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Thread: Hormone therapy and competitive sports

  1. #1
    Senior User
    Join Date
    May 2017
    Posts
    153

    Hormone therapy and competitive sports

    Just got my monthly uPSA from Labcorp at 0.183. I really think this value is an outlier and possibly insignificant. I'll find out for sure next month. I've been thinking about HT and what affect it will have on my lifestyle. One positive outcome from this prostate cancer diagnosis is that I have stopped working long hours and started training again (road bike - five year layoff) and lifting weights. I'm gaining muscle mass and my endurance is also improving rapidly. I'd like to start racing again but I won't be in any kind of decent shape until March of 2020.

    If my PSA really is rising fast I'll be in for radiation and HT in 2020. That will completely blow the lid off my plans to start racing again. I'm wondering if HT will knock me for a loop and prevent me from training. Will I end up loosing all of my muscle mass and fitness level? Will I be so tired and depressed that I won't be able to work out? I've been reading posts from people who have been through HT and I was surprised to see some people did not have severe side effects. However, I don't think those people were involved in competitive sports. I'm curious to know how HT will affect someone who has a background as a competitive athlete and if there will be any possibility of recouping a significant level of fitness after HT is over.

    Maybe I can talk my urologist into giving me some EPO.
    DOB 1961
    2010-05 2.42
    2015-07 7.0
    2015-08 5.4
    2016-02 6.2
    2016-09 7.86
    2017-02 7.2
    2017-05 5.65
    2017-06 biopsy 7 of 13 cores G6
    2017-10 7.11
    2018-04 7.47
    2018-11 11.80

    2019-01 Da Vinci RALP
    Pathology report:
    Final stage pT2C
    Histologic type: Acinar adenocarcinoma with focal mucinous features
    Grade: 3+4=7 35% pattern 4
    23% of prostate involved
    EPE-
    BNI-
    SVI-
    PNI+
    LVI+
    Margins focally positive [1-3 mm] 4 locations
    Cribriform pattern noted

    Roche ECLIA uPSA
    2019-03 0.133
    2019-04 0.116
    2019-05 0.143
    2019-06 0.140
    2019-07 0.183
    2019-08 0.197

  2. #2
    Senior User
    Join Date
    Mar 2017
    Posts
    104
    Not this is of any help. I think the more fit you are going into ADT the better your body will handle it. I have been on ADT for 2 years 1 month and was supposed to stop but was only off ADT for 40 days. I'm still on same HT and added Xtandi. I was an active letter carrier when I started, I am over weight I only gained an extra 8lbs from ADT. For a while felt really weak but continued to do everything I needed to do. Now retired and still on ADT I am staying at same weight but need to stay more active to have the energy level I need to do my task's. The less I do the less I can do. So as long as you continue your level of fitness I believe you'll be fine.
    steve d
    Diag. 56 DOB 2/59 PSA 01/14 (2.0) 6/15/15 (2.4)
    Biopsy 6/23/15 5 Gleason Score 8
    Pet Scan & Biopsy of rib Neg
    RP 10/15/15
    Pathology 54g 5x4.2x2.8cm 4+3=7 Tumor location quadrants Bilateral
    Extra-capsular extensions present,Semi vesicles no invasion
    Vascular invasion none, Perineural invasion identified ,Multicentricity : multifocal
    Margins involvement/Not present on inked margins lymph nodes : five negative pT3a,N0
    PSA 10/6/16 .1 1yr PSA 02/02/17 .4 PSA 02/15/17 .5
    Pet Bone Scan 2/18/17 Neg
    PSA 03/17 .6
    03/17 Axumin trial 17.4mm recurrence rt. semi vascular bed
    03/17 Casodex + Trelstar 2yrs Casodex 6/18
    04/17 SRT (42) completed 6/3/17
    08/31/2017 PSA < .1 Last 6 uPSA <.006 uPSA 2/19 <.030 2nd BCR 5/19 <.235 5/19 <3.2 6/19 <.34
    06/10/2019 Pet w/Axumin inconclusive. Xtandi Trelstar

