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Cycling during hormone therapy

User
Posted 27 Feb 2021 at 11:48

Hello,

I have recently been diagnosed and have been offered the choice between radical prostatectomy and radiation therapy. I am currently inclined to choose radiation. My understanding is that this will involve 3 months of hormone therapy followed by a month of radiation.

I am a very enthusiastic cyclist. The thought of having to give it up is devastating. I am trying to learn how different treatment regimes would affect cycling.

Can anyone offer insight as to cycling while undergoing hormone therapy? Is it possible or adviseable to to cycle while having radiation therapy?

 

I will be grateful for any information.

User
Posted 27 Feb 2021 at 13:46

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).

User
Posted 27 Feb 2021 at 15:51

I am not a keen cyclist but I do a bit, and didn't notice any problem whilst on HT. I agree with everything Andy has said.

We have had people who have prostatectomy who have been back in the saddle after as little as six weeks though I think six months is the more common advice. I guess if there were complications from prostatectomy it could curtail the cycling. If the medics are saying radiotherapy has as good or better chance of curing your cancer than surgery, then considering the potential side effects radiotherapy with hormones is probably the best choice for you. 

Dave

User
Posted 27 Feb 2021 at 16:08

Originally Posted by: Online Community Member

We have had people who have prostatectomy who have been back in the saddle after as little as six weeks though I think six months is the more common advice. 

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.)

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 28 Feb 2021 at 07:38

Thank you very much for the replies. They are informative and help to ease my mind about my cycling future.

User
Posted 28 Feb 2021 at 10:24

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.

User
Posted 02 Mar 2021 at 13:44

I cycled to and from about half of my RT sessions - 4 miles each way. The staff thought this was a very good idea to keep active and fit. Discussed with the consultant afterwards how the HT made me feel a bit tired when out on the bike - her advice was 'just push through it - you can do yourself no harm'. She's a keen runner and cyclist herself and appreciates the importance of exercise.

User
Posted 14 Mar 2021 at 23:24
Do not give up your cycling...................

I have been cycling all the time with my Prostate Cancer and Bone Metastases. I was even doing Time Trials during my Chemotherapy, wasn't doing any PB's but I was out there having a great time even though my body was wrecked...........Due to Hormone Treatment my Testosterone like everybody's is non-existent and my hemoglobin levels are below minimum. During training on the road while having chemo I was pushing as hard as I could and my muscles just crapped up on several occasions and had to be rescued by my wife.............

I have even done 2 training camps in Tenerife and did a ride in Corsica where we covered 1000km with over 15,000m of climbing in 6 days.................raised a load of money for Maggies in Nottingham.

I use an ISM saddle on all my bikes now, which is split down the nose middle and offers some protection to the prostate, but have to admit after 5 hours in the saddle it is all numb down there.

Over the last 3 years I have been using "The Sufferfest" and their training plans and have increased my Physical fitness and endurance massively. I have been getting as fit as I can for my next treatment coming up in a weeks time. So in January alone I managed over 600km on my turbo trainer in the "Pain Cave"

For me physical health, mental health and diet are not negotiable and have helped me stay active and live with incurable cancer since June 2013............

So keep on cycling and exercise, even through the worst times...............

User
Posted 15 Mar 2021 at 14:14
Last week when the urologist confirmed PC T3/4N1M1B Gleason 4+4 he stressed that I had to take great care and not to risk fracturing any bones. I asked if I could cycle and he said no. I have not seen the oncologist as the results of my bone scan are not yet available. I have started the HT and anticipate that the oncologist will describe the options to deal with any mets. But to be honest, I feel great and if it wasn't for the (now controlled) peeing I would probably not think about going to the Doctor. Perhaps the urologist is tending to be pessimistic. When the nurse phoned me I mentioned that from the first meeting the urologist had warned of the dangers of (is it) MTSS that could lead to paralysis and that has worried me.
User
Posted 15 Mar 2021 at 14:40

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 

User
Posted 20 Mar 2021 at 19:18
Gee, guys. What about us couch potatoes?

I'm an idle 80 year old with arthritic knees living in a city retirement flat. There are lots of zimmer frames and invalid scooters outside, but I haven't seen any bikes. Even then, the roads are narrow and fast with no dedicated cycle lanes.

What do you recommend? (PSA=2.2, testosterone <0.3)

JamesWS

User
Posted 20 Mar 2021 at 20:10

Hi James, I am amazed at the amount of exercise some of these lot get up. You'll find posts from "irun" on here who does lots of marathons. I'm even beginning to think the exercise might be keeping the cancer at bay for some of them. Are you on HT? 

Dave

User
Posted 20 Mar 2021 at 20:33

Originally Posted by: Online Community Member
Gee, guys. What about us couch potatoes?

I'm an idle 80 year old with arthritic knees living in a city retirement flat. There are lots of zimmer frames and invalid scooters outside, but I haven't seen any bikes. Even then, the roads are narrow and fast with no dedicated cycle lanes.

What do you recommend? (PSA=2.2, testosterone <0.3)

JamesWS

🤣 

The stairs rather than the lift? Walking to the pub and back (once they are allowed to open, that is)? Sex? Every little helps! 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Mar 2021 at 20:40
Bicalutimide and decapeptyl - those are hormones aren't they?

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?

User
Posted 20 Mar 2021 at 21:16

Hi James, I know you tried starting a thread before and it probably confused the moderators, can you try again. Make sure you pick a topic area otherwise you get an "access denied" error. Keep it really short as you will find it annoying if the system crashes before you post it. Just say Hi, and your diagnosis. It will take a few hours for it to appear but when it does, post any further questions about your diagnosis and treatment there. You will find it is a good way to keep everything in one place so you can refer back to it. Yes those  medications are hormone, but I'll post that again on your thread when you get it live. Don't worry this user interface is a nightmare to navigate. 

Edited by member 20 Mar 2021 at 21:17  | Reason: Not specified

Dave

User
Posted 21 Mar 2021 at 14:19
Thanks Dave. I'll try that.

User
Posted 18 Apr 2021 at 17:15

Andy,

Thanks for your very helpful and encouraging reply. At this point I have received one implant and am still taking the Bicalutamide for a few more days. So far there hasn't been much in the way of side effects, but possibly some fatigue. I'm riding the bicycle and can't tell if there has been a loss of strength. Since the hormone therapy affects haemoglobin, is there any utility in choosing iron rich foods (like liver) to compensate?

The radiotherapy doctor is estimating early to mid July for the SABR radiotherapy, followed by several months of hormone therapy by implants. Do you have any insight about the cumulative effect of the RT and hormone implants in terms of side effects?

Thank you again for your information.

User
Posted 18 Apr 2021 at 19:45

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 member 18 Apr 2021 at 20:04  | Reason: Not specified

User
Posted 20 May 2021 at 20:53

I have had my hormone implant now for over a month and I'm trying to gauge it's impact on my abilities on the bike. I do get some sense of fatigue later in the day and it may be coincidental but my sleep pattern has really deteriorated which certainly can't be helping with performance, training, or recovery. Since the HT affects haemoglobin, is there any dietary changes that help with the low red blood cell levels. I did a sweet spot workout on the Wattbike today and it wasn't far off of what I had done before the implant. I would be interested in hearing from anyone who is trying to balance hard riding with hormone therapy and hear from anyone about how the radiotherapy treatments are going to affect my riding.

Thanks to everyone on this forum for the support and information.

User
Posted 25 Jun 2021 at 13:30

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?

User
Posted 25 Jun 2021 at 14:34

Originally Posted by: Online Community Member

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?

I haven't seen anyone talk about that before.

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

 
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