Muscle Mass Loss ADT, Firmagon Or Zytiga? Any Studies on MML on ADT

[Shorehousejam]

Are there any studies noted what treatments cause more muscle loss than others…

Which is worse for muscle loss Firmagon or Zytiga?

[mperloe]

Firmahon, Lupron and Orgovyx aim to reduce testosterone to 20-50ng/dl. Zytiga should be associated with undetectable testosterone level and thus a greater potential for muscle loss. Strength training with weights or elastic bands can help protect or reduce muscle loss.

[Shorehousejam in reply to mperloe]

Thank you, agreed once started zytiga muscle mass loss was extreme, would like to know if Nubeqa does the same damage with muscle loss.

[mperloe in reply to Shorehousejam]

It will vary from person to person but would likely as well.

[cesces]

I think it's the testosterone that does it.

[London441]

The testosterone suppression causes the muscle wasting. Engaging and maintaining bearing exercise to mitigate it is what matters; the small differences between the drugs causing it are comparatively insignificant.

[Nusch]

I did it all, when I started my treatments, except weight lifting. And this wasn’t a good idea. Now I do some weight lifting almost daily and even with Lupron and testosterone under 10 I regained my muscles. It feels good that I can carry of lift my shopping bags easily again, can get in and out of my car without any hurdles and look better in the mirror. It’s a complete different QoL.

[m1946 in reply to Nusch]

Hi

is there available a weight training programme?

[Nusch in reply to m1946]

I work with HasFit, you find them on Youtube.

[MateoBeach in reply to m1946]

Have weight lifted to some degree my whole life, but never really liked it. 2 months ago I started the "Big 5" strength training detailed in the book "Body by Science". One workout per week. One set only of 5 (or 6) compound whole-body exercises. Done very slowly (16-20 sec per rep) at high intensity, to complete failure (cannot continue) within 90 to 120 seconds. Nothing left in the tank.

I am doing it on machines (MedX) with a trainer, for safety and to maximize each exercise (It is hard!). After 4 weeks lead-in I am now seeing big increases in strength (loads) every week. And have the rest of the week for cardio and other outside exercising I enjoy.

[Boonster in reply to MateoBeach]

Interesting approach to weight lifting. I've been doing two sets of 10 reps on 11 machines that collectively address the entire body.

You wrote: "One set only of 5 (or 6) compound whole-body exercises. Done very slowly (16-20 sec per rep) at high intensity, to complete failure (cannot continue) within 90 to 120 seconds."

One thing I don't quite understand: how many reps are you doing, if you do enough reps at high intensity to complete failure, How do you manage to do 5-6 whole-body exercises. How long do you rest after complete failure so that you can continue to the next machine? Thanks!

[MateoBeach in reply to Boonster]

The Big 5 program sets are just around 6 to 8 reps . But they are done with very slow continuous movement, 8-10 seconds up and 8-10 seconds down, for 16-20 seconds per rep. The first two or 3 seem just moderately hard. But then the Type I fibers start to fail and cannot recover so the Type IIa, IIb, IIc fibers and motor units are sequentially tapped then tapped out. The last two reps are agonizingly hard! And finish with a 10 second hold when you can no longer budge the weight. Very deep workout that creates much delayed onset soreness. Cannot repeat it effectively before a week of recovery.

It covers the entire body with squat motion (or leg press), overhead pull down, upward presses, forward chest presses, and rowing motion. All with higher than typical weights to ensure failure within about 2 minutes. A hinging motion exercise for posterior chain is a 6th that I do (Dead lift or equivalent machine).

Sometimes I come back mid-week and knock out som small muscle specific sets, but at normal reps and pace: biceps curls, triceps, quadriceps and hamstring curls, and a cable twist. Takes me 15 minutes. Otherwise I exercise outdoors a embellishing my walking and hiking. Once weekly “Rucking”, hiking hills with 25-30 pound weighted pack. And circuit training on my walks using street furniture, etc. Inclined pushups, pull-ups, dips, striding lunges, bench step ups, and such.

