New Member - Building Muscle Mass - Prostate Cancer N...

Prostate Cancer Network

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New Member - Building Muscle Mass

andy_diggs profile image

Hi all.

Newbie here with a first time post, so hello to all!

Was diagnosed in Feb this year with a gleason 9 tumor (age 54). Had a radical prostatectomy in March and while initial scans have shown no spread of the cancer, the tumor had broken through the capsule wall.

PSA prior to surgery was only around 4.1 and post surgery so far it is undetectable (end of May). No extra treatment has been done at this stage and we are in a bit of a wait and watch mode which is apparently pretty standard here in Australia.

In the meantime, I am watching the diet and lifestyle and proactively taking a variety supplements/herbs, some of which are specifically focussed on trying to keep testosterone at a minimum, how successful that will be I don't know yet as far as testosterone reduction.

I have always been healthy, but skinny (180cm tall @ 60kg), so my big goal in this watch and wait phase is to focus on building up my muscle mass as I have nothing in reserve should the cancer spread. Realistically, there is no substitute for lifting heavy weights to build mass, but I have always had lowish testosterone (250 - 350) and this will likely be lower with some of the supplements, so none of this helps with the the goal of building muscle mass, which I have always struggled to do.

Does anyone have any experience or tips and tricks in trying to combine the anabolic process of building muscle mass while at the same time reducing as many anabolic stimulants (including protein and specific amino acids) that may promote cancer growth?

There is also the issue of decreasing motivation as T decreases, but that is just as much a mental challenge than anything else.

Any input or guidance/experience much appreciated.

Thanks all

20 Replies

Hi and welcome Andy,

My Diet and Biometrics

I do not take any protein or amino acid supplements, pretty much a paleo diet, and have target macro nutrient ratios of fat 25%, carbs 50%, protein 25% based on a 2,000kcal daily intake. age 57, 178cm tall, 75kg, PSA 5.97 ng/mL, Testosterone 22.42 nmol/L.

My Workouts

I use low weight resistance and high repetitions (20~30 reps per set), to just about failure each set.

The low weight prevents joint injuries, and higher repetitions achieves the same anaerobic burn, and quite a sustained burn.

I do a particular resistance exercise only once one per week, but do daily workouts (7 days a week).

I found muscle groups don’t seem to really adapt to an exercise if done only once a week, and I am sore the day following any workout routine.

I use cable fitness trainers (e.g. Freemotion dual cable cross).

I found fitness trainers to be synergistic, working the target muscle and stability muscles too, and because they do not move in a fixed path like machine weights, prevent joint injuries.

Thanks for the reply and the outline of your routine. I have typically also been a low weight high rep guy, which generally kept me fit and above average strength for my body weight, but it just never let me build mass, which is the current goal. As you point out, low weight/high rep was also good from an injury perspective as whenever I went to heavy weights I was a lot more prone to injury. This time around I am just progressing up the weight scale very slowly. I might look into the fitness trainers as I have always been more a free weights person.

Current program

Upper Body weight training 2 x 30 min session per week in the evening, Wednesday/Sat

Lower Body weight training 2 x 30 min session per week in the evening, Thursday/Sun

15 minute hill run 3 x per week in the morning

Mon/Tuesday/Friday Rest Days

Always tweaking the routine, but that's the current one

Your low testosterone may have contributed to your cancer. No reason to keep it low now.

Hey Tall_Allen, I hope you may be able to clarify something about natural testosterone levels in regards to prostate cancer patients.

Earlier, I made a rapid edit to my posted response to andy_diggs because ADT is a SOC for aggressive prostate cancer to suppress testosterone hormone levels.

Basically, I deleted “I have found some evidence that testosterone modestly correlates to PSA, but also that it may help healthy cells, preventing giving resources to any cancer cells to further grow.”

Question: I was wondering why is testosterone suppression, to extremely low levels, the SOC for advanced prostate cancer patients, yet testosterone levels are not of concern for other prostate cancer patients?

Castrate levels of T suppress cancer growth. However androgen receptors are fully saturated at low T levels. Adding more changes nothing.

