I’m 44 years old with PCa. I’m on ADT for the last 18 months and had radiation and chemo a year ago. I have fatigue and find it very difficult to get the energy to workout. It’s also difficult to get motivation. Does anyone have any suggestions on workouts and nutrition during this treatment?
what’s the best exercise and nutritio... - Advanced Prostate...
what’s the best exercise and nutrition while on Abiraterone/Prednisone and Lupron.
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Exercise with someone else, a partner
I don’t know if I’m an expert, but I’m in the same boat. Here’s what I’m doing.
My wife and I have always walked for health, before all this. Like 2 miles a day. I continued this during EBRT because I heard it was important to exercise. Additionally I did some really minor floor exercises (light weights, planks, crunches) but they were infrequent and I didn’t think they were accomplishing much.
A little over a month ago I started exercising more seriously, because I could see all my (not very impressive to start) muscle tone turn to mush. I also got a belly, which I never had before. Plus I have back pain. I got a gym membership (“free” with my supplemental Medicare, but about $30/month otherwise) and I mostly use the weight machines. I go through stuff for my legs and arms, and try to use machines that help my core muscles, especially because of my back problems. I usually finish with a rowing machine for some aerobic exercise. My sessions last for 40-50 minutes. I do this every other day, and walk the others.
I guess the reason why a mentioned all this is to show you how someone who never exercised before (except for the walking) managed to change his habits. Maybe it’s just me, but I get a sense of being virtuous when I exercise. It is tough, though, to get started and keep at it. But it’s something you can accomplish that will improve your QoL. This disease is so much waiting around, waiting for stuff… it feels good to do something, anything to affect one’s health.
Good luck.
Lifting weights helps for muscle retention and bone density retention. To fight off the fatigue, I feel that cardio is even more useful than weights.
Nutrition wise, I do mostly keto but different things work differently for different people so you can experiment with carnivore or vegan. Just stay away for processed food as much as possible, and completely if you can. So no grain, no flour, no pasta, nothing in a box or labeled. Basically, the fruits, veggies and meat sections of the groceries are the safest place.
I do not think that anything you'll eat with fight off the cancer itself but eating healthy makes you healthy and that is better than the opposite.
I lift heavy 6 days a week and eat like a body builder and take supplements that encourage muscle growth and have gained lots of muscle. I have no fatigue and hot flashes are non existent. Took about 2years to physically get where I am now. Diagnosed in 2016 at 54
if you can afford it, get a personal trainer
If you can join an exercise class with an exercise physiologist and/or physiotherapist, this will help you. I have been through radiation, chemotherapy and are on ADT since 2016. I had a vertebral fusion (7 vertebrae) 3 months ago and have started back to my exercise class this morning. I start rehab for 2 days a week for 2 hours (an hour in the pool followed by an hour of exercises) tomorrow for 6 weeks. I have had 3 of these rehab programs since 2016 and they have helped me greatly. I am 76 and have found I have to push myself, but exercise has helped me so much. My cancer spread to 4 boney areas, two of which led to SBRT radiation, but one of these caused a compression fracture on my T10 vertebrae and weakened the surrounding veterbrae, thus leading to my spinal surgery. That was a very painful experience. But exercise has helped me with my recovery considerably. Best wishes.
Think of yourself as essentially asking 3 different questions. 1, how to motivate past the fatigue, 2 what exercise to concentrate on and 3 diet.
The advice to get a trainer or friend, class etc for the motivation and consistency is very much spot on. Something/someone who you can partner with and be accountable to is beautiful, and very effective.
I feel the opposite of Mascouche, in that IMO lifting hits the fatigue harder than cardiovascular work, but both are important obviously. The problem is, although CV fitness VO max etc are affected by ADT, the muscle wasting is even more dramatic and debilitating. We must lift to counter that, there is no other way.
Best to establish a program that features both, but if you’re out of shape and want to feel more physically able to exercise at all, lifting opens that door pretty swiftly if you can manage to make it a priority.
All the diet advice you’re getting here is good. For relieving the side effects and overall health, the exercise is vastly more important.
Reading here got me started exercising and what a difference it makes, there are days with no energy or desire but still drag myself to the gym and always feel better after.Aerobics for me treadmill or bike for 30-45 min and then weights / machines.
Recently found benefit after reading here to do reps until failure, for me biceps/triceps, getting better results for sure, I help with the other hand on the last few reps, 10-15 x 3 sets.
Following diet suggestions here.
