Prostate Treatment Study - Effects on Exercise Performance

[conbio]

I thought some might be interested in this study that I volunteered for run by the VA and Seattle Cancer Care Alliance. I got tested at baseline before treatment, at 3 months, and at 6 months. At all sessions there is a long questionnaire about mood, sexual satisfaction, sleep habits, etc. I perform a number of strength and aerobic exercises - including a VO2max test that looks out how efficiently my body is using oxygen during exercise. Blood is drawn. Also - at baseline and at 6 months I got a quad muscle biopsy - where they take a small sample and look at mitochondria activity.

So - the results I know. I was in the highest tier for performance during baseline. After Lupron was started my VO2max dipped an insignificant amount - statistically not there. After my EBRT it was another thing. My red blood count dropped by 12% and my VO2max performance dropped by 24% - thus my aerobic capacity is diminished quite a bit. I can feel this - and now I have a good excuse for being the last in line on the uphill track for spring backcountry skiing. I did, however, do well on the strength portion of the tests.

Likely going to be 3-4 months before I dig out of the low RBC hole. So far - the biggest effect has been from the EBRT. I'll get all my accumulated results some time in the future. I think the study has 60 subjects with a variety of treatment programs - that spreadsheet will be fun to figure out.

65 yo, Gleason 4+5, in middle of 18 month Lupron stint, had EBRT and Brachy recently

[Tall_Allen]

Probably from the Lupron.

[conbio in reply to Tall_Allen]

Thanks- I looked into that a bit and have not specifically asked the question. But 3 months into Lupron I had only a very minor decrease in RBC. When checked again after the radiation the RCC nose-dived by 24%, which was 6 months into Lupron But good question in how these things interact

[Tall_Allen in reply to conbio]

It can take a while for lack of T to affect RBC. Radiation to pelvic lymphatics is known to affect white blood cell count, not RBC.

[conbio]

I've been reading on my own and my oncologist sent me to some journal sources that point to similar effects of mine from radiation - but I plan to ask more specific questions tomorrow

Results: Erythrocyte, leukocyte and platelet levels decreased significantly relative to baseline levels at T2-T5. Neoadjuvant hormonal therapy had an impact on hemoglobin levels before and during RT. The cumulative incidence of grade 2 leukopenia was 15 versus 2% (p = 0.02) and grade 2 anemia 8 versus 0% (p = 0.03) with versus without whole-pelvic RT, respectively. Lymphocyte decrease was larger at times T2-T5 (36 vs 3% grade 3 toxicity; p < 0.01). pubmed.ncbi.nlm.nih.gov/247...

The prevalence of anemia increased substantially during radiation therapy in patients with prostate cancer and those with colorectal (44% to 63%), lung/bronchus (55% to 77%), or head/neck (34% to 57%) cancer. Across all tumor subsets, low hemoglobin levels typically ranged from 10 to 12 g/dL. cancernetwork.com/view/anem...

[maley2711]

aren't most of those test declines a result of ADT, not RT?

[conbio in reply to maley2711]

There are numerous studies showing significant drops in RBC, hematocrit, and hemoglobin from EBRT to the pelvis area. My blood draws showed a minor drop in RBC (2%) several months after starting Lupron. Following my EBRT the blood indicators nosedived. From what I have been reading the effects from Lupron are compareitively light - typical 1 gl/d, which lines up with what I experienced.

[Currumpaw in reply to conbio]

conbio,

You have the numbers. Makes it sort of irrefutable.

Wishing you the best.

Currumpaw

[timotur]

Mirrors my experience on HDR-BT/IMRT/ADT— RBC’s and WBC’s went 10-15% under the lower normal level. RBC’s recovered one year after ADT stopped, but WBC’s are still low, but improving slightly.