On Tuesday I had my third dexa scan since being diagnosed with PCA in May 2019. The first scan was performed in Sept 2020, after a year of ADT and zytiga, the second in September 2022, after basically a year off of ADT ( my bcr forced me to restart ADT in July 2022). Now after being on ADT, mono-enzalutimide and now Orgovyx and enzalutimide, my latest DEXA Scan is still Normal according to the WHO standards. There is some loss in the lumbar area, going from .2 to -.4 but the other two locations are stable, those being the hip and femur.I may restart the Calcium with D/K2 just as a precaution. Some of this loss could attributed to the normal aging process.
Latest DEXA Scan Results: On Tuesday I... - Advanced Prostate...
Latest DEXA Scan Results
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Don't supplement unless serum levels are low. Calcium is toxic to the heart and kidneys, and Vitamin D pulls calcium out of bones.
Serum calcium is mid normal (9.7g/dl). I'm inclined not to take a supplement ( I stopped taking supplements all together a year ago) but wanted other opinions. Thanks for your response. For all I know, this could be completely normal and just part of the aging process. I'll discuss with my primary physician. I think it's important to post normal test results because we often only see posts from those who have lousy BMD.
As you i have cut back on my supplements drastically. Calcium is not a mineral human’s are generally deficient in. Now vit D WITH K2 this time of years is to me very important. Your vit D should allow your kidneys to produce calcium and must have K2 to move that calcium out of the blood and into the bones.
Great news on your dexa scan!
Oh your physician won’t no diddly about supplements.
So should I have my husband go OFF his calcium+ D and just take D? He’s already on vitamin K.
Which vit K? Is he eating enough leafy greens like kale and such. I would look at the macronutrients of his daily intake of calcium and stick to the RDA. Read this book it is fantastic. I got it when it first came out in 2013 and loved it.
amazon.com/Vitamin-K2-Calci...
This is an article on K2 from life Extension Foundation.
Hey TA, good morning. Can you point me to the info on Vitamin D? My Onc put me on it as a preventative to strengthen my bones from ADT back in 2020, and what I've read reflects his comments. I understand too much can cause a buildup of calcium in the blood and also can cause bone pain. As I've mentioned n the past I also have MM and Vitamin D is recommended. My last test results were in January 2024
25-Hydroxy D2 - <4
25-Hydroxy D3 - 45
25-Hydroxy D Total - 45
The Doc told me 800 iu per day. I appreciate you input as always, thanks.
Sounds good -800 iu won't harm you. You need 1000 mg Calcium everyday from food.
I always get confused by this. My husband’s oncologst said to take calcium. And yet I’ve read articles like what you wrote. What to do? Also, his oncologist wants him to take Zometa for the bones. But he’s in the middle of dental implant prep. Also, reading about the ONJ issues with drugs like Zometa. So he still shouldn’t take calcium and Vitamin D?
I just looked at my husband’s calcium dose and it’s 1,200 (2 tablets) and vitamin D is 50 mg.
So, does he need to discontinue this? Or just stick with D? He also takes K.
If his serum Vitamin D and calcium levels are normal without supplementing he does not need supplements.
Are those numbers you mention the T-score results? If they are , I envy you!!!
Yes T score.
Resistance training is what you want to be doing if you are invested m bone density loss intervention, not calcium and/or vitamin D supplementation. As advised, unless levels are low.
BMD loss is a part of the ‘natural aging process’ 100%. Be sure you’re not blithely accepting it, though. This is a poor plan.
I do resistance training. It's not from a lack of exercise and resistance training.
Perhaps. It depends on what you’re actually doing. But of course I take your word for it.
Illuminate us on what you do. Include weight, # of sets and periodicity of workouts.
I'm not going to do that, but not to be deliberately vague. I can list what I do in detail, sure, but It would serve to illuminate only the level I am currently at-not particularly helpful.
I believe that in resistance training, the 3 things that matter most are mixing up workouts, progressive overload and RPE (rate of perceived exertion). You are very likely familiar with the last 2 principles, even if not by name. They apply to every person, at every level.
Most people who resistance train either don't know about one or both of these principles, or pay little attention to them. Of course I am not referring to you.
A casual look around a typical gym bears this out.
For example, the average person who lifts weights 3x a week does 3 sets/10 reps a set of a number of exercises, with little or no change in the routine. They usually select a weight that they can somewhat comfortably manage for all 10 reps, with a rest of a few minutes between sets. Additionally, they are likely not to increase the weight much, at least not in a deliberate way, over time.
The 10 reps, even if not 'comfortable', is usually not only short of their RPE, it's usually not close. Studies show that the average person's RPE is on average 5 reps less than what it actually is. So it is that most do not even approach their RPE, much less strive for it.
This while not increasing load much or mixing up workouts.
So this is the long way of saying what I do and how often reveals nothing except the progress and habits I have personally experienced. I have been much less fit and strong at times in my adult life than I am today at 68, but more so than at other times.
For instance, as a young, elite, (and foolish) distance runner I was lacking total body strength to the extreme. I'm far stronger now.
The only metrics I can say I've become quite disciplined about are shorter workouts, sufficient rest, and RPE: once I'm safely warmed up I do my working sets absolutely to failure most of the time. Rest time to a heathy minimum.
You can also bet that at my age and number of replacement parts, this is with a greater eye on safety, less weight and higher reps per set!
Lastly, to the original topic, my bone density remains in the +1 range and did throughout my time on ADT. Including high impact interval training and emphasis on lower body has been helpful and in fact is probably responsible for it.
Everyone who resistance trains is doing a beautiful thing for their health. Most could get much more done in less time. Great luck to you!
