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Hormone Treatment Weight Gain

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User
Posted 21 Apr 2022 at 22:46

With my PSA rising (0.13 in February 2022) after surgery in August 2022, I’m expecting to be put on Salvage Treatment at some point this year, possibly as early as May after my next PSA test.

I’ve been told to expect 6 months of Hormone Treatment with 33 days of Radiotherapy.

One of the (many) things I’m concerned about is the expected weight gain as a result of HT.

Does anyone who’s been through this have any suggestions on how to counter or even avoid weight gain?

I’m grateful for anyone’s experience. Thanks.

Peter

User
Posted 22 Apr 2022 at 07:23
It IS possible not to have weight gain but each person is individual. I’ve been on full HT for 15 months and weigh 12 1/2 stone. No real fluctuations in weight at all nor moob growth. But I’m a highly strung person but also a very hard worker and exerciser. The fatigue makes it hard to keep going sometimes but you must. I’ve never changed my diet a tad. I eat drink and be merry mostly 😀. Good luck
User
Posted 26 Apr 2022 at 23:11

I think it comes down to the individual, their age, and their lifestyle.  I've been on Zoladex since Jan 2020.  Was ok for  the first year but have piled on body fat since.  I continue the exercise I was on pre-treatment.  I walk a minimum of four and a half miles each day with the dog, up and down hill.  It's kept my large muscle group in trim but my upper body has wasted somewhat.  I don't eat any more than I did previously but it's difficult to eat less due to the chronic fatigue I suffer with.  When you feel most of the day like you have zero stamina/energy it's hard to convince yourself to take in fewer calories.  All that said, I am a functioning alcoholic so that has to be factored in in my own case.  Good luck with your treatment.

User
Posted 22 Apr 2022 at 04:59
Agree with John.
Barry
User
Posted 29 Apr 2022 at 22:19

Hormone therapy does easily result in weight gain, typically abdomen and breasts.

While I always say that men on hormone therapy should regard exercise as mandatory, it takes a lot of exercise to consume quite a small amount of food, so you need to watch what you eat too. It's extremely difficult to lose weight while on hormone therapy, so best to try avoiding putting it on, or at least, limit the rate.

User
Posted 22 Apr 2022 at 00:28

Hi Peter,

If it is limited to 6 months then the impact may be limited depending on your current physique and exercise regime. It's always possible however that they then recommend extending ADT beyond 6 months.

In my experience cutback on snacks and treats and limit alcohol. Eat healthy. If you already exercise then maintain or increase level, add some weight/ resistance training if you dont already do it. 

Main thing is to be disciplined. If you give in to early signs of fatigue/aches or  despair then once you lapse it is really hard to recover motivation and continue exercising.

Regards

John

User
Posted 22 Apr 2022 at 23:33

Hi Peter,

It was interesting reading your profile and some of your comments.  I'm preparing myself for further increases in psa levels after it popping up to just detectable, 0.06, last December.

I wondered at what psa level you were referred to Oncology as I got the impression they wouldn't transfer me until it got near 0.2.    They also sounded like they thought the psma test should only be done when it's over 0.2. 

I have mixed feelings as I asked to have a blood test in 3 months but the nurse was dead against it and eventually agreed to 4 1/2 months which is next week.   I now wish I'd waited 6 months as I appear to be in some kind of optimistic denial and that bubble might be pricked earlier than is likely necessary.

I noted your psa growth from 0.01 up to your 0.13.  It seems to stay constant at some tests then to go up again.   I was told if mine went undetectable next time I'd be discharged as it's now 5 1/2 years after the op, although I actually don't think they will, some oscillation appears normal.

I wondered if you'd looked at the nomigrams for salvage RT.  Having hormones halves (correction reduces it by 20%) the chances of it recurring in 7 years using my stats, Gleason 4+4.  Like you I was concerned about moobs as I'm thin but am active and eat low fat food so as others have said it might not happen.

All the best with your treatment, Peter

Edited by member 23 Apr 2022 at 19:23  | Reason: corrected error in calculating reduction in recurrance by having hormones.

User
Posted 23 Apr 2022 at 09:54

I think you can rest easy that you won't turn into Mr Blobby overnight!

I have been on various bits of HT for two years, including a compete blockade for the last 8 months and while I put a few ( about 5) pounds on, its not dramatic, and I have managed to shift it. The real issue is that , over time , the reduction in testosterone will make it harder for your body to make, or even maintain, muscle mass. Crudely, what was lean becomes a bit more flabby.

