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ADT or no ADT? What should I ask my Oncolgist?
Prostate Cancer | Last Active: May 28 7:09pm | Replies (50)Comment receiving replies
Rob Newton, in the article: "Prostate cancer treatment with exercise medicine" https://onlinelibrary.wiley.com/doi/epdf/10.1002/tre.884
" ...we have reported that the combination of aerobic and resistance training has little to no benefit in preventing bone loss in men on ADT and it is only the addition of impact loading (eg hopping, bounding, jumping) that was effective. We have also reported that the combination of aerobic with resistance exercise may compromise growth of skeletal muscle in patients on ADT. This interference effect is particularly evident in these patients due to their catabolic environment, so if the priority is to induce muscle hypertrophy, aerobic exercise should be avoided or limited with a focus on higher volumes of resistance exercise....”
He cites an earlier paper of his where he reported this: "Exercise Mode Specificity for Preserving Spine and Hip Bone Mineral Density in Prostate Cancer Patients" http://iapem.gr/article_files/files/19-4-2019%20Exercise_Mode_Specificity_for_Preserving_Spine_and_1.pdf
My Orgovyx prescription apparently costs the US gov't funded Medicare drug program for geezers $40,000 a year. Newton estimates if patients were referred to exercise oncologists for individual exercise prescriptions during their prostate cancer treatments the cost might be in the neighborhood of $4,000, declining as the years go by.
The impact loading prescription in that paper above is:
2 times a week "The impact-loading component consisted of a series of bounding, skipping, drop jumping, hopping, and leaping activities that produced ground reaction forces of 3–5 times body weight, and was progressive in nature. For the first 12 wk, two rotations were performed of skipping (30 s), bounding over soft hurdles (10 times, 13–16 cm), and drop jumping (10 times, 10–15 cm). In the second 12 wk, hopping on one leg (10 times) was added, and three rotations of all activities were performed. In the third 12-wk period, leaping (10 times) replaced skipping, and for the remainder of the program, four rotations were performed of bounding (19–25 cm), drop jumping (20–25 cm), hopping, and leaping".
It sounds weird, but precise. It works he says. My medical oncologist appears to know nothing about exercise to ameliorate the side effects of ADT.
Replies to "@sushilkbirla Rob Newton, in the article: "Prostate cancer treatment with exercise medicine" https://onlinelibrary.wiley.com/doi/epdf/10.1002/tre.884 " ...we have..."
Thanks so much for the "summery" of exercise 👍 !
Do you know by any chance when will his new app. be available with all of those exercises ?
@climateguy While all of this may be true, not all men can do the things he describes. Drop jumping? Bounding over hurdles? Sounds like freakin Boot Camp!😂
@climateguy Thank you, this is very helpful. For those who want to cut to the chase on Newton's "impact" exercise prescription (as used in the study cited in the "Exercise Mode Specificity...." article), here it is: "For the first 12 weeks, two rotations were performed of skipping (30 s), bounding over soft hurdles (10 times, 13–16 cm), and drop jumping (10 times, 10–15 cm). In the second 12 weeks, hopping on one leg (10 times) was added, and three rotations of all activities were performed. In the third 12-week period, leaping (10 times) replaced skipping, and for the remainder of the program, four rotations were performed of bounding (19–25 cm), drop jumping (20–25 cm), hopping, and leaping." (I made tiny edits for grammar / readability.)
All that is interesting and matches my common sense, so I'll likely add impact training to my aerobic / strength regimen.
BUT: Newton's sample sizes were small (a typical medical study bugbear): Subtracting people who wandered away before the 12-month study ended, the 3 randomized groups had 37, 44, and 29 people left in their cohorts. Not exactly disqualifying, but not very solid, either. More importantly, the impact / resistance training group got much more rigorous supervision than did the aerobic / resistance or the delayed / aerobic groups. The latter two were basically "sent home" to do unsupervised, unverified self-treatment for the second 6 months and the entire 12 months of the study, respectively. After that, the most sophisticated statistical analysis you could apply would just be putting lipstick on a pig. Not to mention the overlap between (some) aerobic and impact activities. (For me, the act of running boils down to about 180 "impact" crashes per minute. So which study cohort would I fall into?)
All that said, I'll still look into Newton's prescription. For all the study flaws, the basic idea still makes a lot of sense to me. So thanks again.
A recent article I read recommends your high impact exercises for everyone especially as you grow older.
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@climateguy
Rob Newton has spoken at more than one large prostate cancer conference.
A lot of doctors are aware of him.
I think it might be a little bit deceptive to say most people could stop taking ADT if they just did the exercises Newton recommends. The combination of the drugs with exercise can stop or delay reoccurrence. I wouldn’t want to risk my life just on exercise.