strange question maybe - is it ok to get a Massage done - bone mets , osteoporosis

[Tinkudi]

This may be a strange question 😊

Dad has bone mets and osteoporosis in some areas like femurs.

Earlier he used to get a massage done sometimes which he had put on hold after diagnosis.

any opinions if it’s ok to do if it’s a light pressure massage ?

[85745]

That would be a good question for the doctor, maybe a google search might reveal some info. I get some muscle pains - rub in hemp cream has pepermint works well also castor oil with or without a heat pad helps loosen tight muscles.

[Tinkudi in reply to 85745]

I am wondering if the masaage pressure may be risky from the osteoporosis/mets point of view

[85745 in reply to Tinkudi]

My oncologist told me bones can break/ fracture very easy with mets. I wonder myself how many of us had this happen.

[addicted2cycling in reply to 85745]

What about an adjustable heat and intensity electric massager?

[85745 in reply to addicted2cycling]

I really don't know. For me heat is good

[mrscruffy]

I regularly get a deep tissue massage. Never really thought about it. Interesting

[Tinkudi in reply to mrscruffy]

Do you have bone mets and osteoporosis?

[mrscruffy in reply to Tinkudi]

Osteopenia and mets on spine and pelvis

[JohnInTheMiddle]

Quite a long time ago I wanted to know more about how much risk I had because I have three rotted vertebrae in my spine (you know the vertebrae in the spine as opposed to the vertebrae anywhere else 😂).

And the advice I have had from all the doctors I have visited related to my situation have said "don't twist". I saw two physiatrists (a new concept to me, sort of like an exercise doctor), and both he and she said "don't twist", but they also said that push-ups are okay and planks too.

This is an important question of course as you know because if there's a breakage then mobility stops and everything can cascade from there.

So I did some searches and reading and came up with one paper where the following statement or something like it was made: "for people with metastatic prostate cancer especially with metastases to the bones, there are a few services to assist in understanding the biomechanical engineering risks".

So there is such a thing as biomechanical engineering. And you can imagine it's very structural and mathematical etc. And apparently they look at if you have 30% of a given vertebrae which is "lucent" on the scan, the capability of that particular vertebrae is probably reduced much much more than just 30%.

And for sure this type of reasoning would apply to long bones. But overall it doesn't seem that physicians and doctors have more than a casual understanding of all this. Even though with apparently a high percentage of people with metastatic prostate cancer, the decline cascade to sarcopenia and cachexia etc etc is often triggered by a skeletal break. Kind of like a blind spot in the world of prostate cancer research.

I would venture to say that massage would probably be fine as long as the biomechanical stresses are very light. And one could look at the various procedures and just consider the kinds of stresses. No bashing and whacking. And maybe ensure it's always the same masseuse. And maybe even write out a script? For example how does one get on the table when one is weaker, safely, etc.

Sorry for the long note. It's so easy to express opinions. But maybe there's more to think about that might enable your Dad to continue with massage.

[Tinkudi in reply to JohnInTheMiddle]

Thanks John 😊. How are you doing. I think I read on some post you are awaiting your blood tear results. My best wishes !

I also wonder about how much resistance training can one do with mets to femurs and osteoporosis there too. Especially like when does leg presses etc. No docs seem to know much.

[JohnInTheMiddle in reply to Tinkudi]

Tinkudi, your question is a really good one about a resistance training. And your comment that doctors don't seem to know much! It's like they're looking through a straw at the situation of someone with metastatic prostate cancer.

I can't remember if you were looking at estradiol add-back? I'm on again off again on this topic. With a little bit of estrogen that a man needs plus resistance training there some hint s that one can slowly and carefully rebuild some bone strength. Or at least avoid further loss of bone mass.

Just got the results now! PSA still less than .01 ug/L 😃

[Tinkudi in reply to JohnInTheMiddle]

Happy for your good results 😊🙏🏻

I asked MO about those patches and he said estrogen can be converted to testosterone so why do you want to risk that. Any thoughts ?

[JohnInTheMiddle in reply to Tinkudi]

This is a very good question Tinkudi, about the safety of estrogen add back. And the whole thing is complicated and there are feedback loops. And of course there is a huge difference between low dose transdermal estradiol and back and high dose transdermal estradiol as ADT replacement.

You may have seen Richard Wassersug participating in this forum. He's an expert on ADT and estradiol, especially high dose for ADT replacement. And he's also involved with the famous PATCH trial out of UK - an enormous RCT looking at Estradiol as primary therapy for prostate cancer including metastatic prostate cancer.

(By the way if you ever run into a doctor who says Estradiol causes stroke, they are very out of date. Because oral estradiol causes stroke yes because of the way it is metabolized in the liver. But this is completely avoided by transdermal dosing.)

Here is the website on everything you need to know about ADT, with Richard Wassersug:

lifeonadt.com/abouttheauthors

His focus however is not so much on low dose estradiol add-back back.

I am slowly coming to the conclusion that low dose transdermal and back is probably safe. It's easy to say that estradiol ("E2") is converted into testosterone. However that is a very crude statement. And not clear to me that it is correct. It might be!

My motivation for all this is that we have zero testosterone in circumstances of metastatic prostate cancer, as long as therapy is working of course. This is a heck of a thing for many reasons - but most of the side effects impacting quality of life everyday are derived from the fact that we also have zero estrogen (estrogen being manufactured from testosterone of course)!

My doctors don't seem much interested in this the question of the impact of zero estrogen. It's like the elephant in the room. It is the loss of estrogen apparently that is responsible for hot flashes, cardiovascular risk, osteoporosis and even brain fog!

At the same time, as I mentioned above, I've been going back and forth on the question seriously for almost 8 months now. It would be tragic and sad if a person did something like this and ended up making things worse.

I'm still working on this.

[MJCA]

It’s a good question. It tells me you’re on top of things. Last week when I found out I had a number of mets to the bones I posed the same question to my MO. He said it was fine. If he has mets to soft tissue, you should check with your MO.

[Tinkudi in reply to MJCA]

Thanks. 😊

[SViking]

I have been wondering the same thing because my last PSMA scan showed too many mets on my spine and hips to count. I lift heavy weights and do squats as well as wrestle. We all heard that it’s good for us to do weight-bearing exercises and so forth, but now I’m suddenly wondering, if I could snap a bone or vertebrae. My bone density scan a few months ago shows no osteopenia in fact due to the Xgeva my bones seem to get denser even while the micromets are beginning to mature. What do you guys think about that?

[Tinkudi in reply to SViking]

What dose of xgeva are you taking and for how long. Maybe you can ask this question to Tall Allen and if he responds let me know also 😊. I did ask him but got no response

[SViking in reply to Tinkudi]

I’ve been on 90 day injections of Xgeva for three years. My PSA is still low at 7.2 however it’s been doubling every 30 days so it’s very likely there are plenty of more micro mats ready to become visible.

[Tinkudi in reply to SViking]

So you take 120 mg Denusomab every 3 months ?

[SViking in reply to Tinkudi]

I’m not sure what the dosage is, but it’s the same dosage they give to guys on the 30 day interval

[Tinkudi in reply to SViking]

If you get any answers on how much resistance one should use with bone mets pls let me know too. Best wishes 🤗

[Mascouche in reply to SViking]

You still wrestle at age 72! My hat's off to you sir!

I used to practice boxing but once I turned 40 and the reflexes vanished I moved away from sparring and I stick to heavy bags, weight and cardio. Glad to read that you are aging well!

[j-o-h-n]

Happy Endings?

Good Luck, Good Health and Good Humor.

j-o-h-n

[Tinkudi in reply to j-o-h-n]

😆🤗