Rebuilding muscle mass post-Lupron

Posted by cbinvt @cbinvt, Jan 7, 2023

I was on Lupron for 12 months and received my last six-month shot in June 2022. I underwent proton radiation treatment in March/April 2022. My PSA dropped from 45 pre-Lupron and radiation to undetectable in November 2022.

With my doctor's agreement, I did not receive another Lupron shot in December 2022 because I wanted to build up muscle mass for a long-planned four-day hike to Machu Picchu in May 2023.

I continued daily exercises and hikes throughout my treatment, but I am conscious that my strength and endurance have dropped significantly. I'm currently working with a personal trainer, but I still feel much less strength on long uphill sections of my daily hike. I'm really concerned that I may not have the leg strength to complete my fairly demanding four-day hike in May.

I'd love to hear others' advice on how long it takes to rebuild muscle mass after the effects of Lupron have moved out of the system.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I have had stage IV prostate cancer for about three years now. My early treatment included the lupron on the theory that high testosterone fed the growth of cancer cells. I have been off the lupron for about a year and a half. Doctor wanted me to go back on it recently as psa began to rise significantly and my testosterone was high. I was not convinced of the inevitable relationship between high testosterone and rising psa so I declined, at least until more time had passed. If my psa continued to rise significantly I told him I would go back on the lupron. What happened was my testosterone increased significantly while my psa dropped significantly. I am not back on the lupron.

I, too, exercise regularly in the attempt to regain muscle mass, strength, and stamina. I generally don't feel too bad, but in spite of my regular exercise my strength and stamina is not coming back. I only have seen marginal improvement.

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I did 18 months of Lupron in concert with six cycles of taxotere and 25 radiation treatment to the PLNs (see attached clinical history). As they say, study of one but throughout that period I exercised regularly, swam, elliptical, indoor and outdoor biking, played basketball, went skiing and hiking in Colorado, walked my dog, did the lawn and gardening work, lifted weights, even did the Bataan Memorial March in White Sands. NM with my sister, a 26.2 mile "hike in the desert, of course, my time sucked.... I was 62 when I started and generally a lifelong active person. That's not to say I didn't feel the affects of those treatments, there were some days during the taxotere cycles where doing 10-15 minutes on the elliptical vice 30-45 were a challenge, once I set out on a 20-25 mile bike ride and had to call my daughter after 16 to come get me!

I did gain weight, about 10-15 pounds, when my GP commented on it I reminded her of the Lupron and the affects of low T on metabolism...lost it after I went off treatment.

So, you're doing the right thing, regular exercise along with diet, managing stress....one thing I think may have played into my situation was the proverbial mind over matter, I believe it's a powerful things.

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Thanks for these helpful reactions. Does anyone know how long it takes post-Lupron for exercise to begin building muscle mass? Theoretically, the six-month Lupron shot I received in early June "expired" at the end of November. However, seven weeks of serious exercise later, I'm still feeling challenged climbing long stairs and don't feel any improvement in my leg muscle strength endurance. Any thoughts?

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@cbinvt

Thanks for these helpful reactions. Does anyone know how long it takes post-Lupron for exercise to begin building muscle mass? Theoretically, the six-month Lupron shot I received in early June "expired" at the end of November. However, seven weeks of serious exercise later, I'm still feeling challenged climbing long stairs and don't feel any improvement in my leg muscle strength endurance. Any thoughts?

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The shots actually linger past the 6 month period. Took me a couple months past for my original shots to wear off. You would have to do a testosterone level to find out for sure.

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I'm Phase IV three years in and on ADT. I Exercise moderately daily. Tia Chi, Walking, Bands, Light Weights, Swim, and Indoor Biking. Strength, endurance, are track with an app. Everything progressing slowly. If I walk/Swim/Bike for more than 30 minutes bone pain sets in the next day and last for a couple of days. I tend to do 60-90 minutes of exercise type movements per day. Measuring my strength and endurance helps, my goal is tiny increments per month, Some months are better than others.

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@kujhawk1978

I did 18 months of Lupron in concert with six cycles of taxotere and 25 radiation treatment to the PLNs (see attached clinical history). As they say, study of one but throughout that period I exercised regularly, swam, elliptical, indoor and outdoor biking, played basketball, went skiing and hiking in Colorado, walked my dog, did the lawn and gardening work, lifted weights, even did the Bataan Memorial March in White Sands. NM with my sister, a 26.2 mile "hike in the desert, of course, my time sucked.... I was 62 when I started and generally a lifelong active person. That's not to say I didn't feel the affects of those treatments, there were some days during the taxotere cycles where doing 10-15 minutes on the elliptical vice 30-45 were a challenge, once I set out on a 20-25 mile bike ride and had to call my daughter after 16 to come get me!

