I know that many of you are well practiced in the art and science of strength training, so I’m hoping you might be able to help me here.
My only therapy for mPC DX 4 years ago has been ADT (Lupron & abiraterone). So far so good in that my PSA remains < 0.1 and occasional imaging indicates that my upper spine met isn’t growing. I’ve learned to live with all the usual SEs. Immediately after DX, I stepped up my exercising at the gym. My every-other-day routine is 15 min floor stretching/exercises, 45 min training on resistance machines, and 30 min cardio on bike. On machines I do 3 sets of 10 reps, with resistance set so I could do just a little more if I had to. Recovery between sets is typically 2-4 min. The reason for these details is obvious in the next paragraph.
All was OK until about 3 months ago. I’ve gained just a little fat around my middle, but I’ve lost about 15 pounds over the 4 years (I’m skinny), so I’ve obviously lost muscle mass. But that’s not my main problem. My main problem is that lately I often feel a new whole-body exhaustion or fatigue come on during resistance training that tells me I should stop exercising now. This new fatigue and weak feeling generally stays with me for the rest of the day. BP is a little higher, but HR is normal.
So when this started, I did the obvious thing of reducing the resistance on the machines I use including the bike (after all, I just turned 80). But I’m still getting these “attacks” of abrupt exhaustion/fatigue that stick with me for hours. This happened again today, so I’m unsure about going to the gym again.
Help. What’s going on? Any advice?
Thanks for reading this long post.
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Gearhead
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I am far from an expert on Fitness, but are you getting enough Protein in your diet? Sometimes we overlook the obvious ....well at least I do! Impressive workout well done.
I've been on the same ADT as you (Eligard and abiraterone+prednisone) for 6 months so far, and starting radiation (proton therapy) next week. I know exactly what you're talking about -- I work out with a trainer twice a week, and sometimes have to just stop and catch my breath after a hard set, chest pounding, sometimes in a cold sweat, til I recover enough to continue. That said, I'm only 69, and your routine puts mine to shame!
I doubt what you report is at all unusual. After all, we have no testosterone for starters, and my bloodwork shows me to be a little anemic, which they tell me is a side effect. It makes sense to me that with RBC count, hemoglobin, and hematocrit all on the low side, my muscles just aren't getting enough oxygen to keep going hard for very long. I'm just glad I (and you!) are doing as much as we can to keep ADT from turning us into useless blobs. 😱
‘From what I read’ isn’t much to go on. There’s a lot of good in creatine. I can think of about 10 other commonly ingested things that are far worse than creatine has a chance of being. Bring data, not folklore please.
I agree that there are worse supplements. But when you google for studies, the newer ones are not too positive about creatinine. Anyhow, we all trust in that what works for us.
I read your bio, we have a similar history of treatments. I‘m currently in month 13 of ADT after IMRT, I will go for 18 months and then go into vacation.
Wishing you a healthy future and let’s stick to vigorous exercise, too.
Been on it for 6 years, no adverse affects, still doing ADT 6 1/2 years later. My Oncologist approves. Red meat and shellfish contain it and your body makes it.
Not to worry you but my routine is way less strenuos than yours. I had a similar feeling working out and also playing pickleball. I thought I was going to faint. My Doc referred me to a cardiologist and he performed a stress test that I flunked. A cardiac cath showed all main atreries good but peripheral artery 60% blocked. I'm now taking a beta blocker and baby aspirin and have had no further issues. After 4 years of ADT a cardiac workup is a good idea.
First I want to congratulate you - you are doing really great! I‘m exercising a lot, too and I totally understand what you say. I recommend that you start using a nutrition APP for a while, one such as CRONOMETER. The free version is sufficient, you don’t need to premium version. There you input your daily intake and it provides you with all details such as carbohydrates, proteins and fat / even all vitamins, amino acids etc. I try to go with 0.8 gram of plant based protein / kg body weight per day, which is the recommended quantity. I also try to go with not more than 40 gram of fat every day. The rest are carbohydrates. I do this sind five years and basically I have enough strengths for my trainings. Of course there are days where I feel weaker and days I‘m doing better. That’s normal. And from time to time I have a day of rest. One more thing: Check your iodine, B12, zinc and other blood values once, just to making sure that you are not deficient.
You probably need to eat more. More protein, fiber and water especially. Exercise depletes all of it unless there’s not enough to spare, and you don’t want that. Cutting back on the workouts is a last resort, and shouldn’t be necessary if you get more of these in. Great luck to you!
