Cycling during hormone therapy

Hi Minnesota,

Your cycling will stand you in very good stead and you should keep it up. I always say to regard exercise as mandatory when on hormone therapy - it has a beneficial impact on several of the side effects. You should also add some exercise to stress/shock bones, which cycling doesn't do.

I did buy myself a noseless saddle, although being noseless wasn't the main property of it, it was having a hole under the perineum and making sure you are sitting on your sit bones (pelvis) and not your perineum.

Both the hormone therapy and the radiotherapy will tend to reduce your hemoglobin level, but as a cyclist, you will have plenty in reserve, and you may not notice (unless you're racing or time trialing). Those without much in reserve get very fatigued at the end of radiotherapy. There's no research to show why this is, but I strongly suspect it's because their hemoglobin levels dropped below normal at that point.

You describe neoadjuvant hormone therapy (before treatment) which is usually 3-6 months, and concurrent hormone therapy (during treatment). However, it usually continues after radiotherapy (adjuvant hormone therapy), to make up a total of 1-3 years hormone therapy. You will need to exercise to maintain muscle (for which cycling is good), and to maintain bone calcium (which needs an exercise which stresses/shocks bones).

The only place I've seen six months mentioned is on these forums. Having a vested interest in the subject, I researched it last year while I was in my post-op walking period. The standard prostatectomy discharge instructions from Oxford state "no cycling or horseriding for 6 weeks".

Santis Healthcare says you can start cycling after 6 weeks if you have a perineal cutout on your saddle.

I think the important thing is to take advice from your own doctors, based on your own circumstances. I started riding after 6 weeks and ramped up gradually over a month. No continence or erectile issues here.

Incidentally, one of the reasons I chose surgery (apart from being strongly advised it was likely the best route due to my age (50)) was that I hated the idea of hormones having a negative impact on my fitness. (It was also why I declined bicalutamide when surgery was delayed "indefinitely" due to COVID. That turned out to be about 2 months delay.)

This is the one I bought, two of them actually for two bikes.

https://www.amazon.co.uk/gp/product/B07R61NZ4V/

This one isn't available at the moment, but you'll see several identical ones which probably come out of the same factory.

It takes a few rides to get use to and get it adjusted right.

I now find them really comfortable, although I don't need them anymore, I've left them on both bikes. I like that I'm sitting only on my sit bones (pelvis) and not any sensitive structures. I wasn't expecting them to last long, but after nearly 2 years, they both still look brand new.

Also, they have occasionally sparked a prostate awareness conversation, so I always have a few of the PCUK or Tackle Z-cards on me.

Hi Andy, great to hear you are still smashing the cycling. Hope things are as good as they can be there fir both of you. 
My FB account has changed. Sent you a message recently

Hope to catch up when we are through all this crap 

Take care

Bri 

I have my next oncology appointment next week to hear about the recent CT, biopsy and blood test. Reading posts on this site has brought home to me how little I know about my disease and possible therapies. Can you suggest some good primers for a non-biologist?

It takes a couple of weeks for the first implant to start working, and perhaps 3 weeks for your testosterone to get low, so you're not going to see anything much while still on the bicalutamide. Even once you have very low testosterone, it takes time for your body to react. The first reaction is often loss of nocturnal erections, although many people won't notice that, except for loss of morning wood. This can happen even on the bicalutamide.

In two years, the only thing I've noticed is that more cyclists pass me than before. I can't tell if there has been a loss of strength. However, I don't race or do anything that would enable me to do a direct comparison. I've also been doing 3 Zoom home exercise classes a week, and I do seem to have better muscle definition in my arms than I remember. However, I have more fat than I had to start with around my belly, and visceral fat according to my body composition scales, with a corresponding increase in weight and BMI. Now that I've finished the hormone therapy, I'm hoping to reverse this when my testosterone returns.

Actually, I'm a bit injured at the moment. Last weekend, I did a trek through Ashridge Forest with Prostate Pedallers, and manged to go over the handlebars of my mountain bike. I thought I'd made a good landing, and carried on without any problem. An hour later after the adrenaline had worn off, I had a painful rib and shoulder - deep breaths and coughing are painful. A day later, some bruising emerged from behind the left kneecap too, but no pain or problems with movement. Shoulder is pretty much recovered and rib is better but not recovered. Not yet sure if I broke the rib (should be interesting on any future nuclear bone scan). Neither of these presented any pain cycling, so I continued riding my bike OK last week. On Thursday I was rushing to get somewhere, and found I'd strained my thigh muscles as a result. Friday, I was careful doing the home exercise class, but that was a mistake, and right thigh got much worse, to the extent I've been hobbling around since. Left thigh recovered OK. I may be getting too old for this, but I don't think I can blame it on the HT.

Edited by moderator 13 Jul 2023 at 06:47  | Reason: Not specified

I have another cycling related question. I have started cycling regularly again after a several week period where I wasn't doing much. I'm about 10 weeks into my first Zoladex implant and it doesn't feel like I've lost too much strength. Maybe 10 to 20 percent. I do have aches and pains and insomnia. My question is about the hydrogel implant that I'm getting next week in preparing for my first radiotherapy session on 20th July. Does anyone have any experience with cycling after getting the hydrogel spacer?

If you are having brachytherapy or the spacer gel, best to avoid cycling for a while afterwards.

Regardless of treatment, you can help yourself by buying a prostate friendly saddle - available from most well-known stores!