Swollen, painful hands

[jazzy53]

I've been on ADT (Zoladex) for six months and am three months past a 40-day course of external beam radiation. Gleason score 9. About a month ago, my hands and to a lesser extent my feet began to swell. Soon thereafter, it became painful to open and close my hands and almost impossible to make a fist. If i do, some of my fingers "catch" as in a trigger finger. Typing is difficult and exacerbates the problem. My primary care doctor prescribed a diuretic to reduce the fluid, but while it took much of the fluid out of my feet, there was little reduction in my hands and no relief from the pain. My oncologist isn't aware of this syndrome as a side effect of treatment, but I notice that in the Zoladex product information,, "swollen hands and feet" is mentioned. It's gotten to the point where I drop things because my hands are too painful to grip. I've got an appointment to see a hand specialist next week, but I'm wondering if anyone in this group has experienced this while on prostate cancer therapy, particularly ADT. If anyone knows of a good treatment, I'm all ears. I've tried a squeeze ball but it doesn't help much. There was some discussion a while back of men with trigger finger but I don't recall anyone with symptoms as bad as this.

[Boxer1450]

Well before I knew I had PC, I was on anastrozole as an estrogen blocker while also taking testosterone. Along the way I developed trigger finger in 5 different digits. Hand Dr. thought it unusual but treatment is straight forward so I had them released. NOW I am recently diagnosed with PC. I found some scholarly articles that seem to show a causal relationship to anastrozole and trigger finger. I’ve brought it up with my Dr’s and pharmacist. They look at me like I’m internet crazy. I am not too familiar with ADT and Zoladex but your question may be related to this article.

Here is one article I found that might be useful.

ncbi.nlm.nih.gov/pmc/articl...

[jazzy53 in reply to Boxer1450]

Thanks for your reply and the interesting link. I've found a few other articles that associate ADT with hand/feet swelling, trigger finger, and the like, but the effect (if that's what it is) is not widely recognized by oncologists. My radiation oncologist, at least, admits she's puzzled but allows that this might be a side effect of testosterone suppression. I hope the hand specialist, whom I see next week, can accurately diagnose it and come up with a plan. I'd rather not have surgery because I'll be on Zoladex for another year and a half and figure any relief brought by surgery will be short-lived. I'm hoping for a good physical therapy plan but also worry that after two years of hormone suppression, the hand problem may be permanent. I know I'm getting ahead of myself, but it's a great source of worry. So far, I have trigger finger in three fingers and pain in most of them. The pain waxes and wanes throughout the day as does the restrictions on movement. At worst, I can only close my hands halfway.

[RonnyBaby]

Swelling of joints is a possible side effect of ADT.

In fact, it is widely published as such.

I had that problem when I was on ADT.

The swelling ended after I stopped ADT (assumed that it takes some time to get better).

[jazzy53 in reply to RonnyBaby]

Thanks. Interesting that nobody at the oncology practice where they administer my ADT and radiation knows of this side effect. At least they don't look at me like I'm crazy. The woman's hands in the link you provided look like mine: really puffy. Hoping the hand specialist has some answers. This is turning into a disability -- hard to type, grip things, etc. Not the end of the world considering everything else, but a major nuisance.

[RonnyBaby in reply to jazzy53]

They really don't want to discuss the negatives.

Can you blame them ?

Sometimes, yes, absolutely, for glossing it over - besides, who knows if YOU will react to any given possible SE ...

[jazzy53 in reply to RonnyBaby]

I saw a hand specialist yesterday. He's not deeply knowledgeable about prostate cancer, but said that cancer therapies such as hormonal therapy and chemo cause edema -- swelling with fluid -- and the edema causes trigger finger and associated hand pain.

He sees lots of cancer patients, primarily women with breast cancer taking hormone therapy or chemo, and has seen this scenario play out many times. He gave me cortisone shots in a few knuckles, and prescribed a 6-day prednisone dose pack and physical therapy. He said I should feel better soon. Since the root cause is probably the ADT, I suspect I'll have to deal with this for the duration -- another year and a half. But at least it's not something terrible like rheumatoid arthritis. When you're on ADT and everything seems to be going haywire, it's easy to conjure up awful ideas about what's happening.

[RonnyBaby in reply to jazzy53]

Although I can''t predict what side effects you'll have to deal with, I would suggest that you get your 'game face on' and roll with the punches.

I had no idea what I was facing and had to figure it out as time past by.

In my case, thank God, I was able to quit the ADT and take a 'holiday'.

I believe that form of treatment is necessary to obtain a goal - reduce the 'T' activity while trying to kill off cancer cells.

As much as I hated the treatment, it has worked wonders for me.

I did it for 16 months - in 3 month Eligard shots / cycles (6 cycles + 30 day casodex + max Rads to prostate and pelvic node area).

YESTERDAY, I saw my RO for my latest 3 month check up.

All I got was a smile and a green light !

My 'T' level is at the lower edge of the normal range (and stilll climbing - (7.1)

My PSA, which is expected to 'normally' climb up is at 0.03.

I'm told there's lots of room / ceiling to go before we get concerned.

2.0 is the number he mentioned as key to intervening AGAIN. He did mention

that he is not overly concerned about reaching that number - looks like I'm clear and

good to go - hopefully the 'cure' word might be pronounced in another 3 years.

[Dreamweaverman]

Hey Jazzy, I have experienced this symptom as well. I have been on ADT for about 6-months and my ring fingers started to lock as well as unable to create a tight fist. This seemed so random and out of nowhere. I mentioned to medical oncologist and they couldn’t explained n why. I am very grateful to you for bringing this challenge to my/our attention. I didn’t know if I was just getting older and it makes a lot of sense that this may be related to ADT’s. I do find going to gym and excercising the hand helps but I will continue to press until I find some more advice on what to do about this.

[jazzy53 in reply to Dreamweaverman]

My hands are quite a bit better now, now that I've completed a 6-day course of prednisone (medrol dose pack), and received steroid shots in the two fingers that triggered the most. Today, I went to the first of four physical therapy treatments, which involved some ultrasound massage and instructions on hand exercises (various kinds of stretching) that I'll have to do several times a day. My hunch is that I'll have recurrent issues with this over the course of my ADT (another 1.5 years), but I hope that I'll be able to manage it with these exercises and maybe some repeat steroid treatments. I don't know why oncologists fail to recognize this as a side effect. Several people in this group have experienced this, and my hand specialist says he sees this among prostate and breast cancer patients on hormone suppression. I highly recommend that you see a hand specialist to get some relief. Good luck Dreamweaverman .. Btw, because I'm on a long course of ADT, I'm hellbent to just get it over with without any ADT "holidays," though I can understand why that's a good choice for some people. Even without the relief from hand pain, I probably would have soldiered on without any interruptions in therapy. I just want this to be done.