Fatigue and muscle loss

Then 73 years old with PSA 11.3, I was diagnosed with T3b prostate cancer in February 2021. Surgery not a realistic option because of the spread into one of the seminal vesicles, so opted for EBRT and ADT (Zoladex).

EBRT (60Gy in 20 doses) completed mid December, last Zoladex implant in January, and no more prescribed.

Last check on 27 April, testosterone was negligible (<0.4) and PSA was 0.13

My question is is when can I expect the after effects of the ADT to disappear?

The major effect was loss of strength, Never a long driver of a golf ball, I used to hit the ball around 220 metres, now its way down on that, and I struggle with long "carries" that were no problem before. Probably struggle to get 180 metres these days.

I exercised throughout the treatment, with a weights and stretch belts routine recommended by the local Prostate Support Group fitness people, walked 10 to 12 kms around the golf course(its a long golf course!) two or three times a week, and only put on a couple of kgs(80 to 82kgs), so I would have expected to have regained the previous distance with my drives by now.

Any advice from the golfers (or other sports people) out there? If nothing else, I'm losing a lot of golf balls in the lake these days!

[Boywonder56]

Im 66 ...moved to sr tees...put away the ego....finally realized golf is a game where you move forward....the 390- 435 par 4s are no more....hitting 3 woods into par 4 s ...no fun...im/ was 6'4"....and have lost atleast 49 percent of my strength to adt...its a sad reality but in my case the cure is worse than disease....others laugh at side effects. Not i .. but i love the gane if golf and the comradery of my mates..so we adjust...and remember the days when you had a bit of a chance to eagle a par 5...bw...ps answer is in the very negligable testosterone.....its what makes us men

[Hidden in reply to Boywonder56]

Thanks for that, may have to follow your suggestion with the seniors I play with. But when I play with my two sons, that's another matter as may get a bit of banter from them

[timotur]

I did 18 months of ADT, and as an avid tennis player noticed the degradation in strength, stamina, and speed. After stopping Lupron, it took about four months for my testosterone to return to normal (about 700), and in about six months began to feel like my old self again on the tennis court. I would give it time and hope your T comes back naturally.

[Boywonder56]

Lucky for you ..us with stage 4 are on adt for rest of our time here....you can gamble and take vacations...but large part have regrets...as i was told when i joined this group 4 yrs ago....this is the new you...went from super man to homer simpson in 18 mos...am master carpenter..so exerciseing was last on my list after doing construction all day...retiring 5/26.....adt wins..just dont have it ...but ill play old man golf till i drop.....

[Hidden]

I was lucky I'll admit. The government run District Health Board was very unwilling to undertake the necessary tests at my age, using the cost benefit analysis that something else would get me before the prostate cancer. But I had a very insistent GP who worked the system to get the tests - so the cancer could have been caught at T2, but, thanks to Dr Young, T3 was ok.

But I do know what you mean by T4 as my younger brother's cancer has spread to his lungs, its slow growing but inevitable - so I hope you go well.

But in my case, first time I've been on a 24 handicap since I started golf, when 24 was the maximum (and shafts were steel, but painted to look like wood).

[London441]

Need to know what your testosterone is. Without sufficient return, you’ll not have much power (strength +speed).

Even if you lift, your power is the first to go as your age. In golf, strength (legs mostly) flexibility and especially swing speed. It’s also the first athletic tool that ADT takes from you. Think of it merely as accelerated aging.

I went through the same thing with my sport.

If your T comes back to reasonable levels you can get it back, but only through sports specific training, not just standard lifting. You also probably have to work harder. Get a trainer if you can.

Of course you’re also getting older, so gotta manage those expectations 😀

[Hidden in reply to London441]

As I said in my original post, testosterone level is neglible.

I recognise that, as one gets older, one gets wiser - but the sudden strength loss didn't allow the wiser to kick in. So chipping and putting has not yet improved to compensate.

Anyway, seems I'll have to wait for the testosterone levels to rise again. From internet research this should be between 6 and 12 months, so still a way to go yet.

[London441 in reply to Hidden]

Oh right sorry I see. Well of course with no T power is limited no matter what you do.

But as it returns even to 200-300 you have a great opportunity to get a lot back. 6-12 months is typical yes.

Ramp up the lifting and be golf-specific about it if you want the good results. Great luck to you!

[Hidden in reply to London441]

Thanks. And fairways watch out in 2023!

[Ramp7]

I've been on Lupron for about 2.5 years. I can feel myself wasting away. 6'4" 220#. I mostly wrench on cars but play golf as well. Hike 3 miles every morning. A 240 yard drive down the fairway would be fine for me. For my game to work, my scores are better with ball placement. Avoid the hazards and try for two putts. Stay strong. PS, Have you tried the JuJu swing?

[Hidden in reply to Ramp7]

Thanks for the advice on the Juju swing, never heard of it before. Think I'll have to try it out on the range first though😊

[j-o-h-n]

Miniature Golf anyone? I just love it when my ball goes under the windmill....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/24/2022 3:04 PM DST

[RonnyBaby]

I love golf as well - lost a LOT of power and strength while I was on the 'stronger' ADT offerings.

This may NOT be an option for you, but I'll put it out there. My Dx was worst than yours and I'm going on close to 6 years now, as a survivor.

I use a monotherapy - Bicalutamide - My 'T' has recovered to normal, but is 'suppressed' by the drug. I have virtually NO side effects and I can maintain muscle mass - I look 'normal' to most people. My one side effect I can report is fatigue - but that is a left over from all the prior treatments I had. The 'great' news is that the ESTROGEN in your body is NOT suppressed - therefore you don't have hot flashes and you can be a powerful 'semi-female' version of yourself.

My PSA is undetectable and has been for about a year now. I had a BCR about 28 months ago - my PSA came back to above 12 after I went on an ADT vacation. It appears that I could 'survive' like this for quite a long(er) time - according to the medical team that monitors me closely.

Monotherapy is not for everyone and you might need to fight for it - but IF you are a candidate (some favourable circumstances) - you will recover your lost power and your golf game will be better than it is when you're a casualty of the more/most powerful forms of ADT than can be a very negative experience.

Wishing you the best on your journey .....

[Hidden in reply to RonnyBaby]

Thanks for that. I'm hoping that I won't need any more medication, but if I have a relapse then I will be discussing Bicalutamide as an option with my oncologist when I next meet with him, currently scheduled for October

[conbio]

66 yo, 8 months into 18 month program of Lupron. Completed 22 sessions of EBRT, then brachy. I've been working pretty hard - have a trainer for dynamic weights once a week, climb in/outdoor 2x a week, hike/backcountry ski 2x a week, another weight session on my own. I faded a bit during radiation but am pretty strong - climbing 11c. Stamina a little down but incrementally moving upward. Only thing I can say is you really have to work it hard to not loose strength or muscle mass. Now those dang hot flashes - ugh!

[Hidden in reply to conbio]

Thanks for that. I think I'll try exercisjng every day, for a while anyway - currently its every other day. Instructor suggested every other day, but that was at the very beginning of ADT when I was possibly less fit, and been doing it on my own since Covid lockdowns. Hopefully fitter now!

As for hot flushes - only got them briefly after initial injection of Zoladex, and not since so I've been quite lucky, on that score anyway.