I did gain weight, about 10-15 pounds, when my GP commented on it I reminded her of the Lupron and the affects of low T on metabolism...lost it after I went off treatment.

So, you're doing the right thing, regular exercise along with diet, managing stress....one thing I think may have played into my situation was the proverbial mind over matter, I believe it's a powerful things.

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I am glad to learn that you were able to lose the weight after finishing Lupron….I have gained 10 pounds during this treatment…I am active👍

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Hello My Brothers! (and Concerned Family Members and Friends),
I'm a "Cancer Survivor" too, with Gleason Scores of 7 and 8 in all 6 sections of the prostate (12 biopsy samples), an inital PSA of 8 in July 2019 that increased to 20 in January 2021 and I also had protrusions in the EPE, that I decided may be too close to the bladder and rectum for surgery. (I was concerned about "clear / clean margins": surgeons like to get all the cancer out of the body and I was concerned that I might come out of surgery with a bag or two, one for the front and one for the back.) I did get a second opinion and learned about a longitutinal study on men with pc (outside of my cohort) that indicated that after 8 years the all cause mortality for the men treated with external beam radiation (25 bouts), High Intensity Radiation (17 stainless steel tubes inserted into various parts of the prostate with an isotope guided through it and positioned for certain periods of time, my Radiologists also has her PhD in Mathematics and Physics.), and ADT -Androgen Deprovation Therapy forever, was only 3% mortality versus nearly 35% all cause mortality for the surgery only group. I've been married for over 40 years, my wife and I have been Blessed with Children and Grandchildren; I, We, both Love "The Marriage Embrace" and we had lengthy and tearful heart to hearts on which option was best for US. At Nearly 70 years old, We decided upon the EBRT, HIR and ADT protocols, hopefully choosing longevity over virility.
It has been 2-1/4 years on the LUPRON Shots and my PSA has dropped to 0.03, Testesterone to a < g which is almost nothing on both! My joints and muscles hurt, sometimes the knee pain is sharp and wakes me up in the night and radiates for some time. I've gone for X-rays and I'm told it is only arthitis. So I don't know if it's cancer going into the bone, arthitis, the statin for my heart, or if I'm a wimp! I used to go for long walks along a road on one of the Great Lakes here in America. Sometimes 14 miles, usually 6.3 miles; on brisk, cold, sunny winter days when I didn't have to carry as much water, a 20 miler. Only a few years ago I would jog marathons, now I can't jog 1/2 a mile. But, I'm taking a break from the Lupron for a little while. That is how I found this "chat room", I was trying to find out how long before my muscular strength and muscular endurance returns? Or am I being Selfish, am I risking my health and longevity to grasp at a mirage of fitness that was my former life, never to return, never to feel the cold brisk air as I pant and gasp my way up and down a hill, the pound of the legs and the mantra in my head- "Run Tall! Run Tall!", the good ache of a rewarding morning jog, with push-ups and sit-ups, energy to cut down trees and dig holes and do the outside work around the house, and most of all the strength to help others- I was strong, I could and would give it away freely to neighbors, family, strangers in need; that hurts me the most and is what I miss the most- the inability to be able to help others. I can still hug my wife, the dancing is still enjoyable but I can only dance fast for about 1/2 a song and then we have to slow down or I need to sit. Carrying the laundry up to the bedroom is like climbing up Mt.Marcy and I need to sit and rest on the bed for a few minutes. I sometimes cry now, on Important things like my feelings for my Wife, Children and Grandchildren; Our Country, The World and The Poor; and sometimes on stupid things like "chick flicks". I appreciate clean, crisp air and huge deep breaths, the trees' leaves that give us oxygen, the birds in flight, the beauty of the sky and Nature; the Goodness in Mankind and I've found a little bit of compassion for the foibles in my fellow man that I have always been harsh and quick to judge. I don't know about you dear sirs, but I have a faith, unfortunately not as big as the size of a mustard seed, but I have a faith and I've been richly blessed; not in material things or money; but with family a great set of Saints for parents and grandparents, a wife I have loved imperfectly but with all my heart and strength, kids who are good people, joyful grandchildren and in-laws, a meaningful job but with questionable results (painfully tragic some of my former students are murderers and some have been murdered), but I believe we all will have a Good, Peaceful, Understanding, Loving Better Existence in our next Life in Heaven. And the Great Gift of Strength and Vitality I had known and still grasp at, I have to graciously return to the LORD with great gratitude and thanksgiving for having been given it for nearly 60+ years, and as my other gifts The Creator has most graciously Given to me as they fade and falter, I too need to be Thankful and Grateful to Him for having been able to have them and use them for so many years. Good Luck and God's Strength and Comfort to your Wife and Family,dear Sir(s)!
I have run out of space and will in the following days post my wife's and my journey together for those interested. God Bless You All and All in the World. Thank you Doctors, Researchers, & Nurses, EtAl.
Sincerely,
weak but strong P.S. (Please, listen to YOUR Doctors on Your PC and make Your Decisions!) I'm just an old worn out gym teacher, not a healer. and my path may not be the correct path for you.

