I have been an athlete all my life and still love working out hard at age 74. I am on hormone therapy and have had several series of radiation therapy. My radiation oncologist has ademately ordered me to stop lifting all weights. This I cannot do. X rays show abundant bone lesions throughout my body, but I keep working out.(running and lifting weights), trusting in God, because it keeps me feeling great. Please share any advice and experience on this theme.
Exercising with bone mets from prosta... - Advanced Prostate...
Exercising with bone mets from prostate cancer
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CountryJoe
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If you are able and have an adequate facility swimming is a great exercise, non-impact. I was a lifelong athlete, daily running (one full marathon), weights etc. have stopped all but lap swimming now. At least 2 miles/ week. It was arthritis that caused me to give up the other exercises. In lieu of swimming an elliptical machine is my 2nd choice.
Thanks for this response. I swim and use an eliptical machine as well as the running and weights. I broke my back in a motorcycle accident 13 years ago and also have arthritis in the back (along with bone mets); but, as I say, I deal with the pain by pushing my body. I was a national champion oarsman in my younger days and learned early to ignore body pain. I know that many consider that bad advise, but it has helped me get through past and current physical issues.
Until a bone breaks from stress. My RO warned me that radiation to mets can weaken bones making them susceptible to fracture.
Are there any warning signs that a bone is about to fracture from stress? Do you have pain first, in time to put down a weight?
Good questions
The answer varies depending on the weight used. The short answer is the lighter the weight, the less pain you will experience. If you are lifting a large amount of weight, expect the pain to be exponential. Since you are relatively used to pain, you might get lucky. If you experience a cracking feeling, ditch the weight pronto!
I recall watching championship (i.e. - best in the World) arm wrestling and also weight lifting competitions WHEN SNAP!!!! ( microphones picked up the noise) YUP, broken bones without warning. Any lifting of heavy weights can result in a fracture and worse.
Hi Joe. My mum who is osteoporotic broke her leg as she was on Forsamex for five years. Xrays showed a bone lesion on the other leg and the doctor warned about a possible break in future. 2 years later she broke her other leg when she lost her balance. The bone just breaks. Essentially bone lesions are points of weakness for a break. As such putting pressure on the bones is not recommended inspite of yr bone strengthening medication. Swimming maybe a better sport for you since you say you hv aboundant bone lesions.
My oncologist encourages me to exercise. If it hurts, he says take something for the pain and keep moving. That said, you may want to get a second opinion. Your doctor may see something specific that could be a problem, but if so he should tell you what it is and what you should specifically avoid.
Mine has only advised me to avoid hair clogs in bathtubs because I cracked a rib trying to clear the drain not long before my diagnosis.
Personally, I would err on the side of being active as there's so many potential benefits. That is not medical advice, just an opinion from a very biased runner.
Thanks so much for this encouragment. You have made my day. I believe that the body was made for movement, and it is through movement that I am holding off the storm.
Country Joe. Just to be clear. You have bone mets. Where and how many?
You have had a series of radiation therapy. Was that radiation to the bone mets? If yes, is the radiation oncologist saying the radiation has damaged or further compromised the bones in which the mets reside and were radiated?
For sure continue your aerobic exercise .
Thank you for your response Dd7757. My bone mets is from prostate cancer and it is essentially everywhere (legs, arms, shoulders, ribs, spine, pelvic area. Nevertheless, I have no pain or other symptoms yet. I have had radio therapy directed at my pelvic area and spine considering that these are weight bearing areas of the body. I feel great, strong and energetic in spite of it all. Like I always say, I know the storm is coming, but I am fighting it off as long as I can. I also feel a bit insane, now that I am writing about all of this. I no longer use heavy weights, just barbells of about 20lb. But I work out hard.
Don’t stop working out. Just be careful. I am sure you are in the minority for your passion for exercise.