Thanks Tall_Allen . I have always been curious about the possible connection between low T and more aggressive forms of PCa when it finally shows up, but I have not really found much in the literature relating to that and providing a good explanation of the underlying mechanism. If you have any references to any papers or info on that it would be good to read to get my head around it.

I get the point about androgen receptors being fully saturated even at low T levels, but are you just referring to the PCa receptors specifically or to the receptors in general. We know of course that guys with normal T levels, when taking T supplementation can significantly drive up anabolic growth, so I have always just assumed this would be the case for driving PCa growth as well with added T, but maybe not?

As a side, we (urologist and I) had been aware of elevated PSA for a few years now (PSA of 3-4), but early tests showed no cancer originally and he was waiting for it to move above 5 before further testing (luckily I pushed for further testing prior to it going above 5, but that's another story). Over that time, I would do the occasional 3-4 day fast and each time I did that my PSA would drop by approx 20%. Weather that drop was due to a nutritional deficiency driving down PSA or the fact my T levels pretty much halved during these fasts, no-one could tell me.

Like many things in life. Building muscle mass depends in the individual. With that said, I find that lifting heavy weight will tield the best results. You can certainly build muscle with lower weight and more repetitions but IMHO you being on the thin side) will need to lift you final two sets should include heavy enough weight that you can do ( correctly) 5-6 times and if you have a spotter another 1-2 times on major muscle groups. (Legs. Chest, Back. Shoulders) . For arms. I do pull-ups. Chin ups and dips. Thats it. I bike and play ice hockey so that's my cardio. Good luck...I hope you don't have to become and advanced pca's the suckiest club to belong too.

I was 53 when dx as g9(55;now)...I have a recent post on my ending ADT soon so you can read about my treatments and pathology if you like.

Hi TomTom1111 thanks for the info. Certainly trying to avoid the advanced PCa club. Most of my sets currently run at around 10-12 reps, but going heavier and running at 5-6 reps is a good suggestion for the next step. I will take a look at your ADT posts in the other forum as well. Did you find that when on ADT you were able to build any muscle mass or was it more of a maintenance at current levels to stop muscle loss?

I forget that there are 2 forms and I can't keep track which one I'm on

The short answer is yes..I did build muscle and some strength from when I started ADT but It can be a struggle to get the motivation to go to the gym.

As Allen says, there’s no need at this point to deliberately try to keep T levels low.

Heavier weights generally do build mass more effectively but there are 4 other factors that matter more:

1. varying your routine

2. Increasing volume

3. Progressive resistance

3. Intensity

Too many people do the same workouts every week. The body adapts, so mix up load, reps, types of lift, everything.

3 sets is some kind of standard for no good reason. High volume sets (eg 8, 10, 12) of say 10 reps with minimal rest time are great mass builders, and you get anaerobic benefit too.

If you’re not used to high volume, this type of lifting defaults to ‘drop sets’, where the weight is decreased with every set. No problem! With practice the drops can be minimized.

Obviously,progressive resistance is very important. Keep track of how much and what weight you’re using, and increase periodically.

Finally, intensity is the driver for all of it. I can tell you right now from the detail you provided that you’re not working hard enough to get the results you seek.

IMHO too many guys worry about getting hurt lifting. I worry about being lazy and having lackluster workouts, or overly long sessions with poor intensity.

These are no good! In and out in 40 minutes high intensity is plenty, but you have to push yourself. In my gym I see very few guys our age working hard.

I’m not saying they’re wasting their time, it’s all truly good. But you get what I mean.

If you do 3 sets of 10 reps, or even heavier weight/lower reps where you could do another 2 or 3 reps if you REALLY want it and don’t, you’re just not going to improve. Once you’re warmed up try to focus on this.

I was on Lupron for 18 months with testosterone below 10ng/dl the whole way. Pandemic closed my gym of course and buying weights was like trying to buy toilet paper-could not. So I did calisthenics only for a while.

I worked hard because I knew what the ADT was doing to me. At one point I got off 1000 pushups in 21 minutes, which was very good for me.

