I was placed of abiraterone and ADT 6 months ago. I am an avid exerciser so I have not experienced any fatigue but I think I was noticing mild weakness. I decided to start weight lifting. My question is: Do I expect to get stronger or just slow the deterioration.
Question about weight lifting while o... - Advanced Prostate...
Advanced Prostate Cancer
Stronger, depending on how hard you work and what your starting point is. If you’re already pretty much maxed up you can expect to maintain.
No I have never lifted weights. Strong legs from running and biking but upper body is really weak. If I can maintain legs I would be very happy.
Keep up the running! You should be able to increase upper body strength and muscle mass with weights
Legs are much easier to maintain or grow on ADT than upper body.
What is the reason?
It wouldn't be easier on conventional SOC ADT unless you add estrogen back (low dose patch). E reduces bone loss and depression. Sources: personal experience, my doctor, and my research. And conventional treatment for 40+ years.
I always add E back and I also use SARMs so I have libido, muscle gain, normal lipolysis (for me), bone growth per DEXA scans, improved lipid profiles, no hot flashes, and no depression. I had a brief taste of what life with low T and low E is like. No thanks!
Discuss with your MO or a knowledgeable doctor if you want to know more. Most doctors don't know enough about hormones but fortunately, there are some who can figure it out. One of my doctors used to be a bodybuilder so he knows the details.
We all react differently. I worked out a few hours a week going into ADT. I dropped a lot of strength and muscle. My legs maintained better than my upper body but still got weaker. I think it would have been much worse if I stopped working out.
Now I add SARMs to ADT and maintain or gain. My muscle mass is higher than it has been for two decades. Fat is lower than when I was diagnosed (2018); not great though.
What is SARM?
SARM = selective androgen receptor modulator.
SARMs are a class of therapeutic compounds that have similar anabolic properties to anabolic steroids, but with reduced androgenic properties. Androgenic AR activation can contribute to PCa growth in a low testosterone environment. Unlike anabolic steroids, which bind to androgen receptors in many tissues all over the body, SARMs selectively bind androgen receptors in certain tissues (typical skeletal muscle), but not in others.
They increase bone and muscle growth and decrease testosterone, SHBG and HDL. It is possible that a transdermal route of administration might avoid the reduction of HDL cholesterol. Some SARMs are being developed with this aim.
My experience with SARMs is that a few weeks of a combination of Rad-140 at doses of 20 mg/day and Ostarine at doses of 25 mg/day does not interfere with ADT (or the low phase of BAT). HDL cholesterol decreased but I didn’t notice any other dramatic changes in my blood labs.
Possible transdermal application:
Transdermal drug delivery is feasible for molecules less than about 500 g/mol. Ethanol (ethyl alcohol) is frequently used to increase transdermal permeability. Ostarine, LGD_4033, and Rad-140 have low molecular weights (330 - 390 g/mol) and are soluble in ethanol and should be suitable for transdermal application. If a SARM can be administered trans-dermally instead of orally, the negative effects on HDL cholesterol will be diminished. I am testing this by mixing Rad-140 and Ostarine with transdermal gel. I should have some results by 9/2022. The main transdermal permeability carrier in Androgel is ethanol (66% of Androgel). When I do the ADT phase of BAT I plan on mixing alcohol with a SARM and some kind of skin moisturizer base for a carrier. Very out of the norm and just an experiment.
