Side effects : I do 5 mg of prednisone... - Advanced Prostate...

Advanced Prostate Cancer

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Side effects

Blueribbon63 profile image
31 Replies

I do 5 mg of prednisone 1000 mg of abiraterone and Lupron every 4 months. Prednisone has been very tough on me, I've gained 29 pounds weight in two months, the muscle cramps and feet twitching are unbearable. My PSA has come down from 24 in January to 0.84 last Monday. I saw my oncologist on Tuesday and she gave me the option to stop all meds except the Lupron injection (I am due for my 2nd injection the first days of May) I do have to whine off the Prednisone in a two weeks period. I am going to concentrate on shedding the extra weight off by exercising and continue with monthly blood work and visit the oncologist each month. I am going for QOL vs. Aggressively fighting metastasis grade 4 PC. I know this is a personal decision, I also know that I am very depressed and anxious (on meds for that for many years, even before PC diagnosis) Is the risk I am taking to high?

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Blueribbon63
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31 Replies
Magnus1964 profile image
Magnus1964

There is a product called Leg Cramp made by Hylands. I use to take it when I was on prednisone.

Kayakbob profile image
Kayakbob

I had severe leg cramps and restless legs, mainly at night. Dr added Gabapentin, and after dose escalations, these symptoms are gone! it's worth a try. effects come on slowly, over several weeks, so stick with it.

Hey guy! You don’t need me to tell you that 29 lbs of fat will do you in .Many of us go by the heart rather than pc .. I lost 65 lbs during imrt by no sugar no animal proteins no processed foods . If I had gained 29 I prob would have checked out by now? It was rough because I was a foodie prior . Can’t you go for quality of life and aggressively fight the pc too? Don’t ever give up on that! It won’t stop so we can never give up the fight . You are about my age . You ve got more life to live .Ditching treatment too early won’t improve quality of life . It will just enrage the beast . #4 pc is a fight for life .. I’m not saying that it’s easy . It’s not . But You can do this! Everything can improve , especially your QOL once you shed the xtra lbs .

epfj3333 profile image
epfj3333 in reply to

What do you eat?

Blueribbon63 profile image
Blueribbon63 in reply toepfj3333

Since a am/was a runner I tend to go more for the carbohydrates, I know I need to get more fruit and vegetables. Oh, I can't lie, I have a sweet tooth too, I like chocolate, but I don't think I overindulge

epfj3333 profile image
epfj3333 in reply toBlueribbon63

I mean what does Slimpicken eat?

London441 profile image
London441

The Lupron is generally more responsible for the side effects than the abiraterone. How much do you exercise and what kind?

Blueribbon63 profile image
Blueribbon63

I can answer to your question by telling you that I ran and finished a half marathon in July last year. It all went down fast. Nowadays, I can hardly complete a 5K walk a day.

jptss profile image
jptss in reply toBlueribbon63

I'm 61 exercise is the best I've gained 11 lbs so far this year but I think it would be way worse if I didn't exercise,I really watch what I eat too.

Blueribbon63 profile image
Blueribbon63 in reply tojptss

I started to so long walks and plan on starting jogging now that the weather is better. I want to go back into running, I do know I have to do it slowly so that I don't injure myself. My PCP and the oncologist are not in the same page PCP is a runner too so he tells me to go ahead and get going. Oncologist told back in January that I should forget about running again because of the bone metastasis and weakened, that if I trip down I'll probably get a fractured bone!

Concerned-wife profile image
Concerned-wife

have you talked to your doctor about the alternatives to Abi with prednisone such as Apaludamide , daraludamide etc. they were more expensive for us but other men seem to have insurance that cover them or receive grants from the drug companies. These drugs don’t require prednisone.

Blueribbon63 profile image
Blueribbon63 in reply toConcerned-wife

No I haven't, my oncologist didn't offer any alternative treatment plans.

jptss profile image
jptss

personal opinion yes, I'm depressed I don't want to get up half the time but when I run work out I feel 100% but I hate it the wieght gain.My wife is my biggest fan and I love her for it So try a week of moving then decide all your missing is the exercise.

Blueribbon63 profile image
Blueribbon63 in reply tojptss

I have been walking at least two miles every day at my lunch time. I am going to try going jogging tomorrow! I know the super great feeling that working out gives you.

jptss profile image
jptss in reply toBlueribbon63

This journey has been stupid but what do you do, Let me know what you end up doing I'm learning from all you good people on this site.

Derf4223 profile image
Derf4223

My $.02 on weight gain. Beware of treatment-related fluid retention gain -- ankle puffiness is a sign. My onco blood tests showed low potassium (K) and my MO put me on 10 meq of K daily.

Also, if you haven't gotten a bone mineral density scan (eg DEXA for one) get one stat. Mine showed osteopenia and my MO put me on Prolia. You stand no chance of offsetting treatment-related BMD loss regardless of calcium, vitamins, exercise, etc. The closest you can come without Prolia is to reduce BMD loss rate via creatine 8 mg/day, with weight bearing exercise.

Grandpa4 profile image
Grandpa4

when I started the same combination weight gain was a real concern. I vowed to burns a minimum of 500 calories ms every day to make up for the extra food I would eat. So far it has worked.

