Any advice for a struggling runner? - Prostate Cancer N...

Prostate Cancer Network

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Any advice for a struggling runner?

MotoGuzziFan profile image

Hi fellow travellers,

I am writing for some advice regarding my running following my prostatectomy and then salvage radiotherapy. I have been a keen runner since my 40’s and became quite good at it, running most days and completing many marathons. Since just before my diagnosis and up to the present day, around two years, I have been struggling, I have no energy in my legs and am getting slower and slower. I feel exhausted and quite disheartened. I have been a life time vegetarian and a vegan for the last few years. I have had blood tests to look for any deficiencies, which was how the cancer was detected, but nothing showed up. Any advice as to what might be causing my tiredness and any suggestions would be very much appreciated.

Best wishes!

30 Replies

The radiation causes fatigue. Hubs did a clinical trial(through the cancer hospital) with stretching and Ritalin (given in the morning) for 7 weeks and it helped a lot. Ritalin is methylphenidate. He had to get blood work done prior, etc. but got approved. Prior to that he just felt like resting most of the day, or he'd fall asleep in the chair (not like him at all).


I’m 60 years old

I meant the slowing down comes with age. It sucks.

Too true! It’s just that it happened so soon, I went from running 19:20 5k in 2018 to struggling to run one in under 23:00 now. I also feel like there is no energy in my legs and often feel extremely tired. I was just hoping there might be some miracle cure, but feel you may be right TA!

clayfin profile image
clayfin in reply to Tall_Allen

Not necessarily so - do you know the level of testosterone and free testosterone from your blood work? Estrodoil? Thyroid, kidney and liver functions? Vitamin d, b and iron levels? If not get them checked out.

MotoGuzziFan profile image
MotoGuzziFan in reply to clayfin

Many thanks clayfin I will ask my doctor to have a look at my testosterone levels, the rest was checked in my last blood test and came back normal. I am not sure what Estrodoil is?

clayfin profile image
clayfin in reply to MotoGuzziFan

Estrogen level.


MotoGuzziFan profile image
MotoGuzziFan in reply to SPEEDYX

What are they?

SPEEDYX profile image
SPEEDYX in reply to MotoGuzziFan

Sneakers from from back in the day....Competed with Keds..Commercial show a boy running so fast with them on!.....If your parents were nice they would buy them for you...More expensive....still available today

MotoGuzziFan profile image
MotoGuzziFan in reply to SPEEDYX

Sounds just like what I need! Sadly will have to make do with Nike!

SPEEDYX profile image
SPEEDYX in reply to MotoGuzziFan

That's commercialism....Fight on brother!!

Do you lift weights? If not, do so if you want retain your good running.

Age. You’re complaining of weak legs. The legs go first, in case they didn’t tell you!

Thanks London441 I used to go to a gym before this COVID nightmare, but have no weights at home. I will start doing more press ups tho!

Pressups are fine, but you need leg work. Squats lunges deadlifts etc.

I had no weights since COVID hit too, but I got by with calisthenics. Even with no weight, squats work fine if you do enough of them.

Good morning Moto, I feel your pain. I had brachytherapy on my prostate 5 months ago and the change in my running performance was dramatic. I went from easily being able to run back to back 20 mi days to having trouble running 8 miles. we had different surgeries so all I can do is give you my perspective but I have spent a lot of time trying to figure this out. In my opinion if you are on flomax or any kind of alpha blocker this could be your problem. These drugs are essentially smooth muscle relaxers. First of all you will probably notice an increase in your heart rate that doesn't really match your effort. That is because blood vessels are smooth muscles so if they are dilated, your heart has to pump faster to maintain pressure in the larger vessel. These drugs may Target smooth muscles but I think they bleed over into skeletal muscles also. it is basically like trying to run while taking muscle relaxers. I started taking the flomax right after my run that way it had 24 hours to dissipate before my next run and it seemed to help. I have also recently changed to Cialis which is an alternative to flomax and I'm hoping this will help however I have an injury and haven't really been able to test it. If you would please respond back to me and let me know if any of this makes sense to you or what you think is causing your problems. I will also point out that one month ago I finished quest for the crest 50K in the mountains of North Carolina . I stopped taking flomax 5 days before the race and it was unbelievable how good and strong I felt. It has over 8,000 ft of elevation gain and 8,000 ft of descent and took 10 hours and 45 minutes. I don't think there's any way I could have done that on flomax. that's what a dramatic difference it makes in my case

Thank you for such a great reply UltraRunner54! Sadly I am not on any meds at the moment. I was on Bicalutamide and Tamoxifen during my radiation, it was for 20 weeks and I ran every day. It just feels like I have lost all my energy and speed in a very short time following my various treatments. Well done on the 50k that is so impressive, the longest I have run here is 40 miles off road.