Have you managed to maintain reasonable muscle tone and mass from your routine....weight gain.? Hope it is working out for you and your bones remain intact
No great muscle tome AND even less muscle Mass. Hormone therapy ended all that. It's hard psychologically, but it's all about feeling strong AND healthy Now. The girls stopped looking at me many years ago anyway.They prefer looking at my sons Now.😂
There are a few on this forum who insist that they have maintained fairly well. Wonder what their secret is? How often do you go to the gym? Do you focus on weight training or cardio more? I’m I’ll prepared to lose everything I’ve worked to maintain for 68 years..... going to be difficult
Hello Tommyj2. I don´t go to the gym, never did. I was a serious athelete in my youth and still love the feeling of training, but I do it on my own, an hour and a half each day. Part of that training involves weights. I do not look good. My muscle tissue was taken by hormone thearapy. I am thin with hanging skin at 74, but I still feel great after a hard workout, and simply cannot knock the addiction - something my RO does not understand.. I am not on this earth just to breath. Being alive is not enough. I work full time on social issues in the developing world and that keeps my mind focused and my energy flowing. If I break an arm or leg in the process, I will be full of regret and have no idea how I will handle that. But I was told to give up weigths over a year ago, and no problems yet. I trust deeply in God and will not blame Him when things turn for the worse. I was told by j-o-h-n, a member of this chat, that I could blame it on his ex wife and that sounds like a good option.
Can’t see any good reason NOT to exercise given what you describe......sorry to hear that muscle mass and tone have been so deeply affected......sorry for ME as well as it won’t be long before I board that train.....know that you’ve lost tone and mass.....what percentage of strength have you lost? I don’t know what I’ll do with myself if I can no longer do my trail work......it’s been both my exercise AND my social life.
Don´t let yourself get discouraged, Tommyj2. I don´t perceive any significant loss of strength. The truth is my body is always calling for heavier weight when I exercise. If you are exercising regularly, I don´t think that strength loss or lower resistance is an issue. The exercise keeps you younger and more resitant in spite of that hanging skin where muscle once was present.
No. The oncologist says my bones will be stronger with radiation therapy. The problem is the lesions of cancer in my bones throughout my body.
I’m not as smart as I used to be (caused by ADT) but all I can think of is I was warned about bone weakness while being treated!!! I was told to take a ton of vitamin D through out. Otherwise, everyone I have heard says keep exercising!!
Jc
Big danger of fractures and spinal compression. Are you taking a bone-preserving agent?
Yes. Every three months I am administered a medication that strengthens bones. Forget the name.
stm.sciencemag.org/content/...
macmillan.org.uk/_images/ph...
bmjopen.bmj.com/content/7/5...
nature.com/articles/pcan201322
Fight on Brother
Beat you to the motorcycle broken back. Mine was 46 years ago, before there was much useful treatment. Now have scoliosis at break all fused and compensating bends and bows above and above. Lately wedge fractures are collapsing and epidermal injections are needed to hold back the pain.
My stage 4 mPca has not manifested itself in those areas of my spine. Exercise and weight lifting of lighter weights keep me moving, just hard to get motivated to keep it up sometimes when the snow flies.
Come spring hiking, fishing and berry picking with grand kids make it much easier. Best of luck to you in this trip through life. I'm only 70 so working hard to see 80.
Joe Hi!
Sorry for you mate it hit you bad. Hey Joe are you prepared mentally if what your RO is telling you might happen, does happen?
What would life look like if you were to stop the exercise. Is it possible to reduce the weights and substitute something else. No body knows your body like you do and no one can think like you do about your body.
I think you are one of a few kind that can do what you can at 74 and no side effects or pain you cannot handle. I bet when you look in the mirror you must like what you see. I am thinking you must have a very strong mind and you really do know your body, and I would guess you are going to keep on.
What we do when we do it, we think is absolutely the right think to do, otherwise we wouldn't do it. Make yourself a plan with an object to arrive where you would like to be in the future. Be very clear about what you want. I think you are amazing and unique Joe 
One other question, Joe have you already made up your mind about the exercise?
