Ask Dr. Garnick
Marc B. Garnick, MD, is a renowned expert in medical oncology and urologic cancer at Beth Israel Deaconess Medical Center and the Gorman Brothers Professor of Medicine at Harvard Medical School. Dr. Garnick has dedicated his career to developing new therapies for prostate cancer.
“Can I still hit the gym?”
Q. I used to enjoy going to the gym. Can I continue to exercise while I am being treated for metastatic prostate cancer? Is there any activity I should not do?
A. If your metastases are located in any weight-bearing areas where a fracture could occur, such as the hip or femur, you should proceed with caution. In general, I encourage my patients to go to the gym, but to avoid any heavy lifting. A great deal will depend on the location of the metastases. It will be important for you to speak with your physician about the possibility of taking drugs that can help strengthen your bones, especially if they are involved with the cancer.
Help for lymphedema
Q. I have lymphedema in my legs. Sometimes they feel so heavy, I just sit on the couch all day. Can I get rid of it?
A. This is a difficult problem, and the success of treatment depends on what’s causing your lymphedema. If enlarged lymph nodes are blocking blood vessels leading to the swollen leg, radiation directed at the blockage will be helpful. Many academic centers have lymphedema clinics that use compression treatments and other approaches to lessen the swelling. I would advise visiting a lymphedema expert for a full evaluation. Note: It’s important to rule out a clot in the leg, which can sometimes be confused with lymphedema.
Missing my libido!
Q. Since starting hormone therapy, my sex drive has tanked. Will my libido ever come back?
A. Hormone therapy decreases the male sex hormone, testosterone, which is key for libido and erections. If you’ve been prescribed this treatment for metastatic prostate cancer, you will probably be on it for life. Unfortunately, your libido is unlikely to come back; however, you can definitely remain intimate with your partner. Manual stimulation or oral stimulation with their partner is very common in men with prostate cancer who can no longer perform penile penetration. And other therapies can help restore erectile function. If you’ll be on hormone therapy for just a short while, be patient; libido and sexual activity may in some cases go back to what they were.