood Sugar Numbers are 10% more than before ADT. But I continue with my Metformin routine anyway.

The visceral fat about the waste will not move. If I reduce calories, and reduce weight, it comes from other area's. I have done as much as a 120 sets of AB Crunches pulling 120 pounds of weight, for a month--and the fat remains. I can feel the muscles under the fat, they are hard--and I might actually have a six pack that cannot be seen thru the fat.

So I asked my Urological Surgeon, who has done over 1,000 RP's over 17 years, what is it with the belly fat???? He just laughed, he said it never goes away after doing ADT for 2 years. He had no exact answer, other than to unscientifically intimate this belly fat was of a different composition than most other body fat. {could be a study here}

So I have made an appointment to have it removed by the Cool Sculpting laser Method. I do not know if pushing 75 years old--if it is worth it. But I do not want what I never had before. They say once sculpted no fat can ever come back.

In conclusion using myself as a person of one---I agree with he facts presented by Patrick--but do believe you can move your T numbers up--and then free up some Free T, with Stinging Nettle, and Avena sativa.

Nalakrats

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Freaking belly fat. I have easily done over 1 million sit-ups/crunches in my life and I have this 2 " pinch of fat on my waist, pisser.

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Yeah---that was what I was saying--my Doc. maintains the fat is different than that is formed without Testosterone---claim is the color of the fat is not off white or yellowish--but brown. In chemistry that would indicate to me in a beaker, or test tube, that the fat was severely oxidized. As I said I have an appointment to maybe do Laser Cool Sculpting. My T climbed naturally from 22 to near 500 in 6 months, and the fat just laughed at it.

Nalakrats

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If you do that Laser Cool Sculpting, PLEASE let me now, this stuff is driving me crazy.

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I have the brochure---and my Dermatology Group, attached to my Local Hospital, will be getting a visit from me. I can tell you it is not instantaneous. That once the procedure is done, the fat cells begin dying, and the usual time for completion of their death are about 12 weeks---so as your cells are dying, you can do AB crunches, so your skin keeps up with the shrinkage. I can tell you the before and after photos I have are amazing. There is one where they do the flanks and love handles, on a man, and in 12 weeks, his area looked like a 19 year old.

I have known about it for awhile---just wanted to get another set of blood work completed, which I did yesterday. Results were good, which I thank my God.

Nalakrats

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I have also seen the ads for cool body sculpting and was interested but didn't pursue any more info. I'm sure the procedure isn't covered by insurance so it would be out of pocket expense. Did you get any idea of the cost?

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I will confirm next week if you can remember to contact me. But initial indication is 1,250 for the Belly Fat, the frontal core, or the flanks and love handles combined.

So I am thinking that if I want the belly fat, and then the flanks and love handles--this would be 2 separate treatments--or about 2,500. You do not do 2 sites at the same time. And there is financing available---So I am thinking belly only at first, and then after about 6 weeks of results knowing it will take 12 weeks for all the fat cells to die---would then consider another treatment site[Flanks, Love Handles]. I need my serious face to face.

Nalakrats

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Thanks for the info. 2500 is a lot of money but if it successfully removes the fat and keeps it off then it is worth it!

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Very interested in this, but will the excess skin become large folds on the belly where the fat was once pushing out the skin? If so, are the crunches sufficient to prevent this problem. Please update us on your progress. Consider a before photo, and progress photos so we can cheer you on.

CalBear74

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My concern too about the skin--but it takes 12 weeks after treatment for the fat cells to die---and when they die they can never come back I am told. So I think one can keep up with it as the fat cells die. But age, and gym history is probably important.

I will not jump into it unless I am sure.

Nalakrats

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My last Lupron was 03/31/2017 and T is now at 493, PSA steady at 4.3 (from 840 and a nadir of 0.1).

Still have damn belly fat and running is hard.

Doing 150 mg Casodex and 2000 mg Metformin daily.

Bone scan and CT upcoming. Getting ready to ride that Lupron train again or more chemos.

Fight on

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Good Luck and Good Health.

J-o-h-n Thursday 06/28/2018 7:01 PM EDT

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So Nalakrats, my husband want to know if you did this...I said I would ask. 😬

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