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ADT and Your Health During COVID-19

So, there’s a global pandemic.  If you’re on androgen deprivation therapy (hormone therapy, or ADT) for prostate cancer, you may think, “I’ve got enough to worry about.” Well – you may not believe this – but we actually have some good news for you: it looks like one of the few things you don’t need to worry about right now is whether ADT will increase your risk of COVID-19.  Hormone therapy does not put men at additional risk of infection with COVID-19.  In fact, clinical trials will shortly begin to test whether a very short course of ADT may actually be beneficial in men (without prostate cancer!) who are already infected with COVID-19.   (Note that there is no data to recommend starting ADT in men with prostate cancer as a way to prevent COVID-19.)

Regardless of this reasonably good news, you may some experience some side effects with ADT, and being stuck at home may require more creative ways to get around them. Here are a few things to keep in mind. We’ve talked about ways to boost your health in general during COVID-19, but for men on ADT, these strategies are especially important.

Watch the carbs!  If you’re not getting to the grocery store that much these days, you might be tempted to stock up on things that will keep:  boxes of pasta, bags of rice, extra loaves of bread, etc.  The problem here is that because you’re on ADT, you are at greater risk of developing metabolic syndrome – a cluster of conditions that increase your risk of heart attack and stroke.  Your risk of getting diabetes is higher, and you have to fight harder to burn off extra calories (discussed here).  Normally, if a man wants to lose a pound, he needs to burn about 3,500 calories.  But a man on ADT who wants to lose that same pound needs to burn 4,500 calories, because his metabolism is slower, particularly his ability to metabolize sugar.  You still need carbs, but there are healthier ones than white bread and pasta.  Quinoa is a high-carb food, but it’s actually a seed that you eat like a grain. Oats are whole grains containing fiber that can help lower your blood sugar and cholesterol, too (note: not the “instant-cook” oatmeal you can make in your microwave in 90 seconds; “original” oats are better, and steel-cut oats are better still).  Bananas, blueberries, and sweet potatoes are also healthy carbs, and they’re not the only ones – for more nutrient-packed plant foods, check out pages 64-65 of our Wellness Guide.   Worried they won’t have a long shelf life?  You can freeze bananas (peel them first; you may also want to slice them into smaller chunks to put in your cereal) and blueberries, and sweet potatoes will keep for weeks in a cool, dark place.

Exercise!  Bad news: the gym is closed.  Good news: there are a ton of online workouts!  If your doctor has said you should exercise, then don’t let a global pandemic stop you.  Exercise will help fight the weight gain that you’re more prone to with ADT: cardio, plus light weights for strength.  Exercise also helps fight depression – another risk of ADT.  In turn, fighting depression also helps lower your risk of cognitive impairment – yet another thing for which ADT raises your risk.  If you don’t like any of the online workouts, then, if you can, go for a walk.  Walking helps you stay connected to nature and what’s happening in your neighborhood.  It engages your brain.

Another benefit of outdoor exercise?  Vitamin D!  Research is ongoing to better understand the role of Vitamin D in prostate cancer.  For now, get some sun so you are not deficient, and DO wear a hat and sunscreen, especially if you’ll be outside for a prolonged period of time or during peak sun hours.  Make sure to follow any local public health guidelines on staying away from public areas and wearing a face covering.  And if you’re just returning to exercise after some time off, check with your doctor first (via phone or email), and don’t overdo it.  You may need to modify those online Crossfit workouts to suit your personal fitness level.

“Social distancing” really just means physical distancing.  Isolation is not good for anybody.  It’s especially not good for you, because of ADT’s higher risk for depression and cognitive impairment.   So, we’ve talked about getting outside and going for a walk.  That includes saying hello (from a six-foot distance) to people you may meet while you’re out and about.  What else can you do?  As they said in old AT&T commercials, “Reach Out and Touch Someone.”  Pick up the phone.  You’re not just doing a good thing for yourself; you can do some good for your neighbors and relatives, too, by checking on them.  Better yet: use FaceTime or a free meeting website such as Zoom, and see people – your brother, your kids, your grandkids – while you’re talking to them.

Challenge yourself…..then take a break.  It’s fun to binge-watch Netflix, and we’ve all done it – no judgment here!  But watching TV is also pretty passive.  You know what else you can watch?  How-to videos!   See if you can learn one new thing a day.  Maybe you’ve always wanted to learn how to knit – because guys can knit, too! – and you’ve had knitting needles sitting there in silent reproach for years.  You don’t have to master the craft; but you could learn how to do a stitch, and practice it.  Or learn a dance step for that wedding you’re going to in a few weeks (when life, as it always does, becomes more normal again after this crisis).  Or learn a few phrases of a foreign language.  There’s so much online instruction available, and an amazing amount of it is free.

And on the days when you’re feeling not up to the challenge?  Don’t worry.  Give yourself a break.  We may be in this for the long haul, so be kind to yourself if you have a lazy day here and there.   Too much “self-development by YouTube” isn’t so good either!  Be mindful of screen time, whether you are age 7 or 70.

Janet Worthington
Janet Farrar Worthington is an award-winning science writer and has written and edited numerous health publications and contributed to several other medical books. In addition to writing on medicine, Janet also writes about her family, her former life on a farm in Virginia, her desire to own more chickens, and whichever dog is eyeing the dinner dish.