Results so far:
4/25/22 Started 10 mg/day “transdermal” Rad-140. HDL was 28
5/04/22 Continuing “transdermal” Rad-140. HDL was 34
1. (SHBG reduction): Fat loss and muscle gain: A Selective Androgen Receptor Modulator for Symptom Management in Prostate Cancer - Study Results - ClinicalTrials.gov
2. Selective androgen receptor modulators: the future of androgen therapy? – PMC
3. Selective Androgen Receptor Modulators (SARMs) Current Knowledge and Clinical Applications PMC
4. Selective Androgen Receptor Modulators (SARMs) | USADA
5. Selective androgen receptor modulators: in pursuit of tissue-selective androgens - PubMed
6. A selective androgen receptor modulator SARM‐2f activates androgen receptor, increases lean body mass, and suppresses blood lipid levels in cynomolgus monkeys PMC
7. Selective androgen receptor modulators in preclinical and clinical development PMC
8. SciHub | Comparison of the three SARMs RAD140, GLPG0492 and GSK2881078 in two different in vitro bioassays, and in an in-silico androgen receptor binding assay. The Journal of Steroid Biochemistry and Molecular Biology | 10.1016/j.jsbmb.2019.02.014
9. Selective Androgen Receptor Modulator an overview | ScienceDirect Topics
10. Effect of GTx024 on Muscle Wasting in Patients with NonSmall Cell Lung Cancer (NSCLC) on First Line Platinum Study Results ClinicalTrials.gov
11. Study of GTx024 on Muscle Wasting (Cachexia) Cancer. Study Results ClinicalTrials.gov
12. Study to Evaluate the Safety and Efficacy of 13 Weeks of the Selective Androgen Receptor Modulator (SARM) GSK2881078 in Chronic Obstructive Pulmonary Disease (COPD) Study Results ClinicalTrials.gov
13. A Novel Selective Androgen Receptor Modulator (SARM) MK4541 Exerts Antiandrogenic Activity in the Prostate Cancer Xenograft R3327G and Anabolic Activity on Skeletal Muscle Mass & Function in Castrated Mice | Request PDF
14. Selective Androgen Receptor Modulators (SARMs): A Minireview
15. Discovery AND Therapeutic Promise OF Selective Androgen Receptor Modulators PMC
16. New Drug Undergoing Phase II FDA Clinical Trials Could Help Cancer Patients Regain Muscle Mass | Science Times
17. Drug‐Induced Liver Injury by Selective Androgenic Receptor Modulators PMC
18. Very large amounts used: JCI Selective androgen receptor modulators activate the canonical prostate cancer androgen receptor program and repress cancer growth
19. Transdermal research:
• LGD-4033: 4-((R)-2-((R)-2,2,2-Trifluoro-1-hydroxyethyl)pyrrolidin-1-yl)-2-(trifluoromethyl)benzonitrile | C14H12F6N2O - PubChem
• Rad-140: Testolone | C20H16ClN5O2 - PubChem
• Ostarine: Enobosarm | C19H14F3N3O3 - PubChem
• Permeability enhancement for transdermal delivery of large molecule using low-frequency sonophoresis combined with microneedles - PubMed
• ANDROGEL® (testosterone gel) 1%
• Under the Influence of Alcohol: The Effect of Ethanol and Methanol on Lipid Bilayers - PMC
Thank you, I have been lost, with every letter..spending so much time on google! That was perfect!Karen
Thanks everyone for helping out. This not an easy road.
I wish you the very best. You are right, lots of potholes on this road. But there are nice rainbows if we look up long enough from the road to see them.
I was fortunate enough to find an MO who listens to me and doesn't just regurgitate what she has been told. An MO who is a good fit is very important for all of us. We all vary in what we want from an MO. I found that interviewing multiple doctors helped me find a good fit.
If you weren't working out with weights previously, you will probably gain some upper body strength with weight workouts. Bench presses, biceps curls, chest flies, dumbbell rows, deadlifts, lateral raises, triceps kickbacks for upper body. If already working out with weights prior to ADT, good luck maintaining the same level of strength, but continuing weight training at least forestalls some of the strength losses. The longer you are on lousy ADT, the worse it seems to get. Personally, I've noticed the greatest loss in leg strength, but I had relatively strong legs prior to ADT from jogging, bicycling, weight training, and hiking/walking. There ain't no free lunch with this stinking disease! ☹️
Did you do heavy low rep compound movements or lighter, hypertrophy, bodybuilding, and aerobic movements?