  3. #3
    Yeah...Positive margins with grade 4 PC...When you talk to your RO about treatment (sooner is better than later) see what HE has to say about ADT.. How strongly does he recommend it in your case ? ADT is chemical castration. Never lose sight of that. Your athletic ability WILL slowly be compromised..Normal athletic activities will be fine but competitive sports will leave you at a big disadvantage..A lot depends on how serious you are about maintaining your physical condition. Some guys do much better than others..
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5. 10/14 PSA 0.6, T-11. 1/2015 PSA 0.106. 4/15. 0.4, 9/15 1.4, 3/16 Zytiga, 0.04, 5/17 1.4 may switch to Xtandi. 3/1/2018. PSA now 54, chemo will begin next month. 7/19, PSA 2000 starting Lu-177 tomorrow..77 years old now..

  4. #4
    Busby, everyone is different. But as Steve said, going in, in good shape gives you an advantage. I was on HT for 6 months,in conjunction with SRT i had side effects, including weight gain, around the middle, I had hot flashes, but i was never fatigued. I was in decent shape going in, but not athlete type decent. You might be surprised and find that you will be fine. I think the Doc would encourage you to engage in any competitive sport you feel you could handle, i think fighting thru this crap with an active lifestyle is hugely important and will give you an edge
    Diagnosed at age 64 (in November, 2014), PSA 4.3
    Nov 2014 BX 3 of 12 cores positive original pathology G8. Johns Hopkins second opinion, G6
    Surgery with Dr Ash Tewari Jan 6, 2015
    Post surgical pathology, stage T2c, bilateral disease, upstaged to G7(3+4)
    5% of Prostate involved in Tumor. Organ confined, Margins, SV, lymph nodes (9) all negative, PNI positive
    PSA <.02 until (uh-oh), 2/17 .02. Then 5/17-.033, 8/17-.033, 11/17-.046, 4/18-.060, 6/18-.068, 7/18- .082, 8/18-. 078.
    Decipher score low risk, .37
    ADT/Firmagon started August 2018. SRT to start SEPT 2018. Finished SRT November 2018, Finished ADT Feb 2019
    T=7, PSA <.05

  5. #5
    I have no opinion but the question you ask is of great interest. Please keep us posted so the rest of know what to expect and how best to prepare.

    Good luck
    History: age 53 It took 3 biopsies (34 cores) to find 2 cores 4+4 Gleason 8
    Lap RP at MSKCC Apr 2004, age 54 All neg margins, nodes & structures. (T2a).
    Post RP PSA: <.1 until Feb, 08 (46 mos) PSA 0.1 - I then got sensitive tests -> 2008: Feb 0.06,
    May-08 0.09 - Jun-08 0.10, - Aug-08 0.10, - Nov-08 0.15
    SRT Dec-2008 ---Post SRT PSA 2009, Feb-09 0.10, May-09 0.09, Aug-09 0.06, Dec-09 .04, - 2010 Mar-09 0.04, 2011 .02, 2012 .02,
    STARTED UP Feb 2014-0.06, Jul-2015 0.10, Oct-2015 0.10, Feb-2016 0.15, Jun-2016 0.17, Dec-2016 0.25, Jan-2019 0.74, Jun -2019 0.72
    Aug 2018 Auximin scan - nothing
    Had an inflatable penile implant 2018 for ED. Best decision ever https://www.peyroniesforum.net/index...oard,56.0.html

  6. #6
    Senior User
    Join Date
    Jan 2019
    Posts
    465
    I have been on ADT 9 weeks. I have not experienced any decline in energy levels. I am also working 10 hour days mostly outside in heat wave we are having. Strangely I don’t have hot flashes when I am already roasting from the heat. I am having weight gain because I love ice cream and with hot flashes indoors and the heat outdoors I really like ice cream.

    Given your PSA, getter done.
    DOB 5/1957

    PSA - 11/2010=1.9, 6/12=2.3, 12/13=2.19, 12/14=2.64, 3/17=5.29, 3/17=3.91, 6/17=3.47, 12/17=4.50, 12/17=3.80, free PSA low risk (local (Uro, “My opinion you don’t have cancer), 8/18=5.13, 10/18=5.1, 10/19 ISO PSA 56% risk cancer. All DREs negative.

