Prostate Cancer treatment choices and affects on cycling, post treatment

59 years old. Because of TrainerRoad, I’m in the best shape I’ve been in since I was in my 20s. Time and tide wait for no man and unfortunately, I’ve been diagnosed with early detected Prostate Cancer. I’ll either have to have the prostate removed or go through some form of radiation treatment. A few questions for anyone who has been through this:

  1. Which treatment did you go through and are you satisfied.
  2. How did it affect your ability to bike ride and train?
  3. The radiation treatments are usually a several week long procedure. Did you, were you able, train during the treatment. Killing the cancer is paramount, but I want to maintain the fitness I’ve worked so hard to attain, if possible.

Bicycling is an interesting sport and lifestyle. It has been important to me since I rode my first bike as a kid, and incredibly, the affect this disease may have on my ability to bike is on my mind.

Thank you to anyone who shares their story.

Hi , I am 58 I had a radical prostatectomy four and a half years ago, unfortunately when they removed my catheter a couple of weeks after my operation I was leeking urine into my abdomen and picked up a MRSA infection that needed daily intravenous antibiotics for a further 6 weeks. So not a typical recovery.
I actually used Zwift to be as fit as possible for my operation.
Once I my treatment was finished I was just as fit as before ( I was more into running then) And as soon as I had bladder control I ran several half marathons setting 10 year PBs,
I was put on regular PSA testing and two years later my PSA started to very very slowly rise and I was put on a 6 and a half week corse of radio therapy, My company generously gave me time off to go through treatment( my job is quite physical and I work shifts). In order to target the area around were the suspected cancerous cells were I had to take a daily enema. Wether it was the enema or the actual Radio therapy I really struggled with fatigue, I did manage to run for every day for the first month of treatment but the distance shrank as the fatigue increased and I lost quite a lot of weight.
Any way a knee injury has forced me to put running on the back boiler and concentrate on cycling. I am on 3,750 miles this year with a FTP around 275 my weight is back up around 76kgs I am back up 6monthly PSA tests and if anything is slowing me down its my age not cancer.
YMMV
Good luck and take care of yourself.
EDIT and do your pelvic floor exercises!

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Greatly appreciate the reply! I have friends who recommend radiation, but the docs told me one problem with radiation is that if you develop cancer again, it is unlikely you can have a radical prostatectomy due to problems created by the original radiation.

Sounds like you’re pounding out the workouts - that’s awesome. Wish I had a 275 FTP! Great job!

My specialist told me the same thing regarding radiation versus surgery. Just out of interest what is your PSA and Gleason score? Mine was PSA 5.5, Hifu treatment sounds interesting, but was not available to me at that time. And I really mean it about the pelvic floor exercises no one wants to be wearing a diaper/ nappy. In a follow up I was one of only a few who had full bladder control, but I was one of the youngest in the group.

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Hi Dave

I’ve no direct experience of training through treatment, but I did have 5 weeks of radiation treatment to treat Hodgkins Disease when I was a child. I remember the treatment being not too bad to deal with at all. I’ve led a full and happy life ever since, with regular checkups to manage the side effects (which have been minor).

I’ve also ridden with a friend through his Chemo. We dialled it right back and used the rights to balance out the challenges he was facing, and also to escape for a few hours.

I wish you every luck with your treatment. There’s a fair few of us cancer survivors on here so don’t hesitate to reach out.

Matt

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I never had prostate cancer, it was bowel cancer IMC. I’m just coming up for 45years and when I think back symptoms started when I was in my late 30s. During the chemo I actually got stronger and set my fastest 25miles and other PRs and ended up despite the op and chemo having cycled 9000miles. What ever you choose don’t lie down to it and fall into the vicious circle a d you can beat it too. Good luck :+1:

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Glad that this has been picked up early but sorry to hear about the diagnosis. My dad required radiotherapy for prostate cancer and found that it ground him down a bit over the treatment (I think it was 5 days a week for 6 weeks), and he eventually got my mum to drive him the 45mins each way as he was feeling tired. He’s a keen golfer with a single figure handicap and managed to get out a few times at weekends despite the treatment, I suspect it would have been more if the treatment hadn’t been in January/February.

