Are man-boobs inevitable? A "bro" in my future?

Is it the length of time one is on ADT that results in breast enlargement? Are some men more inclined than others? If length of time is a factor, please post a time when you first noticed growth, say after one year, two years....And is radiation the way to go, or liposuction if one can't tolerate the having Hooters?

39 Replies

  • I have em. After 3yrs of ADT..& 1yr no visible signs. I’ll take it and if need be I’ll sport a “Bro-sier” .Hey , it’s better than having APC eating me alive....Everything is a trade off to extend life. Ego must go...just noticed recently that pec muscles diminished and flabbytities exist.Although going thru feminization is tuff at 56 or any age, it’s just part of the saga.

  • Lulu, Hey, it's not about vanity--maybe a little, okay--but about inevitability. For some crazy reason, I was told this might or might not happen. I reckon is\t does, will. I'm 66 now, my husband is 71; we've gotten used to all the changes after so many years. And, you know, I love his just the way he is--or will be.

  • Didn’t mean to suggest vanity. We all can relate. We can all paddle up stream against it’s myriad of symptoms and side effects,or we can turn down stream and hold on for the ride.Hopefully we see inward and outward beauty along the way and not solely dwell on the pain and monotony of it all ..Enjoy your weekend!

  • Lulu, I rarely dwell on the monotony (office visits, lab work, scans, visits with my oncologist (PSA ever mentioned), all the questions, the drive to and from the clinic, waiting for lab results and, not to be left out, the drug regimen. I focus on the now. Stay in the day and not jump ahead. I am enjoying mundane tasks more than ever: staining the fence, pruning hedges, cooking good food and being with my wonderful husband. Weekend, so far, v. good.

  • I’m with you in all those thoughts. Peace.

  • Right on. True love goes beyond outward appearances..We are both lucky to have love at home ..Take care ...

  • I was on Lupron for 3 years and had weight gain, but it did not seem like there was any internal breast growth. When I added Xtandi during the 4th year, about 3-7 months into it, I did develop some slight tenderness underneath the nipples, and a little bit of breast growth. Now, at the end of the 4th year, I no longer have any tenderness, and the small amount of growth seems to have stopped. For me, it's not a big deal at my age 69. They are not really big, and not even noticeable when I wear comfortable, looser shirts. I had heard of gynecomastia before, but I never really considered radiation or other ways of treating it as being a big priority, considering my overall Stage IV advanced metastatic state. None of my doctors ever mentioned it before prescribing any treatments, nor did they seem particularly eager to offer any treatment options when the subject came up in casual office conversations. Frankly, I think many men on ADT are likely to have bigger, more unsightly, Lupron Bellies than Moobs (Man Boobs).

  • ctarleton, Thanks for an added perspective/experience. I agree about the bellies, too. I radically altered my diet in anticipation of ADT. My husband has sagging breasts and he is not on my meds. I think it may be a fickle side effect. Thanks for all the detail about breast tenderness too.

  • In 2003 I had a small amount of radiation to my breasts before I began ADT. The beasts did not get enlarged from ADT.


  • I have heard this does help the radiating before. I thought lgs manboobs came from the Vivelle dot. Maybe a reduction....Also need to do man boob exams.

    I hope you're able to figure out what will work :)


  • Thanks, erjlg, I am 66 and quite prepared to wear my "bro" proudly if need be. Physical appearance occupies too my space in the world. We need to get reallly real!

  • And, mammograms, they're fun.

  • I can only hope to avoid that.

  • First the right side, then the left. It was only because they got so painful. Now, not so much, only when they get bumped or the like.

  • Is it possible to have radiation now that I am 7 months into ADT?

  • Please ask your radiation oncologist.


  • I will do so. Thx

  • ADT doesn’t preclude radiation. In my case I was on ADT for 9 months prior to radiation treatment in order to shrink the tumours making the radiation less invasive.

  • RonL, I will follow up with my onco. Thx

  • Absolutely. It's used all the time for palliative care.

  • Thnx, Jonzey

  • Apparently, some kinds of drugs are more likely to induce gynecomastia than others. This article:

    says that androgen receptor blockers (e.g. Casodex) are 50-73% likely to cause the problem but the LHRH agonists (Zoladex, Lupron, etc.) are only 13-32% likely.


  • Alan, What would we do without you. Not even my oncologist mentioned this. The new article in Medscape is about just such lack of communication: Men With Prostate Cancer Receive Inadequate Medical Counseling. Do the doctors know about this website? And if they do, why are they not reading some of the postings? You need to trade places with them, Alan. You're a treasure.

  • And I've heard that Xtandi (enzalutamide) has approximately 5- to 8-fold higher binding affinity for the androgen receptor (AR) compared to bicalutamide.

    No wonder if it may be associated with some gynecomastia !