In fact, this will cause you to lose a bit of weight as flab is less dense than muscle. Where the weight gain comes in is that with less muscle you will burn fewer calories, and as you get a bit more tired, you will exercise a bit less. They are small effects but they add up. 

The answer is the obvious one- a bit less eating ( keep up the protein!) and a bit more exercise, especially with some resistance work. No need to be a gym bunny, but it needs a little bit of conscious effort.

 

User
Posted 23 Apr 2022 at 19:42

Hi Peter,

I relooked at the hormone salvage radiotherapy probability and realised I'd misread columns.  The difference in probability of a recurrence after salvage RT is as below in my case if you have hormones.  I also had to make assumptions as I haven't reached the levels needed yet.  

For a 6month doubling time it was 61%  probability of no recurrence (<0.05) with hormones v 35% without hormones after 6years.  With 12month doubling it was 70% v 48% probability of no recurrence (<0.05) after 6years.

https://www.mskcc.org/nomograms/prostate/salvage_radiation_therapy

Thanks for the information on your case,  I'll bear it in mind as the nomigram also shows a small improvement if you have salvage earlier.  Although from what I've read, actually knowing where it is from a psma scan can give you a big improvement as they can better target the beam.

Peter

 

Edited by member 23 Apr 2022 at 19:45  | Reason: Not specified

User
Posted 29 Apr 2022 at 13:07

Hi, there's great diet info directly written for guys with PCa...by two expert women who ran three webinars last year. The presentations and downloadable slides are still there:

https://www.prostate-cancer-research.org.uk/living-well-library/september/

I've even printing some out and stuck em on my fridge! Biggest changes I've ever made was diet in my PCa journey!

Steve

Blog: prostatecancer.vivatek.co.uk

User
Posted 29 Apr 2022 at 17:07

 I hope so. Stopped CC sorry, HT early owing to problems...see blog.....in profile.

I made a lot of big changes....swapping out dairy for soya, cutting down red meat, including venison....taking lots of supplements... 

 

Hope that helps

 

Steve

Blog: prostatecancer.vivatek.co.uk

User
Posted 29 Apr 2022 at 22:07
For what it is worth I seem to have developed a bit of a bulge round the middle after being started on Zoladex before Christmas, but no big change in overall weight. My wife tells me I smell different though!
User
Posted 30 Apr 2022 at 08:40

Hi, I was trying to find the web page that mentioned the difference in effort between guys on ADT and not.... apparently it takes 4500 cals of exercise to burn off 1 lb of flab compared to 3500 cals for fully hormonal bloke....so we have our work cut out.

https://www.pcf.org/c/adt-what-you-really-need-to-know/

I've currently got a triple whammy.... ADT for 8 months, mirtazapine (biggest side effect is the munchies and weight gain) and now a week of COVID....trying not to eat toooo much. Certainly not drinking beer......yet!

I got one of those fancy scales from Renpho . It gives way too many body parameters but body fat, visceral fat etc...good to keep an eye on...

 

Steve

Blog: prostatecancer.vivatek.co.uk

User
Posted 30 Apr 2022 at 09:18

I'm so sorry to read about your triple challenge, but I do hope you can see light at the end of the tunnel. I'll definitely bear in mind your recommendations on trying not to put on weight during Hormone Treatment!

I really like the photo of your "natural anti-depressant" on your blog. Great job keeping up that blog!

All the very best.

 

 

User
Posted 30 Apr 2022 at 09:26

Thanks....we used to live on a narrowboat, and always said that's not the end of the tunnel but a boat coming towards you!

 

Steve

Blog: prostatecancer.vivatek.co.uk

Show Most Thanked Posts
User
Posted 22 Apr 2022 at 00:28

Hi Peter,

If it is limited to 6 months then the impact may be limited depending on your current physique and exercise regime. It's always possible however that they then recommend extending ADT beyond 6 months.

In my experience cutback on snacks and treats and limit alcohol. Eat healthy. If you already exercise then maintain or increase level, add some weight/ resistance training if you dont already do it. 

Main thing is to be disciplined. If you give in to early signs of fatigue/aches or  despair then once you lapse it is really hard to recover motivation and continue exercising.

