Prostate Cancer, Hormone Therapy and Exercise
Hormone therapy or androgen deprivation therapy (ADT) is a common treatment for prostate cancer. It works by preventing the body from producing testosterone which then slows the growth of the prostate cancer cells.
ADT and bone health
However, shutting off the supply of testosterone to the body has the side effect of reducing bone mineral density (BMD) at a time when your body is already losing BMD due to age-related muscle loss. As we age our muscles reduce in volume by about 1% per year in the fifties, 2% in the 60s and up to 5% from the age of eighty. The loss of muscle allows calcium and other minerals to leach out of the bone structure leaving a sponge-like formation which is very brittle and will not knit suitably after a fracture. This condition is called osteoporosis and data shows that men on ADT have a fifty percent increased risk of osteoporosis fractures over men not on ADT.
Positives of resistance training
Part of the solution is to prescribe zoledronic acid or Zometa and, while this can be effective, the best solution can be found in nature itself by undertaking resistance training. Resistance training is the working of the body’s muscles against a resistance or a force. This can be a weight such as a dumbbell or barbell, an elastic band called a resistance band or just lifting the body against gravity.
Exercises to help mobility
When training it is important to understand the reason behind the training, and in older age, the best reason is to increase or maintain functional ability. A key function is to walk safely, including up and down stairs, so the first exercise is a squat. With the feet slightly apart and the head looking forward simply bend the knees slightly without rolling forward onto the toes. If this is hard you can be supported by holding out your hands to someone strong enough or rest against an exercise ball that is behind your back on a smooth section of wall or support yourself on one side against a kitchen counter. The second exercise is to raise yourself up onto your toes with both feet while supporting yourself in front of a counter, and finally to raise one leg alternately to the side.
Exercises to help build strength
To exercise the arms you can grip a full can of food in each hand with the palms up, and then raise the arm at the elbow to work the biceps. Holding onto the cans keep the arms to the side and then raise them to the sides to form a T, and then raise the arms straight to your front until level. This will work the deltoid muscles of the shoulders.
We can work the chest muscles in one of two ways. Standing in front of a wall or closed door put the arms out straight until your palms are flat on the upright surface. Then lean into the arms bending the elbows out and push back until upright again. If this is too easy then get down onto a non-slip floor and perform a push-up supported by your knees. Taking the knees back increases the workload in the exercise.
Guidelines suggest that we work the muscles in this manner for about two hours a week, so three sessions of about 40 minutes will sensible once you have become used to the activities. Build slowly to this amount of time and intensity though. It's important to remember to talk with your doctor before incorporating any new exercises into your daily routine.
About the author: Simon Lord is a prostate cancer survivor and personal trainer with a specific interest in exercise for older people and people with cancer.
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