I’m 68 and received triplet therapy. I completed chemo and I’m continuing on Lupron and Nubeqa for now, I may need some radiation at some point. I go to the gym about six days a week and I usually do a half hour on the treadmill walking. I also lift weights three times a week (m-w-f) to help prevent muscle wasting. I do four sets of upper body work mostly (curls, lat pull downs, seated chest press and a machine to do butterflies. The walking really season to help the fatigue. I tend to be this about one day a week because I’m too busy with other stuff or I am too fatigued overall if I haven’t slept well. I do really have to push myself sometimes, but overall it’s good for me. Good luck to you!
For me, I find it helpful to do a variety of different exercises to keep it interesting and fun. A couple weeks ago I was splitting logs with an ax, I've loaded up a wheelbarrow with dumbbells and pushed it around the yard, I have a weighted vest, I do yoga, I carry my golf clubs on par 3 courses, and even walking and/or running in different locations helps. To paraphrase an advertising slogan - Just do Something!
Stay active every single day. Lift weights (progressive overload) for at least 3 days per week, 4-6 even better. Do cardio every day. I have always found that by doing all of the above shortly after waking provides me energy throughout the day. According to DEXA scans, my bone density is up vs. when I was diagnosed 6 years ago at 46. I am the strongest I've every been now, but ADT is an absolute killer and I've had to work out much harder than when in 20-30ss to simply maintain weight and muscle. Full disclosure, I was on ADT for 4 years and have been off for the last 2 (PSA check this week to see if I can remain off).
Good Luck.
I am on the same treatment, and have been for the last 2 1/2 years. First thing - accept that your body has changed, and this is the new you. Then, fight through the exhaustion and do something. Go for long walks, walk on a treadmill at an incline, and lift light weights consistently. I was an avid weight lifter before, and can no longer do what I used to do. But just getting out and doing what I can is a huge mental advantage. If you stick with and fight through a consistent schedule, you’ll feel much better overall. That’s all I got!
"... best exercise and nutrition while on Abiraterone/Prednisone and Lupron."
I am on Abiraterone/Prednisone and Orgovyx. I joined a wellness facility associcated with a hospital group and had a therapist design a program to counteract sarcopenia and osteopenia. I do exercises on weight machines like leg press, abdominal curl, back extension, lateral pulldown, biceps curl, triceps press, overhead press, rowing -- all 10 reps x 3, at least every other day. A session takes 45 minutes. I set the weights so each machine causes a little burn, but have never felt soreness afterward. I am not an exercise person and regard it as medicine and a time to let the mind wander.
Breakfast is uncooked oatmeal which keeps for 4 days (look up overnight oats) with cut up fruit and frozen blueberries. Lunch is an avocado and a tomato on a lot of lettuce with Italian dressing, and bread. Dinner is any kind of fish/flesh/fowl, and steamed vegetables. After dinner, dark chocolate, and later two tablespoons of Metamucil. Contrary to advice, I still drink alcohol.
At almost age 82, I have no unpleasant side effects from my treatments and medications, have good energy, no fatigue, no need for naps, and sleep well except for a few bathroom visits.
I alternate brisk walking one day and weights and resistance bands and ab exercises the next. I don’t feel like exercising a lot of days but I always feel better afterwards and I feel good about staying toned, it allows for a more active lifestyle.
Ed
Forty four! You are so young. Do not give up please. Just getting to the gym is an accomplishment. For what I know and heard you must focus on hitting those muscles in the areas where you can tell have been replace by fat or just talen by this horrendous disease. Hugs
I suggest swimming with a mask, snorkel, and small Zoomer training fins…You just put your head down and go.,,,Swim at your own pace and you can’t hurt yourself…Start with just a few laps and increase when you get stronger …..I’m 86 , a 10+ year member of the club nobody wants to be in….I swim 1/2 mile 4x a week at the local Y…..Start with a couple of times a week and build up…
B
Pickleball? I started playing a year ago. Best thing I have done for myself both physically and mentally since dx 12 yrs ago ( and following knee replacement 8 yrs ago, back surgery 6 and hip replacement 5 months ago). I am addicted and play practically every single day. I have always been VERY athletic and following all of the surgeries indicated above, “Pickle” has been my savior.
I take 12.5 mg adderal twice aday I am in the gym now. ask your doc
Exercise -> endorphins -> feeling better & slows down cancer
Exercise -> myokines -> slows down cancer
To make any progress against the effects of no testosterone's sacropenia, you have to up the quantity of exercise a lot.
mayoclinic.org/healthy-life....
You don't mention how you're sleeping. ADT and associated hot flashes are a major sleep disrupter, and fatigue/lethargy/low motivation/low libido are all linked to a lack of sufficient quality sleep in the general population irrespective of cancer treatment side effects. It is universaly recognised as the cornerstone to recovery/prevention in just about every scenario, but seems to be largely sidelined when undergoing treatment.