Regards

John

User
Posted 22 Apr 2022 at 04:59
Agree with John.
Barry
User
Posted 22 Apr 2022 at 07:23
It IS possible not to have weight gain but each person is individual. I’ve been on full HT for 15 months and weigh 12 1/2 stone. No real fluctuations in weight at all nor moob growth. But I’m a highly strung person but also a very hard worker and exerciser. The fatigue makes it hard to keep going sometimes but you must. I’ve never changed my diet a tad. I eat drink and be merry mostly 😀. Good luck
User
Posted 22 Apr 2022 at 09:12

Many thanks John, Barry & Chris. That's all quite reassuring. I'll also bear in mind that Hormone Treatment might continue after the end of 6 months.

Of course my surgery was in August 2018, rather than in the future :)

 

User
Posted 22 Apr 2022 at 23:33

Hi Peter,

It was interesting reading your profile and some of your comments.  I'm preparing myself for further increases in psa levels after it popping up to just detectable, 0.06, last December.

I wondered at what psa level you were referred to Oncology as I got the impression they wouldn't transfer me until it got near 0.2.    They also sounded like they thought the psma test should only be done when it's over 0.2. 

I have mixed feelings as I asked to have a blood test in 3 months but the nurse was dead against it and eventually agreed to 4 1/2 months which is next week.   I now wish I'd waited 6 months as I appear to be in some kind of optimistic denial and that bubble might be pricked earlier than is likely necessary.

I noted your psa growth from 0.01 up to your 0.13.  It seems to stay constant at some tests then to go up again.   I was told if mine went undetectable next time I'd be discharged as it's now 5 1/2 years after the op, although I actually don't think they will, some oscillation appears normal.

I wondered if you'd looked at the nomigrams for salvage RT.  Having hormones halves (correction reduces it by 20%) the chances of it recurring in 7 years using my stats, Gleason 4+4.  Like you I was concerned about moobs as I'm thin but am active and eat low fat food so as others have said it might not happen.

All the best with your treatment, Peter

Edited by member 23 Apr 2022 at 19:23  | Reason: corrected error in calculating reduction in recurrance by having hormones.

User
Posted 23 Apr 2022 at 09:06

Hi Peter,

I was referred to Oncology after my PSA rose from 0.08 to 0.13 over 4 months, which entailed the PSMA PET scan. I'd always been told I would be referred once it rose to 0.1 or beyond. With this in mind, the next test after 0.08 was ordered for 4 months later, rather than 6.

My Oncologist confirmed that (as you say) elsewhere, such as in some other countries and even other NHS Trusts, investigations only start once the PSA has reached 0.2 or more. But that's how my Trust does it.

Two months after the 0.13 reading, my PSA was again 0.13, after which my Oncologist said she'd rather wait with salvage treatment until it got close to 0.2. On the PSA staying the same, she said the PSA did "funny" things and was unpredictable, pointing out that at some stage, between February and July 2020, it had satyed at 0.03. But then it started rising again.

According to my clinical nurses (before being referred to Oncology), they consider any reading under 0.1 to be as "undetectable".

I was very interested to read your comment about hormone treatment halving the chances of recurrence in 7 years. I'm also more reassured about maybe not getting side effects in their worst form.

All the very best for your next test next week. We are still talking about a very low PSA level.

Best wishes,

Peter

User
Posted 23 Apr 2022 at 09:54

I think you can rest easy that you won't turn into Mr Blobby overnight!

I have been on various bits of HT for two years, including a compete blockade for the last 8 months and while I put a few ( about 5) pounds on, its not dramatic, and I have managed to shift it. The real issue is that , over time , the reduction in testosterone will make it harder for your body to make, or even maintain, muscle mass. Crudely, what was lean becomes a bit more flabby.

In fact, this will cause you to lose a bit of weight as flab is less dense than muscle. Where the weight gain comes in is that with less muscle you will burn fewer calories, and as you get a bit more tired, you will exercise a bit less. They are small effects but they add up. 

The answer is the obvious one- a bit less eating ( keep up the protein!) and a bit more exercise, especially with some resistance work. No need to be a gym bunny, but it needs a little bit of conscious effort.

 

User
Posted 23 Apr 2022 at 19:42

Hi Peter,

I relooked at the hormone salvage radiotherapy probability and realised I'd misread columns.  The difference in probability of a recurrence after salvage RT is as below in my case if you have hormones.  I also had to make assumptions as I haven't reached the levels needed yet.  