Because of the particular prognosis he had hormone treatment for a while and really didn’t enjoy getting the dissolving implant - he’d admit himself he’s not good with injections but I think the hormones themselves also made him feel different. Due to a slightly elevated PSA score he’s had another implant recently and is an active monitoring phase with his doctor.

In terms of training through treatment, remember that universal stress at that time will be quite high so maybe trying to go to a maintenance programme or just commit to getting on the bike each day to do something would be good. If your weather is favourable also try to get outside, even just for a walk, there’s so many proven benefits to spending time outdoors.

Good luck and let us know how you get on, stay healthy.

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Im a Radiation therapist, the fatigue people speak of is pretty common with radiation. Its been a minute since I looked at the literature but generally our recommendations are do what you can but listen to your body. Ive had patients that have spent an hour in the pool every day while on treatment, it can be quite varied depending on how much tissue is being treated and how active you were before etc (just prostate treatment or nodes as well etc).

most prostate treatment courses are now 4 weeks total and there are a number of trials currently running that complete it within 1 week.

Brachytherapy is another for of radiation therapy where the radiation source is placed in your prostate, typically this can be two treatments or one used in conjunction with a shortened course of external radiation. Ive had a couple of cyclists have that …they were off the bike for a few weeks (the radiation source is inserted through the perineum…anecdotal note; cyclists have quite a tough perineum to get through with needles)

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Two time cancer survivor here but not prostate cancer. Everyone’s cancer treatment and journey is a little different. I had tongue cancer that spread to my neck that required major surgery. Chemo and radiation followed that one up and it was really tough. Huge ego hit for me when I could get back on the trainer again and dropping the FTP from 230 to 150 but I worked my way back up and am faster than ever now.

The melanoma I had was pretty tame with a surgery and immunotherapy for a year. That wasn’t bad.

As athletes we identify our selves by our sport and when we can’t practice our sport it take a part of us away. However your treatment goes, just remember that cycling will always be there when you get back and you will appreciate the gains you make if you have to spend time off the bike. Let your body recover from treatment. Every time I ride now I’m very thankful and amazed at how strong I am now after the first cancer experience.

Prayers for you in your treatment.

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Sir,

I come to this discussion with an unalterable bias. Please put all that follows in the proper time context. Much has changed in the field since I was involved. I was radiated for prostate cancer in 1997. (Yup, 23 years ago.) It didn’t get the job done. My follow up was with a doc who had seen radiation fail frequently. He watched me like a hawk. It took about 2 years before PSA started to move, but when it did we knew I had not been cured. It took almost 8 years before PSA got to 2.0, which, back then, was the watershed for deciding what’s next, if anything. There weren’t many options then but I did qualify for a salvage resection, which is what they call resection following failed radiation. Very few guys qualify for a salvage. (Interesting way to describe it, huh?!?! But it does get your attention when you realize what’s being salvaged is probably your life.) The reasons for not qualifying are individual, but at that time, anyway, it was very rare to qualify. In 2005, doing prostate resections with instruments and camera inserted through your abdominal wall was just getting going. My surgeons had done about 500 of them, but had never done a salvage through the ‘scope. I was their first. Not many had been done anywhere in the world. Long story short, I walked in one morning at 6:30 and walked out (very slowly!) the next day before noon. I had one urologist advise strongly against it, telling me “it’ll be 10 years before you’ll see symptoms”. That was over 15 years ago. Again, not knowing what’s going on in the field today, I believe I’d likely not be here today had I not taken the opportunity I had.