However, building mass with suppressed T is difficult; maintaining is about all I could do. Energy is down as well. However I have known of guys who do build mass with low T, usually they are not experienced at lifting or are just weak so they have a big window for improvement.

I hope this info was helpful. As some trainers like to say, ‘If it doesn’t suck, we don’t do it’.

If you really want to feel, look and perform at a higher level, and change your body composition, these are words to live by. It’s obviously not for everyone. Great luck to you!

Dr Myers told me that preserving or increasing muscle mass when you have prostate cancer is hormonally helpful.

He encouraged weight/resistance training to do so.

The easiest place to do it is in your legs because those are your largest muscles.

He warned that while on adt you have to be careful to keep it light because it is easy to damage your self. You are not able to repair the micro tears to your muscles so easily while on adt. And it is through that process that weight training works.

So you need lighter weights and longer recovery periods.

London441 profile image
London441 in reply to cesces

‘Keep it light’ isn’t in my vocabulary, sorry. And I didn’t get injured once with heavy lifting through 18 months of ADT.

I think maybe the more appropriate direction is to listen to your body and don’t try to quickly increase weight, intensity etc .

Men, especially older men, are known for this. There’s even a name for it of course, ‘weekend warrior’ syndrome.

Know also the other mistake that men make frequently when lifting-overwhelming the small muscles and ignoring them while loading up fir the larger ones.

In upper body this means lots of chest and no shoulders, particularly the smallest of the shoulder muscles in the rotator cuff. They must be worked.

In lower body it’s doing exercises like squats and deadlifts with insufficient core strength.

In each case there’s a perilous imbalance.

Stretching is vital, whole body. Mobility is different but related. There’s a lot to know.

However, the general advice to ‘keep it light’ is as overly simplistic as ‘go heavy’. Especially from a doctor.

If you don’t know what you’re doing get a good trainer if can at all afford it.

cesces profile image
cesces in reply to London441

Just repeating what Dr. Myers told me.

And he did strongly encourage weight training.

He did make it plain that if you did it with too much enthusiasm while under adt you could too easily do the tearing down better than the building up part.

London441 profile image
London441 in reply to cesces

Snuffy Myers?

cesces profile image
cesces in reply to London441


London441 profile image
London441 in reply to cesces

Like one of my brothers, he’s a retired doctor in his late seventies not trained in exercise physiology. So I would be seeking other opinions on the subject, although he is a legend in the Pca world so there’s that😀

Much like in our Pca itself, everyone is different. Workouts that are routine for me might kill another man. And there are certainly other boomers I can’t keep up with, mostly in pools and on bicycles lol.

Overall I guess the reason I wouldn’t advise a prostate cancer patient to not push too hard is that they’re so unlikely to do it.

But yes, maybe ‘proceed with caution’ rather than ‘keep it light’ makes sense to me.

All good comments but there are two missing items - one is nutrition - building muscle requires extra nutrition. Your current diet of 2000 calories is a maintenance diet if you are battling to bulk up - try increasing it by 10 - 15% and play around with the macros - try fat:carbs:protein to maybe 30:30:40 - see what works for you. Contrary to what many believe eating fat does not make you fat - eating too much makes you fat.

The second is how you train - light weight high reps(15 and above) builds stamina and tones muscle, heavy weight and low reps(1 - 5) builds strength and heavy weights with rep ranges between 8 and 12 build muscle. All are mutually exclusive except for genetically gifted people - ie. you can mostly only do one at a time. Obviously all will build strength relative to not training but each goal is probably mutually exclusive for most people.

Would swimming be ok when on ADT…have recently began weights on machines since soon i’ll be on ADT…I’m not so much into weight training but i know the importance of preventing muscle loss!

Welcome aboard Andy ! So you could be done with pc . That’s the hope . Building muscle is a chore and hard to do with low or no t . More important is any movement to strengthen the bone and joints . Don’t want those to weaken .. I can lift any heavy weight without injury . Jane Fonda it is ! Hang in there . Enjoy life . 🏜✌️

No expertise this area, Andy. Just wishing you all the best. Fairway

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