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative, (Uro opinion “This has been going on for a year”.... ah, more like 2 years ). Bone scan/CT negative

    2/25/19 R-LESS (Robotic Laparoendoscopic Single Site Surgery) outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)

    ADT - 6/3/19
    ART - 8/5/19

  7. #7
    Top User
    Join Date
    Aug 2016
    Posts
    1,639
    It will slow you down, but it doesn't have to stop you. I suspect you will have to rapidly reduce your weight limits to avoid injury. Best to adapt to what is possible than stop all together. It will speed up the recovery on the other side.

  8. #8
    I did ADT for 6 months in conjunction with radiation. In preparation, I upped my exercise routine and modified my diet and I took off 10 lbs before starting in anticipation of gaining it back.

    In short the only side effect I had was fatigue. But it wasn't a feel tired fatigue, it was an energy fatigue. I would be going about doing things and suddenly I would be out of energy. This would happen about 2 times a week on average depending on what I was doing. I had to be aware of that and not overdo things. I had no hot flashes and never gained the 10 lbs back. The fatigue ended about 3 to 4 weeks after the end of radiation. I maybe lost a little muscle mass but upping the exercise seemed to have offset that as I didn't really notice any loss in strength. After the ADT expired at the end of June, I seemed to notice the muscles felt a bit firmer from the exercise. Nothing real significant.

    I really think the better shape you are in going into it, the better the outcome. I experienced the same thing with my prostatectomy. I recovered very quickly. Too quickly as I had to remind myself I still had a lot of internal healing taking place.

    It will slow down your plan for competitive bike racing, but not end it.
    There is no right or wrong decision for treatment. Make the decision you are comfortable with and can live with and not second guess if all does not go optimally.

    6/2016 PSA 5.1, negative DRE
    6/2016 Urologist PSA 6.0, %free = <10% chance cancer, negative DRE
    12/2016 PSA 7.7, %free = 50% chance cancer, negative DRE
    2/2017 biopsy Bostwick 5/12 3+3, perineural invasion. Hopkins 5/12, 4 3+3, 1 3+4 (5% 4), perineural invasion
    5/17/2017 Open RP by Dr Alan Partin - Hopkins (5500+ prostate cancer surgeries, open & robotic)
    5/2017 Pathology 3+4, T2x, +margin (6mm, 3+3), organ contained except unevaluable at +margin, moderate tumor extent
    seminal vesicles, lymph nodes all neg
    Age: 62 @ surgery
    8/2017 PSA < .1
    11/2017 PSA <.1
    5/2018 uPSA .06, standard .1
    8/2018 uPSA .07, standard .1
    11/2018 uPSA .10, standard .1
    12/29/2018 6 month Lupron shot
    1/22/2019 start SRT, 39 treatments, 5 days per week
    3/15/19 ended SRT with no significant side effects

  9. #9
    Experienced User
    Join Date
    Apr 2019
    Posts
    59
    Quote Originally Posted by Busby View Post

    Maybe I can talk my urologist into giving me some EPO.
    There's a clinical trial of EPO at Hopkins, used immediately pre & post RP! If that study gets good results it might be easier to talk your Uro into it.
    Wife Posting, Husband D.O.B. 1975
    2/2018 - routine physical PSA 15
    3/2018 - PSA 13
    4/2018 - PSA down to 11.6, free PSA done, 18%
    6/2018 - PSA 10, free PSA 20%
    7/2018 - mp- MRI done, prostate volume =22cc, "inflammation consistent with prostititis"
    11/2018 - PSA 14, free PSA 11%,
    3/2019 - PSA 12, free PSA 17%, 2nd opinion on MRI = PI RADs 3 lesion
    4/2019 - Cognitive Fusion Biopsy
    5/12 cores positive
    4 Gleason 3+3
    1 Gleason 3+4 (Where PIRADs 3 lesion IDd)
    Decipher Biopsy score: .07 very low risk

    Bone scan negative
    MRI 6/19 said PIRADS 4 lesion, no definite EPE

    RRP 7/19 Final Path: pT3a
    G6 - 75-90%
    G7 - 11-25%
    24mm tumor, 30% of prostate
    EPE+, BNI+, SM + (at bladder neck), LVI-, SVI -, PNI-, Nodes -

 

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