I wonder if there are ADT workout principles that we can follow. Seems like it might be heavy compound strength stuff with cardio. They are opposite ends of the spectrum but might help maintain some strength while decreasing the fat gain.
Something in between. I try to do 5 sets of an exercise, 9 or ten reps per set except fewer reps for bench presses, starting at a lighter weight for the first set and progressively higher weights for the next 4 sets. I don't consider weight lifting as a cardio activity, I use jogging, bicycling, and long walks for that. I'm not a body builder, I just try to stay in shape and maintain some sort of strength for other activities.....I've been working out with weights for probably about 50 years. I used to play softball, tennis, golf, etc., and weight lifting supported those other activities.
Has anyone had experience with switching from free-weights or machines to resistance bands? I mean high-quality flat style resistance bands. I lifted weights for the last 50 years and I’m now 70 years old on Orgovyx for the last six months with possibly another year to go. Two months ago I switched to resistance bands and my strength seems stable but with no more joint pain whatsoever. Unfortunately my leg strength has vanished considerably. This has made hiking much more difficult.
I went back to freeways this last week to see how much if any, strength I’d lost. The odd thing is that my shoulder strength was as strong as ever but legs down 20%
Resistance bands can be very effective and are easier on joints and smaller connective muscles than free weights (in my opinion). You can also do body weight exercises like pushups and planks for upper body and core. For legs, try squats (with no weight or with dumbbells, you can build up), doing sets of stairs, and lunges. Make sure you stretch well also.
I’ve heard it described that when on ADT, you have to work twice as hard to get 80% of the results, and that seemed to be how it feels for me. But keep working at it consistently and you should still feel a lot better than if you don’t. Good luck!
Work hard enough and it doesn’t matter what type of lifting you do. Just don’t neglect the legs.
The only important things are to work as hard as possible and change your routine regularly so your body doesn’t get used to any one style of lifting. Heavy/low reps , light/high reps, supersets, high volume, HIIT, calisthenics, super slow negatives, the list is long and it’s all good.
You can build muscle on ADT if you have inexperienced or have room to grow. If you’re already strong not as much, but no matter. Nothing is more important than lifting on ADT. Eat well and varied also, with plenty of protein.
I lost considerable strength on Lupron for two years. So when your young it's easy to build muscle. As you age maybe in middle 40s to 50 it gets a whole lot harder to move forward when you've been say racing bicycles most of your life, you're training as hard but taking longer to recover and not making gains. You have a lot more feeling off days.You used to hammer hard on long rides and feel fine after completing the ride, now you have a drained feeling come over you hours after finishing.
So this is natural ageing, but on Lupron I lost 1/4 to 1/3 my strength and stamina was really weakened.
Muscles will over work, strains happen easy, joints are weaker. So this is on what you been doing your whole life.
Now when you at this point and start a new upper body exercise like weightlifting your going to be weaker, slower, but you'll develope some strength because it's all new. And kick up the metabolism some.
You'll need to nap more but feel better.
That's my experience.
It takes a long time to lose fat gained on ADT. There's a long period of losing fat and gaining muscle that keep your weight about the same but reshape your body. Then maybe after six months the fat itself comes off easier.
Another example I could only drive a golf ball 200 yards at most on Lupron, now back to 250 yards off ADT.
I've done moderate weight lifting with a focus on endurance rather than building bulk while on ADT. My focus is large muscle groups - a good example of this is seated chest pulls. Seated chest presses, as well. Press downs, too. I also focus on legs extensively - - Dr. Daniel George, one of the primary researchers on the Orgovyx drug, STRONGLY emphasized that to avoid frailty from ADT one should exercise the legs a great deal with a special emphasis on leg presses as the primary leg exercise. Dr. George stated that this is all about avoiding pelvic and hip fractures from falls which he sees a lot of in his urologic oncology practice.