Alan
My MO says weight lifting strengthens the bones, helps with fatigue, increases your chances of surviving longer and makes you happier. He has 2800 PC patients in his office and we’ve become good friends. We went to lunch this week in fact and he told me without question, his PC patients that lift weights, do much better mentally, physically and live longer. It worked for me as I’ve gained muscle mass in ADT. Higher reps at lower weights if your worried. I’d talk to your MO and see if there’s certain areas to protect. What was your last bone density test ? I’d also get a second opinion.
Schwah
Are you still using the personal trainer..? This is an extra that not all of us ca afford but helps immeausureably to maintain motivation. Your results are what give me hope about maintaining some degree of fitness when my time comes for ADT.....( within next few months). Keep up the good work
Even if you can not afford a regular trainer I suggest a couple of sessions to get a good program in place that you can follow up with. I could do mine now without the trainer but it would take a lot more discipline for sure. Remember hard exercise is also good to hold off PC.
Schwah
No trainer, just me, the eoad, my weights and the love of working this old body.
Hi CountryJoe,
I have also been and athlete on and off since 1986, but I hardly ever went near a gym to lift weights because I much prefer a bicycle to keep me healthy.
I was diagnosed at 62 in 2009 and PG was inoperable Gleason 9 but Psa was only 6. I have had continuous treatment since early 2010, but I have managed to cycle about 100,000km on roads during last 10 years.
I used to do 12,000 a year, now at 72 am doing less.
But countless bone mets were a worry, but none went larger than pea sized, and none threatened to allow spinal compression or breakages elsewhere, and docs have not told me to quit exercise. Psa went up-down like yo-yo, and last year I had Lu177 after chemo failed, and I had good response with Psa going to 0.32 at 12 months after first of 4 infusions But now Psa is rising and scans last week tell docs that one met in L5 vertebra and one in left scapula are slightly increasing, but they are not big enough to get more treatments.
Docs say there is no Pca elsewhere which I should worry about. So I am happy to do nothing and keep cycling at least until I see my onco again in 6 weeks. If Psa is say 5.0, he may order PsMa Ga68 scan and maybe that shows more active mets and I have more Lu177.
Unless you stop the bone mets from growing bigger, they will be a big problem regardless of whatever exercise you do. Exercise may be very nice feel-good therapy, but Pca ignores what you are doing and your bones are getting weaker, and when one breaks with micro-fracture or big fracture, you may find the pain is utterly unbearable, and maybe there is no way to make the bone bits heal.
I have been on ADT since 2012, so I have zero testosterone, and on more than one occasion I have proved tp other men my age you don't need T to perform better athletically than they do if they are old like you and me, even though they have "full bottle" of T.
I suggest you have PsMa Ga68 scan asap, and get Lu177 asap, maybe with some Ac225 added. It means going to Germany to get it if you are in USA.
I've had a bad ankle for 53 years since a prang on motorcycle at 19, so I loathe walking or running, but bike is fabulous, and we have 600km of sealed bike tracks here and non congested roads.
I have arthritis as well, like most my age, but its not much of a problem due to diet and fitness etc. On a bike you sit down while working hard, maybe stand off seat on hills, but spine does not gets very stressed.
I have BMI of 23, resting HR 46, waist < 95cm, 12% risk of cardio-vascular bother happening. Blood tests look good.
Patrick Turner.
Hi Patrick. I have a sister who is an Avid bike Rider in the mountains of Colorado. She has taken several nasty falls over the years. Do you fear falling?
All the time I fear falling, which is why I have not fallen so badly that it damaged me beyond repair. I rode a motorcycle from 18 to 34, often much too fast, but survived. I worked in building trades for 30 years, and didn't have big accidents with power saws or falling off scaffolds.
I then changed trades to electronics using vacuum tubes which have power supplies with up to 1kV, and these can kill instantly, but I managed to be careful enough, so I am still here.
If you are not frightened of the cars, trucks and buses on roads, then you don't last long. You MUST assess what your surroundings could do for each minute. I don't insist on my right of way when drivers insist on theirs when they are wrong.