For a 6month doubling time it was 61%  probability of no recurrence (<0.05) with hormones v 35% without hormones after 6years.  With 12month doubling it was 70% v 48% probability of no recurrence (<0.05) after 6years.

https://www.mskcc.org/nomograms/prostate/salvage_radiation_therapy

Thanks for the information on your case,  I'll bear it in mind as the nomigram also shows a small improvement if you have salvage earlier.  Although from what I've read, actually knowing where it is from a psma scan can give you a big improvement as they can better target the beam.

Peter

 

Edited by member 23 Apr 2022 at 19:45  | Reason: Not specified

User
Posted 23 Apr 2022 at 21:20

Hi Peter,

Many thanks! That's a very interesting website/probablity calculator, which I hadn't been aware of.

As you say, you're not at the relevant levels, but I hope you're able to live with the current uncertainty.

All the best,

Peter

 

User
Posted 26 Apr 2022 at 23:11

I think it comes down to the individual, their age, and their lifestyle.  I've been on Zoladex since Jan 2020.  Was ok for  the first year but have piled on body fat since.  I continue the exercise I was on pre-treatment.  I walk a minimum of four and a half miles each day with the dog, up and down hill.  It's kept my large muscle group in trim but my upper body has wasted somewhat.  I don't eat any more than I did previously but it's difficult to eat less due to the chronic fatigue I suffer with.  When you feel most of the day like you have zero stamina/energy it's hard to convince yourself to take in fewer calories.  All that said, I am a functioning alcoholic so that has to be factored in in my own case.  Good luck with your treatment.

User
Posted 27 Apr 2022 at 06:58

Many thanks Stephen!

Although, as you say, everyone is different, you've given me some useful pointers.

Wishing you all the very best for your continued treatment!

Peter

User
Posted 29 Apr 2022 at 13:07

Hi, there's great diet info directly written for guys with PCa...by two expert women who ran three webinars last year. The presentations and downloadable slides are still there:

https://www.prostate-cancer-research.org.uk/living-well-library/september/

I've even printing some out and stuck em on my fridge! Biggest changes I've ever made was diet in my PCa journey!

Steve

Blog: prostatecancer.vivatek.co.uk

User
Posted 29 Apr 2022 at 16:51

Many thanks, Esteban!

That link with the videos is really interesting and very useful.

I hope all is continuing to go well with you.

Peter

User
Posted 29 Apr 2022 at 17:07

 I hope so. Stopped CC sorry, HT early owing to problems...see blog.....in profile.

I made a lot of big changes....swapping out dairy for soya, cutting down red meat, including venison....taking lots of supplements... 

 

Hope that helps

 

Steve

Blog: prostatecancer.vivatek.co.uk

User
Posted 29 Apr 2022 at 22:07
For what it is worth I seem to have developed a bit of a bulge round the middle after being started on Zoladex before Christmas, but no big change in overall weight. My wife tells me I smell different though!
User
Posted 29 Apr 2022 at 22:19

Hormone therapy does easily result in weight gain, typically abdomen and breasts.

While I always say that men on hormone therapy should regard exercise as mandatory, it takes a lot of exercise to consume quite a small amount of food, so you need to watch what you eat too. It's extremely difficult to lose weight while on hormone therapy, so best to try avoiding putting it on, or at least, limit the rate.

User
Posted 30 Apr 2022 at 08:40

Hi, I was trying to find the web page that mentioned the difference in effort between guys on ADT and not.... apparently it takes 4500 cals of exercise to burn off 1 lb of flab compared to 3500 cals for fully hormonal bloke....so we have our work cut out.

https://www.pcf.org/c/adt-what-you-really-need-to-know/

I've currently got a triple whammy.... ADT for 8 months, mirtazapine (biggest side effect is the munchies and weight gain) and now a week of COVID....trying not to eat toooo much. Certainly not drinking beer......yet!

I got one of those fancy scales from Renpho . It gives way too many body parameters but body fat, visceral fat etc...good to keep an eye on...

 

Steve

Blog: prostatecancer.vivatek.co.uk

User
Posted 30 Apr 2022 at 09:18

I'm so sorry to read about your triple challenge, but I do hope you can see light at the end of the tunnel. I'll definitely bear in mind your recommendations on trying not to put on weight during Hormone Treatment!

I really like the photo of your "natural anti-depressant" on your blog. Great job keeping up that blog!

All the very best.

 

 

User
Posted 30 Apr 2022 at 09:26

Thanks....we used to live on a narrowboat, and always said that's not the end of the tunnel but a boat coming towards you!

 

Steve

Blog: prostatecancer.vivatek.co.uk

 
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