I also do 20 to 30 minutes on the elliptical with a focus on heart rate. My cardio and weight routine takes about 60 minutes, every other day. I am now just starting an ADT vacation from Orgovyx so I hope to increase my weight lifting with the return of testosterone.
Do you have any good references for workout design? Before ADT, I was doing P90x so I just followed the videos. I have started back at a gym and am a bit lost so my workouts are a bit random. I have been looking for an app so I can track my progress.
@ PabloK - - if possible, you might consider seeking out a good personal trainer for a few sessions to 1) evaluate your current state of fitness and 2) prescribe a program specific to your needs. It would be well worth the cost.
The gym I go to has trainers but a bit out of my budget- $100 per hour. I was looking for something more sustainable
@ PabloK - - wow! I had no idea that the going rate for trainers is so high, now. What I had in mind, and what I've done in the past, is just do 2 or 3 sessions and then follow the trainer's prescribed program on your own.
Hi G4, In my experience in two ADT courses showed exercise managed to stabilize strength and there was a mild improvement but no significant process in skeletal muscles, cardio fitness on the other hand improves with exercise specially if its cardio, keep at it Patience and Never Give up
I just lift weights to stay toned and try to maintain muscle, depending on what you do it also helps maintain balance (important to avoid skeletal related injuries). I alternate weight lifting and resistance bands with brisk walking every other day 7 days a week. Throw in swimming when the weather warms up.
I agree with the above comments:
good luck maintaining the same level of strength, but continuing weight training at least forestalls some of the strength losses.
on ADT, you have to work twice as hard to get 80% of the results,
8 months into Lupron and Zytiga I find it is harded to do my exercises, first set is always hardest so I know I have lost some muscle mass in between workouts.
I have read every comment....this is terrible to lose this kind of strength. Start out light on bench press, just the bar 30 pounds, then work your way up. One of the posts gave you a routine with free weights. Keep it up. My husband is trying to work out once again. He does go to work every day, but has lost so much strength. We have a fence company, yesterday Jim mentioned that he use to be able to walk with five panels, dig holes no problem. He can barely carry three panels...my strong big man is so thin...went from 210 to 150. Just two years ago we were together in Japan. He was on the USA Power lifting team for strongest world bench press in his age group. He has so many trophies and titles, benching since 13 years old. I was amazed, the other side of the world, they knew my husbands name very well. Japan took their best man out of retirement in hopes to beat him. Japan loves power lifting and bench press. Isn't it amazing, how your life can change over night??? I read all of your stories and I am preying for all of you brave brave men. Jim is fighting this every step of the way, and so am I!!
Thanks for all the info on your workout regimes. Very helpful.
When I first got diagnosed I was reeling from the urologist’s doom and gloom statements about my prognosis. I immediately changed my diet, and started walking 6-7 days a week, no matter the weather. No one said a word about weight training, I hadn’t found this forum yet, and with the initial Lupron fatigue, just walking, maintaining my yard and doing a few projects took about all of the energy I had.
I noticed significant losses in strength and musculature almost immediately.
After I started reading posts on HU about the importance of weight training I started lifting again. I was extremely discouraged by how much strength I had lost, and how drained I felt after some workouts. Previously, my legs were the strongest part of my body. In my younger years I’ve been known to show off my leg strength in the gym, but when I resumed lifting, my 14 grandson’s legs were as strong as mine.
After lifting for several months, my muscle development baffles me. My back and shoulders have responded well to my workouts; my core is strong; but although my legs and arms have toned up, I have only made incremental strength gains in my extremities.
To try and get past these plateaus, I have adjusted my workouts several times, I have added more protein to my diet, and I feel strong and well. However, my working strength (I have 5 acres of timbered land to maintain, plus lots of projects) still remains significantly reduced from pre ADT levels. I welcome any advice on how to improve my strength and muscle mass.