If you are experiencing difficulties, make it a priority to get your onco team onboard to address the issue.
As for exercise - do what you enjoy and feel gives you results; that's motivation. Push to 'lack of form' rather than failure (which brings a risk of injury). Don't beat yourself up if you underperform, you're not chasing a medal; we're all in it for the (hopefully) long haul, next time can be better.
Diet - look at the importance of a healthy microbiome to see if you need to make any adjustments.
Stay positive, mental resilience is hugely important.
I'm 75 and on the same- abie, pred, and eligard shots. Have only been on for a month now but this cancer is recurrent as I first had it 8 years ago and now it has spread to lungs. I have been playing Pickleball 5-6 days a week and golf on Sunday. You would get addicted to PB like many others I play with. Joined a gym but haven't gone yet. Find an exercise that you enjoy. Even an electric bike is exercise. As far as diets go I am the last person to ask but slowly getting to eating better. Everything in moderation but I got to have my pizza once a week. Motivation is tough sometimes, but I think about my wife, kids and grandkids and that usually makes me start moving. Best of luck to you.
A different viewpoint JBB. Sucks having metastatic PC at 44. I have had to restore severe loss of muscle and strength (sarcopenia ) twice recently. First for ADT loss of muscles. And more recently for a severe infection that “ate” the muscles in my legs. Was in a wheelchair until 4 weeks ago and re-learning how to walk.
I know how to do strength training with free weights or machines. Trouble is I really don’t like spending time in a gym. Found a book called “body by Science” that gives the evidence how one workout per week is as good as more frequently; And one set of each main exercise is as effective as 2 or 3. It just requires doing the main compound exercises (called The Big Five) at a very high intensity such that you go to complete failure in 90 to 120 seconds. This gets very hard at the end and for me requires a trainer for motivation and form. Using good machines makes it safe from injuries. I can attest this works.
Walking is fine for your core cardiovascular work. Walk 5-6 days each week. Walk outside in nature whenever possible. I walk alone or with my dog. Sometimes listening to podcasts or audiobooks. If you have a partner who wants to walk with you, fine. But don’t make it dependent. Walk fast so you breathe a little deeply (level 2). Save high intensity for later.
The only nutrition advice I have is to have plenty of protein. I have two shakes per day with 30 grams of protein. Either a whey protein powder blended with water, or an Ensure Max Protein shake ready to drink. Easy. Altogether I get at least 100 grams of quality protein per day.
Enjoy the journey towards better health and capacity and treasure every day. Paul /MB
Sorry to hear you've been thru and still somewhat going thru a tough spell.
I am coming up on 1 year from the start of my treatment (same protocol). Fatigue was my only symptom prior to diagnosis and is my biggest hurdle during and after my radiation stuff. I see a trainer one day a week who works mainly with my own body weight (TRX bands mostly). I work out 4 days a week with 20+ minutes of cardio on a recumbent bike, upper body weight machines 2 days a week, lower body weight machines 2 days a week. In the pool for water aerobics 1 day a week and 1 day off. That is my goal even though I don't always make it some days just due to logistics and appointments.
My diet leans heavy towards Mediterranean. Minimal meat. Fish as least once a week, heavy vegetables, moderate grains. i work with two naturopaths, so heavy on the supplements they have identified, and the ones that I have researched that are the most important. Trying to incorporate a lot of fermented foods, and huge variety of veggies and grains. Lots of medicinal mushrooms and dark colored veggies and fruits. Stay away from processed, fast and ultra-processed foods (pre-packaged meals and foods, sausages and lunch meats) and anything fried or with added sugar.
Mostly, I have a nap every afternoon from 40 minutes to 2 hours and sleep most nights except for 1 or 2 hot flash episodes (I have managed them with herbal tinctures and they have diminished in intensity and frequency, but no silver-bullet solutions),
the fatigue and exhaustion ebb and flow, but there seems to be no direct correlation between my exercise efforts, and diet to the intensity of frequency of fatigue.
I do notice that I feel much better when I eat the healthiest foods.
Why minimal meat? Meat = strength. Veggies, fruit, grains = weakness.
Your quality protein intake is low, and it looks like your fat intake is non-existent.
Switch to meat and fat, and your fatigue will be a thing of the past; and you can stop the supplements as well! 👍
For all cancer patients it is recommended not to have too much protein from meat sources. The Mediterranean Diet and Blue Zone diet concur, as do most of the specialty cancer diet cookbooks.
And this is why the cancer industry is thriving. Cancer is a disease of diet. Meat heals. We are literally made out of meat; not grains, not vegetables, not fruit.
Cut out/Minimise meat, even though it's the healthiest food.
