muscle and ADT issues and questions

[SimMartin]

A question about side effects and Zoladex (goserelin) - I am into the third month of Zoladex and two previous months prior to this on Bicalutimide (casodex) following a MRI and biopsy Gleason 9 (T2cN0M0) last august after HIFU for G7 only 8 months prior didn’t stop  PSA rise. Just completed 20 sessions of 3Gy each RT. My problem is that I am getting pains in my hip (probably muscle) and feeling weaker - it’s a problem for me to distinguish what if normal for me as I have post polio syndrome and get weakened muscles anyway (I have about 20% of normal muscle anyway from polio loss) The oncologist is going to review with me if you stop the ADT next month after my January monthly implant. Si knowing if it’s the side effects of the ADT that’s making me weaker and having hip pains or just the normal slower polio issues. I finished the RT two weeks ago and very few side effects just a bit more fatigued. It’s all a balance of course as the 20 session of 3Gy and 6 months ADT is a newer approach for contained PSMA/PET clear PCa even for high risk. But information is key about if I accept this as equivalent Ane trust to the future as longer ADT would severely impact my health in more muscle loss and more bone density issues.So is there an answer to how much damage is done in 6 months compared to 12 months given my los muscle mass anyway. Also how long does recovery take for testosterone to return and can muscle recover given the low muscle mass and exercise abilities. 

[jazzy53]

I don't know the comparative stats for various lengths of ADT treatment. But I can say that my joints and muscles hurt for much of the two years I was on Zolpidem, which I attribute to the treatment rather than the disease. I don't have post-polio, but the treatment exacerbated arthritic pain in my hips and lower back in particular. I also weakened over the period, despite daily exercise, and fell several times due to muscle loss in my core area. During arthritic flareups, I worried -- just as you are -- that the pain signaled spread of the cancer. Since finishing my two-year regimen of Zolpidem, the arthritic flareups are less frequent and less intense. Btw, I too am Gleason 9, so I well appreciate the anxiety that comes with joint pain, especially in the region of the lower back since this is often where pc spreads when it does spread. My psa has come up a little since treatment, but a recent PET scan revealed no detectable spread, thank God.

[SimMartin]

interesting that in this admittedly older study the testosterone recovery for the 1 month implant of Zoladex was faster than the 3 month implant - and time in ADT dud not alter that. Of course is that good or bad as especially with short term ADT you get an extra protected period whilst the testosterone recovers.

[Steve507]

I had one 3 month subcutaneous injection and my PSA fell almost below 0.01 within 30 days. Side effects were some fatigue and sweating at night. I discontinued because it wasn't necessary for my mild prostate disease. Best