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I am 86.

Before I started Lupron in 2022, I regularly walked 3 or 4 miles to the store three times a week.
No problem. It was great exercise and fun.

I stopped Lupron in August, 2022.

It is now September, 2023.

My muscle mass (and testosterone) still has not returned.

I am basically homebound -- and depressed.

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As a 71 yo recently retired Family Medicine physician, I was diagnosed in February with Gleason 7-3+4, prostate cancer with 1 core positive of 12 and was only seen on one side of the prostate on MRI, even though it can be microscopically multifocal. After evaluating all of my options, I chose Proton Therapy and received 30 treatments equaling 72Gy of radiation. My radiation oncologist was extremely knowledgeable since he was the first at using PT at M D Anderson in 2006. They were fifth in the US in its use. He asked if I wanted hormone therapy and I replied only if absolutely indicated so we delayed until my tissue was sent for genomic evaluation. I was discovered to have high risk cells. The results were available after about 2/3 of my PT, so I began Leuprolide (22.5mg x2) and bicalutamide (50mg orally daily for 60 days). I have completed the oral treatment and now anticipating a second Leuprolide in about 2 weeks. My first post treatment labs show the testosterone diving from 711 (upper limits of normal) to 8 (way below lower limits of normal on a different scale), and PSA from peak of 4.9 to < .o6. I have been an active runner since 1987. I recently experienced an overwhelming fatigue, weakness, muscle aches, and of course, poor sleep. I chose PT in order to maintain a good quality of life with as successful a cure rate at radical prostatectomy and external beam photon radiation therapy with dramatically less side effects. The ADT has complicated that and I am in a dilemma regarding taking the second Leuprolide. I think the studies are still in progress and not to be reported for another 2-3 years about the conclusive value of the adjuvant ADT for someone in my intermediate risk category.
Everyone is different and I am Blessed to have discovered my cancer early. The science is not absolute. My life has been Blessed beyond measure. I want to be active until I cannot and I am not certain about the return of my strength and endurance at 72, soon. I post this mainly to show that we are all a bit different and must make our own decisions. God Bless all of you! I pray that your suffering is as minimal as possible. Thanks for the time. rog

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@roger52

As a 71 yo recently retired Family Medicine physician, I was diagnosed in February with Gleason 7-3+4, prostate cancer with 1 core positive of 12 and was only seen on one side of the prostate on MRI, even though it can be microscopically multifocal. After evaluating all of my options, I chose Proton Therapy and received 30 treatments equaling 72Gy of radiation. My radiation oncologist was extremely knowledgeable since he was the first at using PT at M D Anderson in 2006. They were fifth in the US in its use. He asked if I wanted hormone therapy and I replied only if absolutely indicated so we delayed until my tissue was sent for genomic evaluation. I was discovered to have high risk cells. The results were available after about 2/3 of my PT, so I began Leuprolide (22.5mg x2) and bicalutamide (50mg orally daily for 60 days). I have completed the oral treatment and now anticipating a second Leuprolide in about 2 weeks. My first post treatment labs show the testosterone diving from 711 (upper limits of normal) to 8 (way below lower limits of normal on a different scale), and PSA from peak of 4.9 to < .o6. I have been an active runner since 1987. I recently experienced an overwhelming fatigue, weakness, muscle aches, and of course, poor sleep. I chose PT in order to maintain a good quality of life with as successful a cure rate at radical prostatectomy and external beam photon radiation therapy with dramatically less side effects. The ADT has complicated that and I am in a dilemma regarding taking the second Leuprolide. I think the studies are still in progress and not to be reported for another 2-3 years about the conclusive value of the adjuvant ADT for someone in my intermediate risk category.
Everyone is different and I am Blessed to have discovered my cancer early. The science is not absolute. My life has been Blessed beyond measure. I want to be active until I cannot and I am not certain about the return of my strength and endurance at 72, soon. I post this mainly to show that we are all a bit different and must make our own decisions. God Bless all of you! I pray that your suffering is as minimal as possible. Thanks for the time. rog

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Thank you for sharing …I am 73 hrs and have very similar prostate cancer info..Gleason 3+4…
I also was diagnosed with high risk cells.
After a similar review of treatment options I had external beam radiation and have just finishing Lupron and casadex(balcalutimide)for 2 years…PSMA is undetectable…like you I feel fortunate to have early detection and the opportunity for some treatable options.
I am often reminded that your first treatment is important and an aggressive approach make sense.
Lupron is not fun…BUT slowing the PC and having a easonable quality of life is important.
I am active and try to get to the gym 4 days a week for aerobic and resistance training….push through the fatigue which we all experience…you can do it!

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