I am a cyclist and not a runner, no RP but RT and on Lupron, Zytigs/Pred. I am no super cyclist but have not seen a decline in my legs per UltraRunner. Upper body slimmed out quite a bit from intentionally losing weight and the gym closing due to covid. No idea why what happens to one does not happen to all but had RT in Jan,Feb,Mar 2020 and am 41 miles from my goal of 4000 this year a increase of 600 miles over last year. I stuck with it and I saw increases in distance and speed this year. So I can't speak directly to your reasons but is it possible it is partially mental or emotional? How have you handled your dx in regards to both. Just a thought, I don't mean to make light of your side effects which very much could be the only reason but thought I might offer this for thought.

Hi treedown, thank you for your reply. I have had the same thoughts myself, I did get very down with my dx and have been on Sertraline for the last two years and had some counselling. Very occasionally I feel better and I am able to run like I used to, but these are few and far between, which has made me thought that perhaps it is psychological? I also wondered about my diet and have tried to increase the amount of protein I eat and take a multivitamin supplement for vegans. Anyway I am determined to carry on and not let it get me down as running is by far the best thing for a troubled mind!

Good, this disease wants to take everything from us, fight it like your life depends on it. Maybe, don't beat yourself up if your runs aren't as good or to a standard they used to be and just run for the joy of running. I rode 50 miles yesterday and not as fast as in the warmer months but it is always great for my psyche to be outside and moving. It also kicked my butt and I always love that feeling.

Schwah profile image
Schwah in reply to MotoGuzziFan

“Fatigue and tiredness are two of the most common side effects of sertraline, as well as several other SSRIs.”

Looking up Sertraline that’s a quote of a typical side affect. Perhaps that’s your issue?


I run as well for about 45 minutes,but only 3-4 times a week now and have similar weakness in my legs, lack of energy, general fatigue, and a lack of stamina. I'm 60 as well and had surgery, salvage radiation, and have been on Zoladex. I'm blaming the Zoladex for everything. Without testosterone your body just can't perform the way we are accustomed to. Hard to stay motivated when you don't have the zip to get your ass up and moving. Right now my testosterone level is .01 ng/dl and once it recovers to normal or near normal levels I'm expecting to get past this period of sluggishness. 60 isn't old enough to affect one's performance this much, it's the pharmaceutical's creating havoc. Eat right, try to get the sleep you need, keep running and accept the substandard performance until your body recovers naturally.

Many thanks Afterglow! How long does it take for testosterone to return to normal?

Everyone's different I believe, but I would expect anywhere from 6 months to 2 years from the time you stop taking Zoladex or its equivalent. The problem for most of us in this predicament is if our psa levels increase, the standard of care dictates that we go back on the drugs that created the problem in the first place so in reality only being in remission can get us back to normal.

Hey MotoGuzziFan!

If you don't have weights body weight squats will be fine. Do one legged, pistol squats going down only as far as you can and still rise up. Even if you can only go down a few inches it will be helpful. Save the gallon jugs and fill with water to hold when doing squats. Lunges? Do you have stairs with a railing? You can do calf exercises using a stair.

Rather than distance at first perhaps some short sprints allowing time to recover between them. HIIT --"high intensity interval training". Maybe two or three sprints at first. Try it and see what you can do. Compete against yourself at your own level of fitness and try to increase it. Don't try any Usain bolt stuff--that would be insane to try to be like Usain!


Many thanks Currumpaw. I will try those out, I’ve never heard of a pistol squat before, but have some stairs and a railing and would be good to work on my calves.

Hey MotoGuzziFan!

The sprints will build stamina, muscular and pulmonary. Start gently.

Pistol squats were what I learned as a martial arts exercise. The Cross Fitters might have adopted them and named them. Doing a pistol squat as far down as parallel would be very good considering you are recovering. Halfway to parallel for a few reps is excellent!


Hi MotoGuzziFan ... Will be 70 in a few months and was hoping to run the Boston Marathon in 2020 and again in 2021 to celebrate being finally "off" ADT after 2 years. Alas, a combination of Covid 19, PC fatigue (affecting training) and believe it or not: a severely sprained ankle with fracture after rolling my foot on a walnut kept me handicapped for over 2 months.

Yes, fatigue is OFTEN a part of one's PC treatment journey. Radical P,, 39 rounds of Radiation, and ADT for 2 years (plus the inevitable ageing will affect one's speed and stamina. Not to boast but I did run Boston marathon at age 65 in 3:30 and change! I may no longer run 8 min/mile pace ... but ... I will celebrate each opportunity to put one foot in front of the other.

Work on your muscle tone and strength and do not be ashamed of the 'run / walk' method.

All the best ...

You're lucky.... I'm having trouble just walking.....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/24/2020 9:49 PM EST

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