I disagree. I think it would be helpful to tell us what type of weight you throw around the gym. Is it free weights or machines? Are you doing supersets or just regular old sets of 8, 6, 4, etc. I still would like to know what you do so I can compare it to what I do and I'm sure others would be interested as well.
Ok, ok. I use dumbbells, kettlebells and cables mostly. Lifting is not my top priority though. Four 45min-1hr slower cardio sessions a week plus 1-2 weekly sessions of intense ‘4x 4’ (4 min on, 4 of rest) at 90% or so of HR max preserves VO2max and keeps the mitochondria flowing. (Helps prevent Pca recurrence and of course CVD likes to be first in line to kill us as it is). All usually on a rowing machine or bike.
For lifting, my working sets are usually 10-15 reps but what I like most is high volume drop sets. A sample would be 10 sets of 10 reps, decreasing weight as needed since resting time between sets is only 15 sec or so. The 10th rep should always be nearly impossible for best effect.
Rarely do I do heavy weight/low rep sets anymore. Collateral damage from surgeries and just plain age make it a little risky. Cables and calisthenics I like also
My returns are humble now but it’s just the stage of life I’m in. Depends on how it’s measured. So for instance I can only bench press 165 lbs or so for reps but I can do about 75 pushups in a set and 500 or more relatively quickly if I’m trying for that. I’m not great with rows, good mornings etc but I can do a set of 25 full hang pull-ups. My 1 rep squat max is maybe just 225 but I can goblet squat 70 lbs for 25-30 reps no problem. Safety first! My back has become cranky sometimes but yoga keeps serious trouble away. I hope this answers your questions!
Thanks for sharing the details. Like most things in life everyone has different taste and workouts are no different. You and I have different taste in approaching our exercise. I emphasize lifting over the cardio but still do cardio. I workout 3x a week and emphasize a different upper body part at each session. All my workout start with 15 min on the rowing machine followed by 3 sets on the dip machine, 3 sets on a chest press machine and 3 sets of pull ups on a seated cable machine. These are lighter weight of 15 reps to exhaustion. Then I'll rotate between upper body and legs for the remainder of my workout. Monday is Shoulders, Wednesday is Back and Friday is Chest, all heavier weight and smaller sets of 10-8-6-6. I finish each workout with a 20 minute Sprint 8 session on a Matrix Ascent Trainer. I'll leave it to those who are interested to read about this HIIT program.I enjoy the feel I get after working out (always have) and for me it keeps the aches and pains to a minimal.
Tuesday, Thursday Saturday and Sunday are cardio days that vary by season. Mostly bike riding in the warmer months and turning to swimming in the colder months.
Ice Hockey started last Sunday, so now until March will be 45 minutes or more of playing ice hockey once a week.
The lack of weight bearing exercise is not the cause of my decrease BMD.
Hockey! Now there’s some exercise!
It all sounds great. Yes HIIT seems at my age to be the drug of choice. I almost can’t believe sometimes how good I feel after really testing my limits-and I can do it start to finish quickly. I try to remember this when I pretend there’s not enough time, when the truth is that it’s just hard!
As the old saying goes, it’s the hard that makes it good.
There’s one that once would have prompted the old ‘that’s what she said’ joking response, but for a lot of us I guess it’s not so funny anymore so I’ll leave it alone.
Making the best of what remains never gets old that’s all I know. 😀
How does the saying go? I went to a fight the other night, and a hockey game broke out (or something like that!) 😀
A DEXA scan is a feeble instrument with prostate cancer. Tall Allen is your best guide.
What does this even mean? How else does one measure BMD?
An MRI (magnetic resonance imaging) scan is a better imaging test than a DEXA scan for prostate cancer because it can provide more detailed information about the prostate and surrounding tissues:
Accuracy
MRI scans are more accurate and efficient than traditional biopsies for identifying suspicious areas in the prostate.
That's wonderful if that's what the scan is for but when monitoring BMD (bone mineral density), a DEXA Scan is used. Men on ADT should get DEXA scans when starting ADT and every 2 years for continuous monitoring. Otherwise, osteoporosis will set in and bone fractures can occur.
If you are currently on ADT and you haven't had a DEXA Scan yet, you should contact your PCP and have one ordered.
I won't argue with any of the comments above (though I think some are questionable, and a few contradict each other), but will just add my own experience. Diagnosed in June 2022, PSA 20, Gleason 10, cT3bN1M0 (stage IVa). Had 2 years of ADT with Eligard, abiraterone and prednisone. 44 sessions of proton therapy to full pelvic region with "prostate boost," finished in April 2023. Started having low back pain in June 2023, progressed to severe sciatica in both legs. MRI revealed sacral insufficiency fractures, and consensus of orthopedist and oncologists was that it was due to a combination of radiation damage and reduced bone density due to ADT. Dexa scan showed osteopenia. Was referred to endocrinology bone specialist, who after appropriate testing put me on Reclast (zoledronic acid) and 1200 mg/d calcium (specifically Citracal, which she said is better absorbed/retained) and 2000 IU/d Vit. D3.
Sciatica and back pain disappeared in a month or so, and I was able to go back to full workouts with trainer pain-free. I will receive annual Reclast infusions for 3-5 years. A second DEXA scan recently showed no significant change in a year (which I gather is a good thing; you can't reverse bone density decrease, but you can stop it). Again, my understanding, which is certainly incomplete and could even be incorrect, is that calcium is constantly being transferred to and from your bones. The point of zoledronic acid is to regulate this process so that calcium added to bones at least matches that leaching out. Testing during this treatment includes not only serum calcium, but also 24-hour urine calcium, to measure how much you're peeing out. Other tests includes parathyroid hormone and c-telopeptides.
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