Weight loss, No appetite during ADT?

[ELOfan]

Prevent further Weight LOSS? BACKGROUND: From June 2024 til PCa was D'gxd on Sept 5, 2024 I lost 20 lbs and I now only weigh 145 and am 6 foot tall. I had been taking IBUPROFEN 200mg ranging 10-15 a day for what I thought was back pain and didn't go to the Dr. til Aug 27th when he put me on Prednisone.

So this problem was here BEFORE starting with Oncologist on Sept 5th the two ADT drugs with both Eligard-injection and Casodex/Bicalutamide 21 days of 50mg pills. Both drugs list nausea as a side effect. Plus I had a big injection of Antibiotics before Sept 11th biopsy.

FEELS: It feels like my stomach has been PUNCHED and no food seems appetizing. I just have to stop after eating several bites as gut pain increases, but I don't vomit. Then an hour AFTER eating my stomach kinda gets calmer.

FOOD: My wife makes me a protein smoothie then I have toasted sourdough bread and some lentil soup or stir fry for dinner and lettuce or celery, sweet potatoes, mashed potatoes, steamed green beans, eggs, cooked fish, Greek yogurt. My favorite fresh Toasted bread with olive oil or avocados or almond butter settles best. I eat savory things but not spicy. I started taking a CBD gummy to try to increase my appetite. I've NEVER been a smoker of anything.

Worried that 3 months of taking 10-15 Ibuprofen have messed up my stomach before PCA was diagnosed.

QUESTION: I welcome any advice from you fellow-warriors to decrease the feeling of gut-punch and how to eat MORE? What can you eat most Easily during ADT? I tried a canned liquid meal-replacement from Costco but it tastes bad. Have u found a brand that's tolerable? What should I ask my Oncologist? Should he prescribe something for decreasing nausea?

Thanks in advance

[London441]

Losing weight on ADT happens but it is almost always the opposite. Specifically not gaining weight but a combination of fat gain and muscle loss (sarcopenia). You don’t want that, especially if you’re just losing weight period.

Eat more, take nutrient rich shakes etc. Exercise more if you can. Probably much more. It’s good for the appetite.

And of course, cut out the megadoses of ibuprofen. This is obviously no good.

Always ask yourself ‘what would Jeff (Lynne) do?

[Birdwood in reply to London441]

I would re-mention the high intake of ibuprofen to your doctor and at the same time ask for a kidney check. I am sure the initial ADT knocked my kidneys around and I know the ibu doesn't help. Like your food selections.

[ELOfan in reply to London441]

I gotta find a shake I can tolerate. I gained 1 lbs today. Yes I stopped large doses of Ibuprofen.

Haha What would Jeff L. do? Agreed Exercise helps appetite as does good company of a friend at mealtime.

I found some PT exercises on YouTube with Canadians Bob & Brad.

I do walk everyday about 1.5 miles and do joint mobility moves. Light weights and resistance bands. I can't lift my right arm more than 4 inches cause staring 2 weeks ago the muscle under shoulder blade is locked up.

[Grandpa4]

if you have an ulcer from Advil Prilosec might help. It is OTC. When I took abiraterone the prednisone stimulated my appetite.

[ELOfan in reply to Grandpa4]

Yes yesterday we talked to a Gastroenterologist and he suggested I start Nexium first thing each morning in an empty stomach and later Malox liquid between meals. But he said avoid tums cause they made my pain worse. So my wife went and got that for me.

[vintage42]

"What can you eat most Easily during ADT? "

I can eat anything. I have been on Orgovyx ADT 9 months, and Abiraterone+Prednisone for 6 months, and have a large appetite. I eat "overnight (uncooked) oats" with fruit for breakfast, a large salad of lettuce with a tomato and an avocado for lunch, and a steamed vegetable with chicken, seafood or meat for dinner. Then dark chocolate with bourbon. My primary care doctor asked if the Prednisone increased my appetite, and I had not thought about a connection. I had heard that ADT caused weight gain, but I have held that to 5 lbs.

[Jpburns]

Sorry to add my experience. I’m on doublet therapy (Abiraterone + Orgovyx) and have no problem eating. I seem to be much more moderate (one plate, no seconds) and I eat slower and more thoughtfully. I kinda have a constant …tension…in my stomach, but my appetite is still ok.

[middlejoel]

So, ELO,

10+ years ago, it was Lupron. Good news, it looks like it's controlling the cancer based on scans and PSA. PROBLEM be that I lost 20-25 pounds. Love food, eat plenty, and heathy, but unlike your situation, always hungry., Went from 165 to 145 lbs, 128 recent measurement last week.. Unce I was 6 ft tall, played in a 6 foot and under basketball league, now I am looking for a 5 ft 11 and under league.

Thanks Lupron, probably woun't be here without you. Welcome aboard,Elo. For me it's been 16 years but still kicking at 88. I no longer go into the pool...don't want ot scare anyone.

[CAMPSOUPS]

Hmmm.

I looked at your past post and looks like you got the results of your bone scan with multiple bone mets. I had/have way more and my PSA at diagnosis was higher than yours (1,621 PSA, numerous mets from skull to ankles, lymph nodes pelvis to neck).

I was about 20 pounds below "my weight" around 170 vs. 190 (I'm 6'2") at diagnosis and my lack of appetite which became couldn't eat at all made a 180 turn about a month after my first Lupron, Chemo continued the trend. I gained weight to the point I was at 150 about a year after my diagnosis. I must say it felt good to eat again. My wife and I are foodies lol.

I just wonder if your cancer load is still high enough to be affecting your appetite and maybe just maybe your appetite will return as treatment continues.

I'm not 150lbs anymore and not by choice but that's another story. A long one lol. (I try to get in a Ensure and a cup of pedialyte every day, and luckily for now I'm getting food in me too. Not much though.

Anyone who know me will claim Im bias (just kidding) but I have to mention cannabis as a possible appetite stimulator and a calming effect on the stomach.

Prilosec helps possibly as well especially if there is indeed mucosal stomach/digestion inflammation.

But hey. Of course get your best scoop of help from your medical team.

[ELOfan]

MoonRocket, Thanks yes we like seafood like salmon, cod and most sushi too. Small meals is a good idea.

[ELOfan]

Well 12 days later my stomach still feels TIGHT but not as painful. Despite trying OTC Nexium and Mylanta liquid, I haven't regained the 25 lbs. My appetite is not strong.

I met with a registered dietician yesterday and she had some tips. Drink ensure or muscle milk + full fat ice-cream as a milkshake. After both breakfast and lunch are finished set a TIMER for two-hours later to SNACK (almond butter, 2 handfuls of nuts, cooked fish, eggs, a protein meal bar....) so I don't miss that window of time. Add FATS to every meal butter, avocado, olive oil....But honestly the more I eat the more frequently my bowel empties.

[ELOfan]

Update Dec 3rd I have regained my appetite and weight. Perhaps the answer, as CAMPSOUPS wisely suggested, was patience, to allow time for the medication to affect the cancer/tumor load to decrease enough not to interfere with digestion.