Muscle loss and ADT

Hi Warrior,

I've been on combined hormone therapy for about 2 years, and I'm a pretty avid gym goer - 2 or 3 times a week. I work on strength exercises to mitigate against muscle and strength loss, and am doing ok, even building some muscle. I've never had much body fat and that hasn't been a problem with the hormones, but I lose about 5 kilos of lean muscle mass around the time of diagnosis and for a while after (I'd stopped going to the gym for 6 months or so due to pains). 

During chemo I started going again but took it easy. I've now put about 3 kilos on in the last year. I guess the standard tips should help you - focus on the whole body 'big lifts', so squat, deadlift and bench press, and aim for progressive overload, increasing weight and/or reps. It is definitely not easy building muscle in our situation, but possible (plenty of female body builders not using testosterone out there!).

Keep at it as 3 months is still early days! Good luck with it. 

Hello Warrior 

I’ve been on HT ( 6 monthly decapeptyl injections ) since November 24 and a non curative op in August . RT was not a viable option due to the location of the remaining PC .

The HT is working as it’s down to <0.03 from a level of 1.7 post op.

have not noticed significant muscle loss as yet . I’m being as active as I can with home bike and weight sessions together with golf , walking , kayaking etc . I’ve got a bit of a pot now but not gained weight elsewhere .. my diet is pretty healthy but I do like a beer(s) .

Getting going with exercise is the challenge as the HT has affected my ‘get up n go ‘ in all respects . It is worth the effort as it certainly lifts the spirits by doing ‘stuff ‘ .Feeling good in yourself despite ‘IT’ is essential.

I know I am maybe fortunate compared to some but hopefully the above helps others commencing this journey realise that there is life after diagnosis .

i think they key is to keep going . Medically , I don’t know the significance of testosterone in building muscle .

All the best and get pumping with those weights 

Magpie 

I have been in HT since June 2024. I have put on weight round the middle but arms and legs are still good. 

I have an additional problem, which is that I suffered an acute episode of back pain whilst undertaking radiotherapy which is only improving very slowly. I have had 3 such incidents over the last ten years, each one worse than the previous. I am diagnosed with spinal stenosis, which means I am getting old. 

Weights are off for at least 6 months, but I have a static bike which I am using in bursts of 10 minutes a time, and done seated exercises put together by a Les Mills instructor which I do 3 times per week. 

These are stopping me sinking further into the mire.

However,  biggest problem is walking. Not that  I can't do it, but that it is no fun at all. There may be an electric mobility scooter in my life, to extend my range and because this is going to happen again. 

Keeping myself sorry of fit is an ongoing trial of new ideas to fit my current situation. 

The lesson: don't beat yourself up. 

Start from where you are, not where you were, and keep experimenting until something works.

If you're serious about gaining muscle, ask your oncologist and GP about creatine supplements. Evidence is showing it helps muscle growth and energy amongst other things, but I'm not certain, medically, if it is 100% safe in our situation - I'd be interested to find out though... (I've not yet asked) 

Hi Warrior68 ,

I second BrightonBiker , focusing on compound movements like squats and deadlift with progressive overload is the way to go. I've initially lost a lot of muscle due to HT as all my exercises were cardio, and was able to gain it back once I started lifting. If you haven't done this type of lifting before I'd recommend getting a personal trainer, as correct form is really important when you get to heavy loads. I train twice a week in the gym , one of which with a personal trainer.

I did ask my oncologist about creatine supplements and he approved, though I haven't started using it yet.

Hi BB I was wondering if you got anywhere with this. I'm just going back on ADT after 3 years off it and I'm thinking about how to maintain muscle. I've looked at a few articles and papers about creatine and think it's probably worth a go. 

Hi, I didn't actually ask, but might get hold of creatine supplements and give it a go. Away on holiday for a few weeks, so will wait until I'm back to get started 

I found this paper about using creatine supplement to help build/maintain muscle in people with prostate cancer.  

https://bmjopen.bmj.com/content/9/9/e030080

Here's an AI summary my son did for me. 

“Examining the effects of creatine supplementation in augmenting adaptations to resistance training in patients with prostate cancer undergoing androgen deprivation therapy”
Published in BMJ Open, 2019.

Recommendation: Any prostate cancer patient considering creatine should consult their oncologist or healthcare provider, especially to monitor kidney function and ensure compatibility with other treatments.

 Very Short Summary

This randomized, double-blind, placebo-controlled trial investigates whether creatine supplementation enhances the effects of resistance training on body composition, muscle strength, and physical function in men with prostate cancer undergoing androgen deprivation therapy (ADT). The study hypothesizes that creatine will lead to greater improvements in fat-free mass (FFM), strength, and quality of life compared to resistance training alone.

 10 Key Bullet Points

1. Study Design: 12-week randomized, double-blind, placebo-controlled trial with 56 men on ADT for prostate cancer.
2. Intervention: All participants underwent supervised resistance training 3 times per week; half received creatine, half received placebo (dextrose).
3. Creatine Protocol: 20g/day for 5 days (loading), followed by 5g/day for 12 weeks.
4. Primary Outcome: Change in fat-free mass (FFM), measured via DXA scans.
5. Secondary Outcomes: Muscle strength (1RM tests), physical function (e.g., walk tests), quality of life, fatigue, and blood biomarkers.
6. Rationale: ADT causes muscle loss, increased fat mass, and reduced physical function; creatine may counteract these effects.
7. Creatine Mechanism: Increases phosphocreatine stores, enhancing ATP resynthesis and exercise capacity.
8. Safety Monitoring: Included creatinine levels and gastrointestinal distress questionnaires to assess side effects.
9. Expected Benefits: Improved training volume, muscle hypertrophy, strength, and physical function.
10. Limitations: No long-term follow-up; results may not generalize beyond men with prostate cancer on ADT.

 Conclusion: Should a Male with Prostate Cancer Consider Taking Creatine?

Yes, with medical supervision.

Explanation:

• Benefits: Creatine may enhance muscle mass, strength, and physical function when combined with resistance training, which is crucial for counteracting the catabolic effects of ADT.
• Safety: Creatine is generally safe and well-tolerated in older adults and clinical populations, though this study is among the first to assess its use in cancer patients.
• Therapeutic Potential: Given the consistent muscle loss and functional decline in men on ADT, creatine offers a low-cost, accessible strategy to improve outcomes.

Hello JoBe 

I am aware creatine supplements are widely available (indeed your body makes it naturally!).As with any supplements and none prescribed medication - check it's ok with your cancer team or GP - you don't want a medication clash!

Best wishes - Brian.