Huzzah1 profile image
Huzzah1

I am now 10 months into ADT - during IMRT for 9 weeks, I lost 10# due to eating right and still being able to do a fast 4 mile walk every morning and going to the gym. Then came another unrelated surgery that prevented both for 3 weeks - then COVID. I then had a hard time getting back into the routine. I put on 30#, hot flashes increased etc. During my last MO appointment, my wife mentioned these things. As I have gone to a number of MO visits by myself, he knows me pretty well. He looked at me and said "I think I know the answer but if you want we can back off of some the meds to make you feel better" My answer was no way, I will put up with these SEs if it means controlling this cancer! Since then, I have been able to loose 12#!

j-o-h-n profile image
j-o-h-n

Just place one foot on the scale.................works for me........

j-o-h-n <===<<< Senior management is about to spike my spikes....

Good luck, Good Health and Good Humor.

j-o-h-n Friday 04/07/2023 6:22 PM DST

Islandboy2021 profile image
Islandboy2021

The treatments you are on are working to keep your cancer from progressing. I believe we can deal with the side effects. The question is how do we deal with the cancer when it progresses. Do not give it a chance to spread because it will!

Blueribbon63 profile image
Blueribbon63

Thank you Islandboy2021 I just read your most recent post and has really hit me hard. I am going for my Lupron injection May,2 I am ask to continue treatment. I think the Prednisone is what really hit me hard. I know there are other treatments that do not require to take Prednisone, I am really look into it and discusse it with onco.

Islandboy2021 profile image
Islandboy2021 in reply toBlueribbon63

I am on the same treatment. I have switched the prednisone for dexamethasone. Not sure if the side effects are different yet. I started the abiraterone in November and the last couple of weeks I have really noticed the fatigue settling in. Like everybody on this site writes, we need to exercise. I just find it difficult to start now.

Blueribbon63 profile image
Blueribbon63 in reply toIslandboy2021

I am trying to keep my job, but it is a daily battle with the fatigue, I have ward time staying awake. I started walking for at least 30 minutes a day, it does make feel better.

PhilipSZacarias profile image
PhilipSZacarias

Hello Blueribbon63, ADT alone is probably the major cause of your weight gain. The dosage of prednisone is relatively low compared to other medical conditions that its used for. Some medical oncologists prescribe 10 mg, which is what happened to me - I demanded 5 mg to start. I monitor my blood pressure, circulating potassium levels and indications of fluid retention (press a finger into the skin in your lower calf and if you see a depression that is slow to level out then you have fluid retention; also sometimes I see sudden weight gain which, I attribute to intermittent water retention). If BP and K levels are normal, then you can try decreasing the dosage of prednisone to 2.5 mg/day (the pill is easy to break in half). If BP remains normal, then stay at this dosage, but if it increases return to 5 mg.

I take supplemental potassium, which is what DERF4223 also recommends. Also avoid adding regular salt to your food. You can use potassium chloride as a salt substitute.

You can talk to your oncologist about eplerenone (Eplerenone, sold under the brand name Inspra, is an aldosterone antagonist type of potassium-sparing diuretic that is used to treat chronic heart failure and high blood pressure, particularly for patients with resistant hypertension due to elevated aldosterone. Wikipedia). There are papers on Pubmed that describe its successful use as substitute for prednisone. Cheers, Philip Zacarias

Blueribbon63 profile image
Blueribbon63 in reply toPhilipSZacarias

@PhilipSZacarias During my last visit with my oncologist, she presented optional stopping of Zytiga and Prednisone part of my treatment, I will continue to get Lupron every 4 months. At this point I've started my second week winding off Prednisone by reducing to a half 5mg tablet a day and starting next week it'll be every other day. This is to minimize any negative response from stopping it. If and when PSA levels start increasing we'll look into putting together a different treatment plan that won't include Prednisone. Thank you so much for your comprehensive response.

PhilipSZacarias profile image
PhilipSZacarias in reply toBlueribbon63

I respect your plan, especially since it is being done with the concurrence of your oncologist. When I started to gain weight, I initiated a time restricted feeding regimen (also known as intermittent fasting - you can search with these term) which is eating only with an 8-10 hour window and also ramped up my exercise. I was able to manage my weight this way. Cheers, Phil

Islandboy2021 profile image
Islandboy2021 in reply toPhilipSZacarias

I also have started the intermittent fasting or time restricted eating. I believe it helps. I take the abiraterone in the morning on a empty stomach and don't eat until 12:00pm.

Blueribbon63 profile image
Blueribbon63 in reply toIslandboy2021

I was taking both the Zytiga and Prednisone on an empty stomach in the morning and wouldn't have breakfast until I got my first morning break at work. I also took another Prednisone at bedtime.

Islandboy2021 profile image
Islandboy2021 in reply toBlueribbon63

I take the Zytiga on an empty stomach in the morning and the Prednisone (now dexamethasone) at lunch with food.

Seasid profile image
Seasid

Why didn't you consider early chemotherapy? I am on Degarelix ADT injection 5 years after my initial diagnosis as polymethastatic prostate cancer. I recently radiated my prostate and my last PSA was 0.37. It dropped from a maximum of 1.5 to 0.37 4 months after radiation of my CRPC in my prostate.

Blueribbon63 profile image
Blueribbon63

I am afraid of chemotherapy and it's side effects. I live alone in this country, all members of my family are back in Ecuador, where I come from. I can't get any type of treatment down there, otherwise I would go back to be with my loved ones.

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