Kinetic Energy dissipated in crash = 1/2 M x V squared, where M is mass, and V is velocity, so a fall at 20kph does X damage. But at 40kph damage done is 4 times worse, and at 80km its 16 times worse. So bicycles are fairly safe providing you do not ignore risks developing right in front of you at all times.
I know when I have taken too many risks in any day, and chastise myself for doing it. I used to ride at 30kph average everywhere I went on a bike at 40, but now at 72, I manage only 21kph. But I often clock 55kph down a hill somewhere. I have to be prepared to swing off a road or bicycle path fast to avoid a collision. I don't have enough near misses to frighten myself off my bike. I used to race in bunches up to 60 men in my 40s, and av speeds were often 35kph, and along a flat road it was helter-skelter, everyone close together, doing 40kph+. I did many races, but never was in a bad pile up with others. The keenest and fastest cyclists as you see in Tour De France are freaks of Nature, possessing capabilities beyond most of us, and they have crashes despite their skills, and often are put off their bike for a long time after a collar bone breaks or some other bad thing happens. But when just cycling around here alone at 21kph, I minimize the risk by huge factor.
I have had falls off bike over years since 2006, when I returned to cycling after 12 year pause following 6 year time racing. Falls were all at low speed,
often onto grass beside track to avoid a child running without fear across my path, or a dog. Once a frame broke in heavy traffic and down I went fast, bits of bike spread out, a buss went past, a foot away. But I later found why that happened, I'd adjusted for stem height too high, metal fatigued fast, so it broke. I phoned for a taxi, and fixed the problem and continued.
I did not break any bones, just minor skin abrasions.
Someone said to me when I was 25 "youse are de man de could not root, shoot, or electrocute..." and I replied saying "well, I am flattered..."
I kinda knew how to survive while pp died around me. I hope that luck continues, and its only hope; shit could happen badly any time.....
Pca could take me out soon. Hey Doc, watcha got this time to avoid trubbel appenin? Docs like that, I found. They like seeing me turn up to talk in lycra, in real good shape, and not with 4 other illness conditions. One said I deserved a medal for being the hospital's healthiest stage 4 cancer patient. "Well ain't that grand, eh, "
Takin it easy today, will try to go fast for 30km across town tomorrow am, Sunday, when little traffic is around, maybe I get a 25kph average. It feels good when all things are going well.
Patrick Turner.
Love that spirit of your's!!! I also have spent more than the 9 lives cats and foolish men áre entitled to.
I'm a Leo. Of course I never believed in astrology. Do I get 29 lives? Hoo Noze?
I'm alive now, and glad to be around.
Patrick Turner.
When I was first diagnosed with PCa and a met at L5, my radiation oncologist referred me to an exercise trial involving weights. Now I am on a two year international trial for metastatic guys with bone mets, also including weights.
Joe, please listen to your oncologist and stop the free weights. Through a chemo trial in 2004 my spinal metastasis were resolved and replaced with new bone growth. Yet, the T3 and L2 remain weakened. They also will.
In 2015, I cracked L2 lifting more weight than I should have. Both my Medical Oncologist and Cardiologist told me no free weights; instead concentrate on resistance weights at 80% of my max weight. 15- 20 reps three times and move to the next machine. I work out twice a week.
I had to sit down with a personal trainer to develop a regime based on my doctors recommendations. With this said, you are a responsible adult and if you want to push and dance with the devil, it’s your choice. I wish you the best.
Gourd Dancer
Your mo may be trying to prevent fractures, so he errs on the side of safety. Do you take a bone hardener? Far be it from me to take away anyone's happy exercise regime! Personally, I hope you keep it up, with a smile on your face and in your heart and strong bones to boot. Doing what makes you feel good is a blessing in my book!
