Aching bones from ADT

[Runner1957]

Recently after 9 months of an 18 month plan of ADT (Zoladex) I have started to experience what seems to be bone aching especially around my hip joints. Has anyone experienced this and if so what did you take to ease the aching?

Thanks.

[treedown]

My hips get achy once in awhile. In my case it seems to correspond with being sedentary while working.

[Tall_Allen]

It may be arthritis- does an NSAID relieve the pain?

[Runner1957 in reply to Tall_Allen]

I am using Ibuprofen and paracetamol (Tylenol) but it only offers minor relief.

[Runner1957 in reply to Tall_Allen]

I don't take any supplements, but is there anything you would suggest taking?

[Tall_Allen in reply to Runner1957]

I would talk to an orthopedist. If it's arthritis he might offer some solutions.

[Runner1957]

Thanks. That might work as have been running lots lately and probably not drinking enough.

[London441]

Do you do any other exercise besides running?

[Snoe]

Yes, I am at month 18 of an 18 month ADT regimen (which also included 40 radiation sessions) and I have had quite a bit of joint pain, including hips, ankles, knees and more. I take Tylenol or Advil as needed. Just one of the many side effects, including weight gain, muscle loss, shrinkage, constipation, brain fog/inability to concentrate, lost libido which also affects motivation. In short, ADT was much worse than I anticipated. The good news is that my PSA has been less than 0.01.

It hasn't been easy but I did it. It is an effective treatment. Stay strong. The time will pass. You can do this.

[Runner1957 in reply to Snoe]

Thanks Snoe, I am sure it will work out. Hope your future is good.

[Monitoring]

Runner.

I echo what SNOE says.

Doing my own research saved me a lot of extra treatment ... I explain.

For 16 years I was on AS with daily Avodart to shrink prostate (very successful).

Was Gleason 3+3 for those 16 years.

Then, in 2018, PCa became aggressive and PSA went from 5 to 18 in 6 months, and Gl went to 4+5!!!

Referred to radiation oncologist who recommended 24 months of ADT (Zoladex, like you) with injections given every three months.

My research indicated that 18 months of ADT was just as effective as 24. Rad onc agreed. If I had to do it over again, I would have discussed with rad onc stopping after 3 or 4 injections as Side Effects (SEs) very uncomfortable (and some still persist two years after my last radiation treatment).

The ADT injections were designed to lower my testosterone (T) level to as close to Zero as possible in order to make the planned 40 EBRT treatments the most effective.

Again, my own research indicated that 25 sessions were just as effective as 40. Again, my rad onc agreed. So I had 5 weeks, 5 days a week of EBRT. Tolerated this just fine, but more SEs.

One of the SEs was arthritic hands Could not form a fist in either hand. Worse, I could not twist off a beer cap!!!!!

No arthritis in hips or any trouble with aching hips.

With the ADT, not only did my T level go to near Zero, so did my PSA (<0.02, or "undetectable").

I am now two years since my last rad treatment and 18 months since my last ADT injection. Still have certain SEs (hot waves, fatigue, breast enlargement, somewhat screwed-up plumbing, no libido although some recent stirring, and poor sleeping because of the regular hot waves that persist day and night).

Despite all the discomfort from the ADT and the radiation, I would do it all over again as I believe that (for now) the cancer has been contained and (maybe) eradicated.

However, no matter what treatment a guy has, there is a very strong likelihood that some microscopic prostate cells were left behind.

So, I am monitored every three months with blood-work to check PSA and T.

My last blood-letting in mid-May indicated that my T was back to the same level pre-ADT, and my PSA only rose to 0.04. When your T rises, so does your PSA. No concern until PSA reaches 2.0.

Hope my comments are somewhat helpful, but every guy is different and each of us has to choose what he thinks is best for him.

Hope your achy joints dissipate over time. The hardest thing is being patient.

Monitored (in Toronto)

[Runner1957 in reply to Monitoring]

Runner really appreciate your reply. The worst part of the reading was that you struggled with the beer cap Hope that psa stays low.

[Mischa1111111 in reply to Runner1957]

Thanks for sharing your experience And Congratulations. I just finished 26 treaments of IMRT and currently following the 18 month ADT regime. Occasionaly I have pain in left hip when doing jumping jacks . Then again I have escoliosis. But overall feeling good with my choice and the treatment.

[StillMoving]

I am a 75 year old lifetime runner. Diagnosed with high risk but localized PC three years ago. I was prescribed Zoladex three monthly injections to overlap with 5 weeks of image guided radiation. Initial plan was for 18 months of Zoladex but I pulled the plug after three injections. Reasons, the Zoladex side effects were mostly just annoying (hot flushes) but I did experience some muscle weakness and some heart irregularities when running. I was told stopping Zoladex at 9 months would result in a small statistical increase in risk of PC recurrence. At my age I'd accept that and take a few more years of running. Live well over live long. But your calculation may be different. Just remember that you can stop the hormone treatment early and still get good benefit from it.

[Runner1957 in reply to StillMoving]

Thanks for the reply.

[jazzy53]

I definitely experienced this. I'd never had hip pain before ADT, but it developed several months into my two-year course and then persisted for the duration and then some. I had similar problems in my hands, which became swollen, stiff, and achy with painful trigger fingers in both hands. I am over a year past ADT now. Neither problem has completely gone away but they are less severe than before. I, too, was on Zoladex.

[Runner1957 in reply to jazzy53]

Thanks Jazzy53

[Monitoring in reply to jazzy53]

Hi Jazzy.

As I mentioned in my thread, I am now 18 months since my last three-monthly Zoladex shot. I was hoping that my arthritic hands would get back to normal after a year. It looks like it will be a minimum of two years, and probably closer to three years before normalcy returns. Both my hands were like yours, stiff, achy, swollen, bad trigger fingers, and could not form a fist. However, I was able to use both hands fairly well, except taking caps off bottles. I squeezed a rubber ball constantly, and also used hand squeezers in order to build up strength. Still experience swollen fingers and achy finger joints but I can now make a fist and removing beer bottle caps no longer a challenge, a much-needed ability as the hot summer approaches. I can put up with these slowly dissipating uncomfortable side effects knowing that I am getting better. The bottom line for me is that I would advise discussing with radiation oncologist just how many ADT injections were really necessary. In my case, two shots lowered my T level to close to Zero to make the radiation treatments most effective. Maybe I could have got away with just three injections instead of the six that I had. The more injections, the more the intensity of the side effects. I wonder how things would have progressed with me if I did not have any Zoladex at all.

Monitored (in Toronto)