There are many opinions regarding best prostate cancer treatment. Every doc and every patient has their own narrative. People talk about the negative things that can come with surgery. Been there, done that with all of them. So, it’s true for sure, but given the perspective I have now, none of those things even move the needle. I’ll deal with them. I just turned 78 a few weeks ago. I’m doing 350-450 TSS weekly on the trainer purely for cardio pulmonary benefit. I see no reason to change that as far out as I can see. I’m not conversant with the status of treatment options in field today. My best advice is fully own yourself and your decision. There will be no lack of voices offering their point of view. Nothing wrong with that at all, but make your own choice for your own reasons.
Subsequent note: It may come through that I feel very strongly about calling one’s own shots on this. The reason for that is that I didn’t do that when I was radiated in '97. I had many voices in my ear and an uninformed imagination of my own running in my head. Essentially I took what looked like the easy way out. I think often of how lucky I was to have it all work out the way it did. Very low chance of even qualifying for a salvage and then to run onto a place that could do it without open surgery. Very, very lucky guy here. My decision to do the surgery was made against unanimous advice to not do it or at best significant doubts about it. Outside of the operating surgeons, I didn’t have even one voice telling me to go for it and even they realized they couldn’t make any promises so they didn’t push it . If I had “owned myself” in '97 and had the surgery then, none of what followed would have been necessary. This is never an easy decision. I get rather fervent about the issue since I’m one of a very small number who have had two chances at it. Stay strong!

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My PSA had risen to low 5s over the last year, then jumped to a 7 two months ago. The urologist said “time for a biopsy”. The biopsy showed the highest percentage of “bad” cells at 46, and Gleason score mostly 6 and 7, but highest at 8. I agree, I’m hoping that being a relatively younger guy at 59 that I can work in pelvic floor exercises with my TR workouts! :slight_smile: Thanks!

Wow! PRs during chemo - that’s amazing! Great job. I plan on pushing my training as hard as I can before during and after. Glad your treatment worked well.

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Appreciate the information. My uncle had both the Brachytherapy, with hormones and radiation - he’s 20 years older and has done well afterwards. Like you say, I believe his treatment lasted 4 weeks or so. Thank you!

Thank you to Trainer Road for allowing these (somewhat) off topic discussions.

Class of 42 - first I wish I had the time to pump out 350-450 TSS weekly! Most impressive. I know if I did I could break out of my current FTP plateau.

Thanks for discussing the “salvage surgery”. That’s exactly the term the urologist used and he said the same thing about “qualifying” - that most surgeons won’t even attempt it once you’ve had radiation. That to me is concerning and since most men in my family live well into their 80s and 90s, I am leaning on just getting the damn thing taken out.

I appreciate the information from you and other survivors who come out the other side with the same or greater fitness levels. I still have dreams and goals to achieve, including one of the long distance (100 mile) winter fat bike rides. Glad to hear that won’t be unachievable after radiation or surgery.

Very grateful for everyone’s story,

Dave

My father in law had brachytherapy for prostate cancer several years ago. He hasn’t had any cancer recurrence, but has had all kinds of problems with urinary retention and need for hyperbaric oxygen treatments. Radiation is the gift that keeps on giving

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There is some “smoke” in my TSS numbers! At my age, I don’t push the big watts numbers any more so I get what I do mostly through volume. I’ll just mention again how much has changed since I was dealing with this. No matter how one approaches prostate cancer things are always advancing. It still remains a tough call.

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Hi A7Dave

Early stage (I hope!) prostate cancer here as well. Diagnosed in Aug 19. Did active surveillance for a year but now need to go into treatment. Radical prostatectomy scheduled for mid Sept 2020.

I’ve had a lot of great advice from two great institutions. For me prostatectomy is best course.

I’d be happy to share my story and decision making further with you or anyone. DM me.

Thanks to others for the encouraging stories in this thread.

Thanks man. Between the talk here and discussions with affected friends and doctors (including a Radiation Oncologist) I decided to get the damn thing removed on the 21st. Good luck with yours! I’ll post my results after.

Take care and best of luck.