Het and read the Body by Science book if you decide to test it out. Indeed it is very good science behind it. MB / Paul

[Boonster in reply to MateoBeach]

Thanks so much for the elaboration. So impressive, your workouts!! Have saved your message for periodic review. Thank you.

[duwa]

As MateoBeach stated, I too started a "Big 5" strength training program about 3 months ago. I do have a "workout machine" ( Inspire from Costco) but, using any free weights will work also. I ride my stationary about 15 minutes daily and I work out hard, 3 days a week and light on the other 2 days. No workout on Sat or Sun. I have controlled my mussel loss and have started to gain some mussel back.

[Hidden]

I was pumping iron for years before PC. I continue to lift exactly as before. No lowering weights, same number of sets and reps. While Lupron kicks my butt every day the one thing that gives me satisfaction and a good feeling is pumping iron. Done carefully and with skill I recommend it. I have not seen any muscle mass loss or strength loss yet. It is likely harder for someone to start a routine after ADT. I prob had an advantage simply maintaining an existing routine.

[JohnInTheMiddle]

This is a fantastic discussion about PC therapy, testosterone suppression, muscle mass loss and exercise.

SITUATION - I have just finished my Docetaxel chemo. Very tired. Seven months since diagnosis of high volume metastatic-to-spine prostate cancer. Also Zytiga and Firmagon.

EXERCISE - My MO has noted significant "deconditioning". So I'm involved now about four times a week in a great program for about 40 minutes with stretchy bands. And walk an hour most days. I'm feeling stronger! (Another motivator is the research that indicates that exercise may produce powerful epigenetic effects against cancer.)

WEIGHT LIFTING RISK - My big question is about weight lifting, which several people have mentioned. I have free weights and used to do them. I believe this could be important. HOWEVER I have three somewhat compromised vertebrae. It's not a good idea to risk spinal fracture and paraplegia!

RISK ASSESSMENT - Apparently research on biomechanical risk, based on engineering analysis of bone mets and exercise or work activity, is just beginning. I'm not really getting personalized and deep advice except "don't do it".

So I don't. On one hand weight bearing loads increase bone strength. On the other though apparently rebuilt bone after lesion recession is quite weak.

Any thoughts on weight lifting and bone mets-related fracture risk? Especially concerning the spine? Precaution is warranted - but being over-cautious might result in missing a real opportunity to improve health.

Thanks,

JHMX

[Seasid in reply to JohnInTheMiddle]

I am thinking a same way like you. Did you have a bone density scan?

[JohnInTheMiddle in reply to Seasid]

Yes, they said it was very good. (I'm 62). I think I need to be more familiar with what this means.

[Seasid in reply to JohnInTheMiddle]

What is your PSA now? I didn't know that you can receive Abiraterone plus Prednisone in Canada before CRPC develops?

[JohnInTheMiddle in reply to Seasid]

.03 - not a typo - from > 1500 seven months ago.

[Seasid in reply to JohnInTheMiddle]

I see. Good response.

My PSA was 100 when I started ADT. I also had lots of spinal mets.

After 4.5 years I am reasonably well, I don't have any visible.mets by the 68 GA-PSMA PET scan.

My only concern is now that they will put me on Prolia.

Did you receive Prednisone during your early Docetaxel chemotherapy? Or only dexamethason before and during the chemo infusion?

[Hidden in reply to JohnInTheMiddle]

Start light with the weights at first cuz you will have to. Start slow to warm up muscles, always. You-tube has lots of useful stuff: 'bob and brad' have a great channel, 'Athlean-X'. Athlean looks like too much and intimidating but what he is good for is GOOD form!! Bob and Brad have good band ideas. Watch a bunch of videos before starting.

[JohnInTheMiddle]

Dexamethasone only for three days around chemo. Nice energy boost! As for PET scans, which are expensive, haven't had one as the doctor say it would not make any difference in terms of decision making. Ok.

So, just read up on your mention of Prolia, a.k.a. Denosumab. Lots of scare posts on this here - the statistics apparently though are that the risk of fracture is greater than the risk of side effects. Either way horrible.

This is why I want to do the bone strengthening exercise. Except I know at least some of the big five are off limits for me because of the vertebrae compromise.