Fatigue with exercise makes a bit worried you might have coronary artery disease and block in a blood vessel. Probably not but I think I would get a stress test to be sure.
if I was 80 with advanced prostate cancer I wouldn’t worry about it. Do the exercises that you’re capable of without getting overly fatigued from them and enjoy the day. I’m 15 years younger than you and exercise every day, but after almost 9 years of ADT I can’t do what I used to, getting older is probably a factor too. I keep my BMI in the normal range and focus on staying toned and work on cardio to keep my heart healthy. I focus on keeping the “machine” in good working order so it can handle the current and future treatments and challenges of living with advanced stage cancer.
Hey fellow gearhead. I just turned 79 and you have a lot more ambition than me. I go to the gym twice a week, biked on the gravel roads here, 760 miles last year, cross country ski. I have a lot of fatigue day after workouts. Been on Adt going on 6 years but had the boys removed a couple years ago. Try higher protein in your diet. I use plant based organic protein powder every day. Bob
As one that has been on ADT and also exercising at the gym with a workout similar to yours but with one and a half hours of weights and two and a half hours total time, although I experienced a decrease in strength and stamina it was progressive and not something that occurred in a short period of time like you indicate has happened.
If you have not changed anything in your diet, are still getting the same amount of sleep, but are experiencing these problems nonetheless , I would not suggest dietary or supplement changes until you have met with your primary care MD.
What you mention could certainly be the result of years of ADT, but they could also be a symptom of something unrelated and more serious. Perhaps asking your md for a complete blood panel first, and if this shows nothing then possibly a referral to a specialist possibly a cardiologist might be prudent.
When I experience such fatigue, it's roots tend to be in a lack of carbs in the day before and the day of a workout. Warm up slowly and give your muscles time to adjust to activity as well.
Good comments here. It’s really up to you. Smart to know all your numbers, meet with your doctor and see what he says. Eat well. Losing weight on ADT is rarely a good sign. A good Cardiovascular base is important as we age, as is VO2 max and strength. ADT is the biggest physical challenge many of us have ever faced. It’s quite simply an aging accelerator.
Some say just stay on the easy and safe side with the exercise. I totally disagree, but again it’s a very personal decision. Look around you at people who’ve made it to 90 and beyond. Some are well and happy, but lot of them are not, for some very good reasons. Yet sadly many often outlive their physical utility. If I make it that far, I don’t want my body to fail before the rest of me does.
What I’m doing my best to achieve is not longevity per se. But since longevity is quite possible, I want the machine running as well as I can so if it happens I’ll actually want to be here for it.
I am suspicious that it is more likely medical in nature, some underlying imbalance. Perhaps related to abiraterone? Suggest getting full blood work including electrolytes, kidney and liver function (metabolic panel), CBC, TSH for thyroid, perhaps B12 and CRP and see your doctor
Get this cleared before messing with supplements and the other advice. Paul
Hello Gearhead! I’d say that it’s normal for a man after stage #4 treatments especially if you have low t or practically no t like me . Ive had only 3-T for 8 yrs . Every woman has more t than I do .However , 7 yrs of no pc seen in me . I did the orch so no t to be seen in me ever again with out injecting and no doc tells me to do that . . It’s depleted living for a fine fellow . I’m 61 yet I feel 87 .. my doc said I’ll never see 80 . I ve traded my muscle strength agility energy and a bit of cognition for life itself in any form . Not the strong image of self I used to have ..but accepting our lot is it ! I know that flat feeling in the gym . I ve lifted weights most of my adult life . My joints are now shattered by djd so …sets of 10-15 are fine ,nothing heavy anymore . Now I do some cardio and that it’s. You’re great at 80 . Keep moving ! Good day Sir!
Gearhead, prednisone for one can contribute to muscle wasting and loss when taken long term. Geranylgeraniol is a substance produced in the body that can mitagate prednisone's effects. See what geranylgeraniol offers in skeletal muscle protein synthesis, bone health, hormone regulation and CoQ10 synthesis . Check on it's benefits for prostate cancer as well. Also, investigate annatto tocotrienol's benefits for prostate cancer and others cancers as well. Both are available as supplements and teaming the two looks like a win win. Always consult your health care professional before using any supplement.
The symptoms you are displaying, particularly the “fatigue” lasting all day and calling these episodes an attack is disconcerting and I would recommend consulting a cardiologist to rule out any coronary artery disease as a precaution. I’m sure you would know from your bloodwork if you were anemic. Best of luck
You may be doing the resistance training too often. My sweet spot is 4-5 days between resistance machines for any muscle group. My strength goes down if I don't skip at least 4 days, muscle needs to recover. I do spinning/bike/walk on other days.
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Zometa or similar for bone strength 
Enzalutamide at half strength? 
Denosumab if bone strength increasing on ADT?
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Weight training Supplement 
