Diagnosed Stage 4 with cervical (neck) spine met Jan 2019. More background in my profile. ADT (Lupron, Zytiga) has reduced PSA from 111 to < 0.1. I've anticipated, experienced, and accepted all the side effects like zero libido, hot flashes, and night sweats.
But a couple of months ago, I noticed this flabby "spare tire" forming around my waist, but I'm not gaining weight. I'm 76, and I've been real skinny all my life (165 Lb, 6'1" for the last 30 or so years). So now I'm starting to look like a snake that swallowed a gopher. I eat healthy, exercise at gym 3 times a week, and walk a lot. But spare tire is growing.
Are my only choices to A) go on extreme diet and exercise program, or B) just accept my new belly flab?
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Gearhead
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Once you start eating good food in smaller portions you’re appetite decreases. Bad carbs are addictive. I use the “ my plate” app to track what I eat and have switched to a primarily plant based and seafood organic diet. And you need to drink a lot of liquids which help you feel full and detox your system. It’s a hell of a lot easier and a more effective way to lose weight than exercise which can make you hungrier! But I exercise daily as well which burns another 200 avg. calories so my net daily calories are less than 1000.
Believe me I had lost the will to lose weight and though I was exercising daily my stomach grew to over 44”! I was blaming it on ADT thinking I couldn’t do anything. That’s a cop out! The more depressed you get the more junk food you eat to “ feel better”. Vicious cycle!!
I accepted the flab until I got sick of it. You get rid of it by eating good carbs , protein and fats , counting calories to ensure small portions, and vigorous exercise! I’m down from 250 to 224 in four weeks . Goal is 190. I’m 6’3”.
I am afraid that belly flab is the result of low testosterone. It is part of a general deterioration in the body functions from ADT. There is a hidden problem - your weight may remain constant and you think you are doing well, but you are losing muscle mass and gaining belly fat. There is an even bigger danger - this fat is "bad" as it also accumulates around the heart and adds to its problems from being constrained, poisoned and starved. It affects breathing too. This fat also produces "pseudo" estrogen which feeds the cancer (and why receptor blockers may need to be added to the medications after a while - a subject much more complex than touched on here). It is thus a good idea to do whatever it takes to keep that fat from becoming a problem. Stopping ADT for a while can create a gap (about 6 months later - it hangs around) to get back into shape, but at the expense of that PSA creeping up again. Perhaps the use of estrogen patches (this is different stuff from the one the fat makes) to fill the gap (and stop PSA climb) may be better for fat control, but I have no experience of this. Since I have the same problem after 4 years of ADT, my next move is to stop the Lupron and try the patches (which produces boobs if taken for a while ....).
I have been on Firmagon for close to eighteen months now and I have not gained any flab at all. My libido continues relentlessly but there is not any point as my body has lost all sexual response.
Apart from that I have the night sweats, insomnia and these weird leg pains which wake me up every few hours. I get up, walk around for a few minutes and then go back to bed.
My blood pressure rose to dangerously high levels 210/150 so I am now taking Irbesartan and Amlodipine for that, I am also on Metformin for slightly elevated blood sugar and Avorstatin for a slightly elevated cholesterol.
ARB's like Irbesartan, Metformin and statins like Avorstatin have shown some promise for slowing the progression to metastasic disease so here's hoping!
Lupron 9 mos (after 1 mo of Firmagon). Despite my reading, I had no idea of the impact ADT would have on me. True poster child for side effects (envious of those who write that their side effects are non existent or minimal...lucky men). Gained 12+lbs over 6 mos despite 5-6 days of exercise and change in diet. Belly, butt and thigh fat. Not pretty. And, combined with zero libido and other side effects, a real blow to self esteem. But, that's another story.
Anyhoo, I do not know if, post Lupron, given the exercise and diet changes, the blubber will begin to lessen and muscle mass return (btw, no muscle man here; aver 70 yr old body). Or, like you suggest, a plump me is the new normal (god, I hope not).
I guess your choice becomes: how much time and energy do you want to devote to getting rid of your gopher? Doing something will give you a sense of control and fighting back. Is that important to you? Or, do you continue your current course? Tough call.
Interesting to read the responses of others who are on the same journey.
😜😜😜 yep welcome to the Adt world. I’m on Xtandi but similar response. Spare tire I never had, zero libido. Lost all the hair under my arm pits, eye brows, can’t grow my mustache anymore . Not sure if anyone else has experienced this one but when I’m hot my nose runs off my face 😖. Any rate I’m on the right side of the grass 🙏🙏
low carb diet, maintain and improve the tone of your abdominal muscles. this will ameliorate the effect of the chemical castration you are experiencing.
I still sport a full beard after eighteen months although it is softer, I have lost chest and abdominal hair, underarm hair is thinner as is my pubic hair which is less and softer, arm and leg hair is about the same. The hair on my head is thicker and darker, more like a younger me!
Tamoxifen. On Lupron and Xtandi for 14 months and got the spare tire in spite of regular 70 mile bike rides, gym workouts, and net weight loss. Tamoxifen reversed the trend. Boobs shrinking. Belly fat going down nicely. Even putting some muscle back on.
From the comments above and to state the obvious - everyone of us is different and it amazes me how different our experiences are. From, "what's the big deal," to "omfg, this shit is killing me."
I'll keep going with the exercise and diet changes but I've also lowered my expectations about what I can realistically accomplish (PC, meds, time and age are no one's friend). BUT, if I fall off the wagon, as it were, re a "treat" - a drink or slice of pizza or dish of ice cream - so be it.
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