    Interestingly, the Patient Prescribing Information that comes with Xtandi does not even contain the word gynecomastia anywhere in the list of potential side effects, or is it mentioned or measured in any of the Clinical Studies that led to the FDA approval.

    Perhaps they got away with that because adult humans having some breast development affects approximately half of all the adults on the planet. It is a cosmetic thing, rather than a "side effect" or a "symptom" or a medical "adverse event". Except when it happens to a man, and then potentially becomes a psycho-social problem, instead of a "cancer" problem in the realm of oncology.

    In terms of doctor-patient relationships, and Quality of Life issues, the impacts of all the "sexual" type issues in prostate cancer (and probably women's cancers, too) are probably greatly neglected, at best - erectile dysfunction risks and treatments, matters concerning gynecomastia in males, realistic discussions of what will happen to the penis and testicles as a result of hormone type treatments, loss of libido, etc.

    A notable exception that I have seen is Dr John P. Mulhall at MSKCC. He has some very good videos available via the MSKCC website, Google Searches, YouTube, etc.. and has been a past Keynote Speaker at several major Conferences related to prostate cancer, going into great detail and with personal passion into expectations, potential side effects, and various things one might do before, during, and after specific prostate cancer treatments & procedures.

    My two cents today,


  • Alan, thank you for posting this. It was a bit of a sigh of relief.


  • Firmagon, eleguard,Lupron ,Then orchiectomy And Tak-700 until failure ,and also Only RT After this 3yr regiment,I Now notice some gynecomastia.But as my 90 yr old mom says “ You’re still here”.Even 50 yrs ago I would have died 3yrs ago if not for by-lateral neauphrostemy tubes and massive antibiotics. So in the grand scheme of things man boobs is low on the list of radical changes. .At least for me. I am happy however that I’m Not as busty as “Meatloaf “ in the movie “Fight Club” .If any of you have seen this flick. Meatloaf as an APC patient just goes “With “ the giant knockers. what choice do any of us really have?Time to get in touch with our feminine side .To say the least.

  • I forgot about "Meatloaf." Did you see the Seinfeld episode that dealt with this subject? The sight of seeing Jerry Stiller with his "bro" on made be laugh but I also thought how brave the actor was to reveal so "much," even for a laugh and a paycheck.

  • Kramer was a crack up!

  • He was! Too bad he got X-ed for going off message. One of the funniest guys on TV.

  • I had tender breasts which grew when I went on bicalutemide. I did not have them the first time on ADT with Lupron only.

  • Leswell had pain and minimal breast swelling while on Estradiol patches and ceased using them. Having just added bicalutamide without irradiating, it will be a cautious wait and see.

    Right now, we’re more concerned about the mini-breasts on either side of his pubic mons due to lymphedema moving upward and what sort of contraption to compress those with. He says a nail apron. Blame him for this morning’s irreverence please. I ran for the tape measure to check his chest size. 36”. That was mine too fifty years ago. Mrs. S

  • I use the patches too ; couldn’t be without them! I take cabergoline to mitigate breast issues.


  • Hmm...most of the references I find on Cabergoline are from a decade or so ago and often have to do with steroids and bodybuilding. Les had some gynocomastia from the Lupron which became worse with Estradiol patches. (The dexamethasone given during chemo was reduced from 10 to 5 and then to 1 mg; those are the only steroids he has taken. We saw what they did to my once slim brother during brain tumor treatment.)

    Thank you, Bob, for letting us know what works for you. We’ll be sure to inquire about the combination of Estradiol and Cabergoline when we see our urologist/surgeon who is our primary physician at the moment.

    Still working on a patch of Swiss Chard and listening to jazz but getting a beep when someone writes. Isn’t Health Unlocked the greatest?


  • Been on ADT (Eligard) for four years including Zytiga for the last eight months. So far no boobs and my weight has been stable.

  • RonL, Did you see Alan Meyers' recent reply to my question. Check it out. Good on the stable weight. I can be a struggle if we get lazy.

  • I'm annoyed that I wasn't offered radiation to prevent gynecomastia. But hey, my mammogram came back negative so why should I be annoyed? See Alan's excellent link on preventing or treating the effects of ADT. By the way, I was given only a six month eligard shot, so it took months, not years, to develop this problem.

  • I did read and make notes from Alan's reply, WSO. Thanks and I agree that boobs beat more disease.

  • There is no set rule, and no set time---too many variables to answer this question---but it will happen if you are on ADT long enough, and do not exercise, with Chest Press Machines in the gym, and if you do not try to offset the fat deposition, with Metformin, and CLA.


  • Gotcha, Nala. I am striving to keep the fat off. Just amazed by the small but noticeable fat that has migrated to my belly. I don't plan to "blob out" without a fight.

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