I am younger with less Mets, I just turned 48 and have spots on my ribs spine, and pelvis. My first urologist told me to stop running and gave no advice on exercise or diet. My second opinion doctor at Duke university told me to absolutely keep doing what I was doing and eat a heart healthy diet. I have had radiation, I take Xtandi, and Lupron shots every six months and I always feel 100% better after I exercise. I have noticed some days I need to take it a little easier rather than push it too much. But I run about 3 miles every other day and do some resistance bands and light lifting with push-ups and sit ups. I’m no doctor at all but my advice would be keep moving if possible. Without exercise I am certain my side effects would be worse and I would be very tired. I’m actually in better shape now than I have been since high school .
I am an advocate of exercise and nutrition, and sending good energy your way.
Dr. Armstrong
Are you on xgeva for bones? Plus estradiol patches are better for bones than ADT.
Many top triathlon athletes lift lighter weights but do each rep super-slo. This allows stress to the muscle for muscle building but results in less injury. For you this would mean muscle stress with less bone stress.
Thanks to everyone for caring and for lots of good advice. When I lift weights I use dumbells of 15-20 lbs. Most of my exercise are done lying on a bench, with the excepción of curls and chinups. It doesnt generate much muscle mass like the old days because I am on hormone therapy. But it makes me feel great.
in reply to CountryJoe
Feeling good is everything!
Joe, in my opinion it better to be able exercise less strenuously and to be mobile. Once a fracture occurs the ability to exercise may be significantly impacted and QOL will decline. If your bone density puts you in the low fracture risk category then perhaps you can continue your current regimen. If it is low, then it is better to be cautious. Avoid a fracture at all costs - the decline starts after having one that affects ability to exercise or get around. This what I am doing. Cheers, Phil
Sound like solíd advice. One of my problems is that I live in a developing country with access only to the pulic health system. Its hard to know where to go at times for good and informed advice.
Yes, as others have pointed out, the risk is real. So are the benefits. Prudent stress of the bones can and will strengthen them; osteopenia from whatever cause puts you at risk of stress fracture. That said, even getting out of a chair puts you at risk. How will you live?
The Summer Day
Who made the world?
Who made the swan, and the black bear?
Who made the grasshopper?
This grasshopper, I mean-
the one who has flung herself out of the grass,
the one who is eating sugar out of my hand,
who is moving her jaws back and forth instead of up and down-
who is gazing around with her enormous and complicated eyes.
Now she lifts her pale forearms and thoroughly washes her face.
Now she snaps her wings open, and floats away.
I don't know exactly what a prayer is.
I do know how to pay attention, how to fall down
into the grass, how to kneel down in the grass,
how to be idle and blessed, how to stroll through the fields,
which is what I have been doing all day.
Tell me, what else should I have done?
Doesn't everything die at last, and too soon?
Tell me, what is it you plan to do
with your one wild and precious life?
—Mary Oliver
This is beautiful. Thanks for sharing.
I am on just lupron, the Mets have healed no disease progression. I walk over 10 miles a week, still work part time and eat a modified Mediterranean diet, only eat red meat 2 to 4 times a week. I walk trails outside in the summer and the mall in winter. The problem in the summer is the hot flashes, did try meds but reaction was worse so live with it. Did you have chemo? I had the 6 rounds in 2018, was well worth it.
No chemo. Just radiation therapy and hormone therapy. AND LOTS OF EXERCISE.
Trust In God CountryJoe!
I'm torn between you should and you shouldn't. So do what you want to do?.... and if bad things happen never say "i should have"...Just blame it on my ex-wife.....
BTW Where do you live?
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 02/14/2020 11:40 PM EST
Hello John. Your answer yo muy dilema reflecta muy own mundo. But thanks for offering up someone yo blame. That Will be importante if things go bad😁
2 months before my diagnosis (3 yrs. ago) I fractured T12 just getting off couch. Damaged 2 discs a year ago slipping on stairs. Have extensive bone mets. T12 is now a 50% spinal compression. Will be 70 in June. No warning. Never had radiation treatment. I guess you can shop doctors and online replies and find someone to agree with what you want to hear. That's what we all do. Sounds like you are doing the right things. All things in moderation. Nothing sudden or heavy is my motto. You are going to do what you want to, so, just do it. Best of wishes.