I‘m running all my life. When I started ADT I continued running but didn’t do any weight lifting as I’ve never done so before. My legs stayed strong but my upper body suffered a lot. So last July I added weight lifting with dumbbells and gymnastic (planks etc.) to my fitness program. I really gained muscle mass back & more. It’s tough sometimes but it works. I can recommend the APP from HasFit, there is a free of charge version and I‘m following the programs. Very importantly I‘m not only doing arm and upper body strength but also lower back training. All my back pain is gone.
Thanks Nusch, I'm going to check out the HasFit app.
I've always been very active, biking, running, basketball, weightlifting, hiking etc. I actually feel really fit and healthy most days. I think for me the impact is more psychological. First, I cannot believe that those are my legs and forearms I'm seeing in the mirror. Second, I occasionally get a hold of something that I used to lift with ease, or have to use force above my head, and it is striking how much strength I've lost - even with the weightlifting.
Yes, I experienced the same. When I started weight lifting last July I felt like the weakest guy on the planet. Sometimes In had to ask my wife to open a bottle. Now I‘m happy with what I see in the mirror and I‘m looking forward to summer season and beach. But I warn you. It’s tough. When I promise, it pays off when you stay constant and make it a part of your life. All the very best!
What does your Medical Oncologist say? Look working out on a gym is good; however, if you have bone metastatic lesions, you might want to rethink weights. It’s a terrible thing to fracture an already weakened spot; especially on the spine. Good luck.
Good point. Any exercise regime should take into account the individual's particular strengths and weaknesses. It also isn't a bad idea to use weight belts, knee wraps, and gloves when appropriate when weight lifting, especially for heavier weights. And overdoing it can sometimes lead to injury, negating all the benefits of working out in the first place. I knew someone who was constantly training to run marathons, running all the time, and he was his doctor's best patient from an attendance standpoint. Why he never dialed his workouts back a little to avoid so many injuries was beyond me. He sometimes actually missed going to planned marathons he had paid for because he was too beat up when marathon time rolled around. 😁
Check with your G.P. before you start lifting weights (or shoveling snow).
Would you please be kind enough to tell us your bio. Age? Location? When Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
ALL INFO IS VOLUNTARY, but it helps us help you and helps us too. When you respond, you might want to copy and paste it in your home page for your use and for other members’ reference.
Note: Answers are for your benefit, not mine.
THANK YOU AND KEEP POSTING!!!
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 05/06/2022 7:57 PM DST
Welcome to the club Grandpa4! I have been on ADT (Zolodex) for just over 12 mths and whether you know or not, it is not much fun. I have hot flushes regularly (joined the women's club, lol), have put on weight around the middle and lost body hair on my belly, chest and back, but, thankfully have plenty of hair on my head. And, I decided to grow a beard to compensate, lol. The other disturbing factor with ADT is that your pecs become breasts that some women would die for! lol. The important thing is to exercise as much as your body allows and forget about what is happening to your body - stay positive. Most importantly, exercise is good for the mental outlook. Cheers and good luck on this journey we now have to take.
I got breast irradiation before starting to eliminate the gynecomastia. I am really working on weight gain. I exercise a minimum of 500 calories worth a day. So far so good. I do have hot flashes but they are not too bad. Don’t the hot flashes go away eventually.
I recommend BODY BY SCIENCE book and many YouTubes by Dr Doug McGuff . Radical , iconoclastic , evidence based approach to resistance training . Also , my United Healthcare Medicare Advantage plan covers my gym membership and sessions with the trainer . I’m 73 .
For what it's worth, I do all my training in the mornings as early as possible when mental and physical energy is highest. Some times the ADT afternoon fatigue makes working out more challenging. My intermittent fasting window feeding time is 11:00am to 5:00pm. Training on an empty stomach enhances my energy level considerably so I always train before eating.
So far I can still wrestle Jiu Jitsu twice a week, lift three times a week and hike three-miles six days a week. Also started hitting the speed bag again and am teaching myself how to play the piano in order to halt cognitive decline. I'll turn 70 next week and plan to do the same routine at 80 and 90.