leg weakness

[mediocra]

How common is leg weakness with metastatic prostate cancer and/or treatment for it? My dad is 6 months into diagnosis/treatment. Has been on ADT and also finished 6 rounds of docetaxel. Response has been good (PSA dropped from > 2200 to 0.05 on last check) and post-chemo bone scan shows significant reduction in mets.

However, at some point along the way he gradually developed severe bilateral leg weakness (now having trouble rising off the toilet). It seems to be most severe proximally (hip flexors and thighs) and not really that evident in his ankles/feet. He definitely developed a sensory neuropathy with chemo, but that is worst distally (fingers, toes).

His oncologist is chalking up the weakness to chemo/neuropathy, but it seems to not fit the pattern to me. Again, his weakness is all proximal legs. Spine MRI has not shown anything that would explain this.

I wonder if it may be some sort of side effect of the ADT v some other issue less directly related to the cancer or treatment.

As always, appreciate the input.

[ctarleton]

There was a similar discussion a couple of years ago. Several different ways of possibly dealing with it were mentioned.

healthunlocked.com/advanced...

Charles

[Drcrunch]

Does not fit into any pattern. I can not think of any way that can happen.More info needed.

[Drcrunch]

Sometimes depression can masquerade as motor lesion.

[Bjry]

Thanks Ctarleton for the 2017 reference, the comments there are

helpful.

Mediocra; I’m in a similar but not the same situation.

I’m about 11 months in after diagnosis and have ADT as well as 6

cycles of docetaxel for stage 4 Gleeson 8.

About 5 weeks ago I started experiencing a loss of leg drive strength;

most noticeable when I try to get up off the floor after playing with grandkids

plus I had what felt like leg muscles cramping when I stand up after

sitting. However after warming up I am

still able to walk reasonable distances for exercise. My GP offered no diagnosis but suggested a

magnesium supplement might help - which it has (maybe a placebo effect). I see my oncologist next week and leg pain/strength

is near the top of my agenda.

[monte1111 in reply to Bjry]

Yes. Getting up off the floor is an issue for me. Great shape 3 years ago. I have wondered if foot neuropathy was slowly creeping upwards. It is all so slow, you barely notice.

[Magnus1964]

Chemo can have some serious side affects on older men. Does he have severe neuropathy in his legs?

[charlesmeyers1964]

a lot no testosterone thats one reason what do u think all that meds do to your body it takes a beaten

charlie

[BrentW]

I was getting weak in my legs, due to muscle loss while on ADT (I have been since 2004). Her in the Good Olde UK, I was referred to an exercise clinic, held for an hour each week at a local leisure centre. I have been given exercises to do at home. The main one is getting up from a chair (without any aids) as many times as I can in 3 minutes. I am to do this once each day. The improvement in my stamina has been amazing, and that is after only 8 weeks. I can now walk up short but steep Welsh hills without pausing to regain my breath. My next goal is to be able to hold conversations with my wife while doing it.

[monte1111 in reply to BrentW]

Getting up and down from chair sounds excellent.

[Jbooml]

I was incredibly weak after adt and zytiga commencement....felt like a staggering bipedal teeter tooter. couldn't pivot in anything but ramrod straight legs. Couldn't straight lift my legs...oddly not so bad on the back side. It took a month to resolve...but guess what...i'm now absolutely fine....can't comment on the neuropathy as I haven't taken any taxols. Dad was absolutely loaded with mets and whats interesting is his response was like mine despite my not using docetaxel...i did resort to a few yew berries which grow locally. One has to wonder if he wouldn't have responded similarly without the chemo. its possible and important if his mets were similarly osteoblastic as i've assumed mine were.... I'm absolutely convinced mine were non lytic and led to the fantastic results. We need more data to establish protocols for what I feel is a critical distinction in bone mets in first Rx standard care.

All my personal opinions

[gleason9guy]

I would say that leg weakness was definitely a problem for me. I'm 56 and normally my legs are my greatest strength. Not anymore. It's just something to adapt to and work around. Best of luck!

[TommyTV]

I’m in exactly the same position. Started on Zytiga 7.5 years ago, and both femurs had large metastases. My thighs show substantial muscle wastage, and I was never strong enough to exercise my way out of it, as my femurs would ‘buzz’ and I’d get really bad restless legs. I use a walking stick now, as anything more than 20 metres leaves my legs very unsteady and weak. But so what, I’m still here after 7.5 years. Once I’m stood up, It’s not too bad, but I’m like a tortoise on his back trying to get up.

[wagscure259]

I went through similar paresis during continuous ADT in my hip musculature particularly the extensors which are most important to arise from the seated position from I believe the ADT itself and lowered testosterone levels . Usually the docetaxal evokes sensory peripheral neuropathy versus motor . You may need to get a raised toilet seat and elevate sitting surfaces particularly at night . Exercise will significantly improve that . Even after move than 6 years on ADT I no longer have those challenges . Start slow perhaps with bridging and then perform from an elevated surface ie 2 then one pillow sit>stand exercises with two , then one , and then no hands . Weight training is the key .

[j-o-h-n]

Sorry to say but it's part of the play.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 04/26/2019 6:20 PM DST

[Shepard]

I have leg weakness also and maybe would anyway since I am 80 years old. I feel the problem began after taking Xtandi along with Lupron. I have bone mets in hip. I work on my ranch and probably walk over four miles a day. My legs are very muscular from many years on the ranch. At the end of the day I need to sit after taking the Xtandi, but I can not find a comfortable position for them. When I began Xtandi there was some ankle swelling which is now passed, but my toes feel sort of numb. I get some relief from rotating my feet in a circle to improve blood circulation. Some days, I have to give it up and go to bed. I am ready to go to work the next morning. Experiment to see what will work for you. Good luck.

[monte1111 in reply to Shepard]

4 miles a day is amazing. Hope the Xofigo is working. Sunshine and flowers to you. Enjoy.

[JimVanHorn]

Walking helps, even with a walker where you can sit down quickly. I would want to check his lab reports, like CBC (complete blood counts) to see if he is anemic, or has low numbers of Red Blood Cells. If he snores at night maybe he needs a CPAP mask when sleeping. This would increase his oxygen in his blood. Are his Vitamin levels (like Vitamin B-12) in normal levels? Does he have kidney disease, because that can effect his ability to release RBC's into the blood stream. Iron levels are also important for strength. What I did was to ask my Doctor if I can use my home computer to get all of my lab tests one week after I left the doctor's office. Then I would write down questions I had about my tests. Sometimes a doctor is interested in only 2 or 3 results of tests and does not talk about all of the tests because of time (they get into a rut). Using his legs to exercise would help, but don't start too hard and be sure he holds onto something sturdy. My Dad had similar problems and he pushed himself to do just little dips with his legs. Keep in touch with us and we can help you with ideas to ask your doctor.