The concern is likely due to fear of a bone fracture due to loss of bone density.
It is listed as a long(er) term side effect of ADT.
I don't believe it is as black and white as they state.
Some of us were born stocky and stay that way, for the most part- so we aren't 'frail' to begin with.
One must assume that we are capable of monitoring ourselves, at least when it comes to the ability to exercise in various ways and means.
I suspect we would sense / feel that our bones are 'degrading' - at least I hope we would be more aware ....
My reciente x rays of shoulder área shows that bone density Is normal with no signs of fracture. But the Bones also show a number of lesiones from bone mets which lead my RO to prohibit lifting. But I like your lógic AND am going with it.
CJ: have you had a bone density test for ostopenia? Might be worthwhile to baseline your risk, and decide how hard to push it during weight lifting. Using 15-20 lb barbell routines should be low risk.
Lots of good info, Joe. So, I’m only 53 but was diagnosed 3 years ago w stage 4 and bone Mets all over with worst in neck and spine. I was advised to stop the workouts (I was a major runner). I still walked every day and over a year ago started doing supervised weights again and doing 15,000 steps per day or elliptical trainer. The result is a wiry slim build but w some strength. I work hard for it! Tomorrow will be my first bone density scan in a year and I hope it shows that my bone density loss rate continues to decline so I can avoid full blown osteoporosis as long as possible. Good luck and keep moving! ✌️ Doug
Thank you my friend. This is all great to hear. My shoulder x rays show that my bone density is normal, but with several lesions. I am lowering the weight I use to 15 lb dumbells with the idea of doing more reps and adding swiming. Hang strong.
If you are on hormone therapy light resistance training is good.
Heavy stuff is going to wear or break something. One issue is that your ability to repair tears and damage is gone or at least substantially degraded. And your bones are now more susceptible to breakage.
Light means real real light.
Error on the side of light.
What is light without hormone therapy... is heavy when you are on hormone therapy.
Be careful or you will f*ck yourself up.
Again, Error on the side of light. If you feel you are pushing yourself in the least, you are screwing up.
Oh,,, did I say Be careful or you will f*ck yourself up.?
====================
Soooooo, how much is "light" in terms of dumbells? I am currently using 15 lbs for all my exercises (bench, pull overs, curls).
I'm 68. Dx in 2002 - Gleason 8 - all cores positive - I walk on a TM on an incline.
300 minutes per week. According to the Harvard School of Public Health,
aggressive walking 300 per week (40-45 minutes everyday) lowers all cause mortality
INCLUDING mortality from prostate cancer by 61% - HELLO- Why isn't this on a marquee
in front of every hospital - No matter what treatment protocol you choose, have that 61%
in your back pocket !! Keep on Keepin' on !!!
What was your radiation oncologists reasoning. Getting a 2nd opinion? Stationary recumbent bike can provide great cardio without impact.
I walk, I run a bit (have fractured spine from motorcycle accident), I lift weghts, I swim and anytjing else I want to do. I've been doing it all my life (and for a year and a half after my RO told me never to lift another weight). I have bone mets throughout my body and a gleason score of 8, and I feel great. I am 74, but I do miss the sex now and then.
.. perhaps switch to resistance bands ?
Don’t forget that if you do break a bone it will be harder to fix than in a cancer free individual. My husband fractured his neck of femur just by stamping his foot down hard following a sneeze! This was pre diagnosis of metastatic PCa. It took five hours in surgery and seven transfusions to fix it. The fracture has also allowed in a a large amount of the cancer cells leaving him with a heavy load on his right hip that required radiation therapy. He walks with a significant limp now as he is still in pain with it. That said, he was diagnosed late and that didn’t help, and his oncologist said do what you feel comfortable with exercise wise, as you have to keep living. He likes sailing so he has just moderated it a bit by sailing for pleasure rather than racing. His sailing buddies have been great, dealing with heavy equipment and running him out to his boat in a dingy etc.
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