Always go for low fat/keep cholesterol levels low, even though the fattiest organ is the brain; and the liver makes cholesterol if we don't consume it; and people with high cholesterol levels don't develop Dementia/Alzheimer's/Parkinson's.
Eat "healthy" whole grains, even though they are difficult to digest, cause inflammation that leads to autoimmune disorders; steal minerals from the body and have virtually no nutritional value.
Eat fruit, even though the acids and sugars damage tooth enamel, spike blood sugar and cause inflammation.
It's a crazy world we live in. 🙃
chicken is ok. Red meat should be avoided. Good quality fish is best. Again, too much is not healthy. ncbi.nlm.nih.gov/pmc/articl...
Thank you for the link. It's almost like I didn't write anything in my reply.
Why are you taking the article as fact, when it makes no sense?
The original human diet consisted of red meat; so how can it be bad?
The one thing that has changed dramatically in the last 100 years is our diet. We've been eating red meat for hundreds of thousands, if not millions of years. If red meat is so bad, how did we survive? What happens when we feed animals our fake foods? They develop the same diseases we do.
Carbohydrate poisoning is a thing.
Breast cancer, gastric cancer; or any cancer is not caused by red meat. A diet high in carbohydrates and low in (or devoid of) meat and fat is the cause. And additionally, in the case of breast cancer, can we honestly believe that mammograms aren't also responsible? Traditional mammograms could easily be replaced by thermography (no radiation and no need for the breasts to be squeezed between plates); and the machines cost significantly less yet they're not widely used. Why?
People who have had multiple sclerosis for decades, had all symptoms disappear after a few weeks/months eating nothing but red meat. How can that be when red meat is bad? IBS, Fibro, Eczema, arthritis, kidney stones, gall bladder inflammation, prostate issues, etc. all resolved when removing everything but fatty meat.
Arthritis has been linked to eating grains. But wait, grains are oh so healthy!
The bright people in the cancer industry continue to scratch their heads (or pretend to), puzzling over this great mystery: why is cancer so prevalent? It really is completely baffling to them; while at the same time looking at the latest list of healthiest foods, and seeing Lucky Charms cereal at the very top and beef at the very bottom.
Your premises are not based on research. There are tons of studies that show red meat is a major factor in cancer. It is not completely baffling, there are obvious things that have been discovered as causes. Lucky Charms are not food. They are sugar, with no real nutritional value, and anyone who understands nutrition knows this, and no one is saying otherwise. Your statements have no scientific backing and are quite contrary to most of the studies out there. One of the problems with thermography is the training for the imaging specialist. I have been through many procedures and am familiar with it.
Cultures always had minimal red meat as a part of their diet from purely functional standpoints. As in Blue Zone societies, meat is reserved for special occasions and in small amounts. I put these articles form different sources so that no one is taking your comments as sound medical advice, because it is incorrect.
Proper proportions are important. Understanding healthy diversity in a diet is the goal. Overoing anything can result in an unhealthy response. (e.g. water is healthy and necessary for you, but too much can kill you.)
mdanderson.org/cancerwise/i...
health.clevelandclinic.org/...
cancercouncil.com.au/1in3ca...
nature.com/articles/s41591-...
medicalnewstoday.com/articl...
aicr.org/cancer-prevention/...
So many good inputs from the group. I always learn a lot.
I was Dx in 2021 at age 59. Triplet therapy with 24 months ADT (Abi/Pred/Ellegard). Had complete response and I'm 9 months into ADT holiday and keeping fingers crossed. My biggest issue is osteopenia. Bone density numbers kept dropping. Doc said being thin contributes to that, so I'm hoping my holiday will arrest that. I was an avid runner and have kept up but with fewer miles. Trying to get in weight bearing strength work, but I need to perhaps get a trainer to keep me accountable. I do push-ups and core exercises 5x per week, but I know I need more weight bearing work, especially if I need to go back on ADT. One recommendation I'll add is to get your workouts in early. For me, I can beat the fatigue this way. All the best - Jeff
I had similar story (Dx in 2021 at 58yo) and started ADT in 2022/03. Bone scan showed -2.7 Z-score in my right hip. I searched online for non-drug options to combat osteoporosis and found Osteostrong. Luckily I have local location in Los Gatos so started weekly osteogenic loading sessions there in December 2023. Check it out. through that I discovered X3 Bar and got that for my resistance training workouts (I follow suggested 12-week program). this is on top of regular cycling (150 mi/week on average)
I perform monthly body-comp DEXA scans and that shows positive trends:
Body composition over time
To add to my reply below,
1, The best time to start exercising is on or before ADT starts
2, The second best time is NOW
3, Get a bone density scan (DEXA) NOW
4, The time to stop exercising is NEVER
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