They recommend:
• addressing CV reversible risk factors
• involving a cardiologist upfront if 2 or more risk factors; endocrinologist if diabetic
• using orchiectomy or GnRH antagonist (Orgovyx, Firmagon)
• monitor BP, waist circumerence/BMI, serum lipids, HbA1c
• aerobic and weight-bearing exercise
Thank you. Excellent information!
Thank you for this Christmas present information link. So was the,< 0.014 undetectable PSA lab on 12-20! 7 years remission! I am at risk having an arrhythmia in prior testing. Seeing a heart specialist regularly, He just noted my rising B.P. averaging 145/86, so starting Losartan 50 mg./day. Also need to exercise lots more(did 1 1/2 mile walk yesterday. Also very much need to change diet. (28-30%BMI) New year's resolutions all. Happy holidays Mr. Tall Allen (my PC mentor!) Shout out and much Love, keep the Faith!
Well said.
Hello wings! I Too am working on over six years on adt with 3 t. My veins and muscles are tiny . They have a hard time drawing blood . My veins were bid before this . I wonder what this has done to the ol ticker ? Truth is dodging the devil for many years is a miracle IMO . Yo7 can do the diet . I did . Good luck ! Happy new year ! 🥳🥂👍
Thank you for sharing!
Some SOC doctors prescribe a low dose of estrogen (parenteral - I know one who recommends a patch).
I doubt any good doctors would prescribe estrogen shots - very high risk of blood clots.
My understanding from my MO is that oral estrogen causes blood clots and other cardio issues. Parenteral has an advantage and doesn't have as many cardiac issues and actually becomes cardioprotective after a year or so.
Do you feel that she is a poor doctor? And is the PATCH trial invalid?
Parenteral means other than oral. Since you mentioned transdermal separately, I assumed you meant shots. The high estrogen spikes with shots cause clots. It sounds crazy that estrogen shots are cardioprotective - do you have backup for that?
No. Just what my MO told me and some PubMed research. No RCTs as far as I know.
I assume that tE2 such as the patch and gel have much lower clot risks than the injections?
Hello Tall Allen, I came across a paper that appears to indicate that parenteral estrogen might be safe: 40. Phillips I, Shah SI, Duong T, Abel P, Langley RE. Androgen Deprivation Therapy and the Re-emergence of Parenteral Estrogen in Prostate Cancer. Oncol Hematol Rev. 2014 Spring;10(1):42-47. doi: 10.17925/ohr.2014.10.1.42. PMID: 24932461; PMCID: PMC4052190.
Great information and very much needed. Thanks, TA
It s important to try to reduce the damage . 👏👏👏👍🥂
Thanks, Tall Allen. Good reminders.
I watched my diet/intake and exercised hard and consistently on Lupron, Zytiga, chemo, radiation, etc and still saw increased fat, decreased muscle, big jump in LDL, bone density loss and all the rest.
The changes were a bit distressing sure. But not anything like it would have been if I hadn’t come into it in shape and then maintaining as much as possible!
I cannot imagine the struggle guys must have who begin ADT sedentary, severely deconditioned and with co morbities , as so many are.
I’m glad to see the agonists are better for CV risk, if that’s actually true.
I think we really need to track our numbers (besides PSA and testosterone) throughout the process, good bad or ugly. Dexa scans, lipid panel, blood pressure, glucose, all of it. Most men with pca I know do not.
Thanks for this good general outline of what’s needed.
Interestingly my MO (Scholz) believes that most of the heart issues associated with ADT therapies, are related to the associated weight gain and loss of muscle mass experienced. If one can work out hard enough to avoid that, he thinks the heart issues mostly go away.
Schwah
I thank you for the very useful information. I think I have a floppy heart valve and I have had rheumatic fever. My Gleason reading was 4+5=9. I had 68Ga PSMA PET scan. I had a Holtz monitor for a day before I started Firmagon for a month during 39 days of EBRT then for 12 months I have been on GnRH agonist Goserelin ( Zoladex). In September my PSA was down to <.01. My blood pressure when last checked was OK.
Thanks, very useful info.
Thankyou for posting.
Thank you. Vital information.
Thanks, Tall Allen. This month marks five years since this journey (and ADT) started for me. Yesterday, I received the nice Christmas present of another non-detect for psa. Thanks to this group, I’ll have resources the day the result is different. In the meantime, my doc said, “please just keep on doing what you’re doing”. That updated list is a good reminder! Happy holidays, gentlemen! ✌️ 🌲 Dougnola
Even in the absence of known or prior cardiovascular disease, men with APC on long term ADT are at high risk vis a vis dyslipidemia, central adiposity, sarcopenia and insulin resistance, etc. IMO lipids (cholesterol, LDL, HLDL,TG) should not just be “normal” but should be as “optimal” as is achievable. This very often requires statins as well as careful disciplined habits of diet and exercise. LDL <100 (ideally near 70) and HDL >50 (ideally 70) are my targets. Requires lots of exercise and max dose, 80, of atorvastatin with my very low carbohydrate keto diet (not for everyone).
I seem to have been lucky controlling the risks. They told me I'm now a type 2 diabetic, changed my eating habits and dropped HbA1C from 6.8 to 6.0 and now about 5.4Blood pressure was on the rise, low dose Losartan brought it back down. last BP was 122/75. the change in diet dropped my weight and BMI although a bit too much.
thank you for this article it will help with follow up.
Thank you for your contributions and the base knowledge you have extended.Thanks also to all and everyone who shed their vision and experience and all those who have left us because of PCa. To all including moderators may all us acquire a Merry Christmas in some form….
Thanks Tall_Allen, I am coming up on my second year end of Lupron and Abiraterone. My PSA went down to 0.16, but it’s not zero, I am worried about what it is doing to my body, this article has some great info to discuss with my Onc, but I should get a cardiologist only medical team. Happy holidays and stay strong!
Thank you Tall Alan for all of your time, energy, and valued information you have given over the past year. May your holiday season be merry, healthy and bright. Your comments though the year has given much to think about and help in dealing with this desease.
And don't forget the most important one...... Always insist on the bottom position....
To Members: Re: MaleCare donation.
I don't want a medal but I contributed money in the beginning of this month. I just want to say the information and camaraderie you receive here is worth it's weight in gold. So for the Holiday season write out a check or charge an amount to your credit/debit card to keep this wonderful organization up and running every day of the year. Thank you!!!
Good Luck, Good Health and Good Humor
j-o-h-n Thursday 12/23/2021 6:18 PM EST
Thanks, and Merry Christmas.
Merry christmas ta......thanks for all you do....bw
I would suggest men consider buying a Electric bicycle for exercise and CV health.
I suggest one that REQUIRES pedaling and the motor sensor detects your effort and provides help. These are called "Pedelec bikes". You select and vary the amount of motor assistance on the fly.
They will open your world back up to you and and you can get a better workout/exercise experience than on a regular bike.
There was to be some federal assistance to buy a ebike in the build back better plan, if that were to pass.
Docetaxal prior to Hormone Therapy
A positive about hormonal therapy?
New to hormone therapy
going off hormone therapy
Testosterone Therapy & PCa Risk.
