Bobs introduction

[Bobdhs]

Hi I’m Bob

I had a Gleason of 3+4 three years ago. I had proton therapy and had a PSA of .09 for three years and two months ago a 16. Started on A DT and now after three weeks, at 7. Looking into castration as don’t want the side effects of oral meds. Also I am 88 so it comes with the territory but I am still working part time and fairly active. Hope you all are doing well today

[Tall_Allen]

Maybe you can get a PET scan (e.g., Axumin). If the recurrence is in a place where the protons didn't quite get it all, you can have salvage focal brachytherapy or focal ablation. It might spare you some of the side effects of androgen ablation (whether pills or orchiectomy)

[Bobdhs in reply to Tall_Allen]

Thanks Tali. Looking to castration as a start. At my age I could care less

[AlanMeyer in reply to Bobdhs]

Bob,

I'm not an expert on this but it is my understanding that many of the side effects of chemical castration are due to the lack of testosterone in the body rather than some unrelated side effect from the drugs. It is therefore possible that you will experience some of the same side effects after orchiectomy that you are experiencing now on ADT. I recommend that you discuss this with the doctors before deciding to have the operation.

I also suggest that you discuss other options for eliminating or significantly reducing the side effects. Some patients have responded well to estrogenic hormones, e.g. Megace, a synthetic progesterone.

Best of luck.

Alan

[arete1105]

A small amount of T is also made by the Adrenals. Physical castration will take care of the testes, but what about the adrenals. Would chemical castration also take care of the adrenal T?

Also you might/not get a strong reaction to ADT.

[Grumpyswife]

Hi Bob, My husband had an orchiectomy at age 74 and it was not so easy for him. He felt it was the worst prostate cancer treatment so far although he is fully recovered from it now.

Just choose your surgeon more carefully then we did as he had some complications.

[Currumpaw]

On the other site, I have a friend that had a G10 who within days had a double orchiectomy. He is an athlete competing in bicycle races. He has testosterone injections to keep his T levels acceptable. He is closely monitored by his doctor.

At the age of 88 and still working I have to congratulate you. Please know that losing the T that your body produces should you choose orchiectomy will cause muscle and bone loss. At the age of 88 your body isn't producing large amounts of T. Losing it would sap your energy as well.

Tall_Allen's advice is excellent. If a Focal laser Ablation would be possible that would cause the fewest side effects. You could resume your life in a short time.

[Hidden]

Proton gave you 3years Without AdT. I consider that a success.. I did. Radiation therapy and started a test adt drug that I’m still on and also Lupron until I opted to chop the nuts 9-16 , two years now and no shots. I had no complication except some dark thoughts and depression for several months. That passed and I think it was the right choice for me.. Had a hard start with APC almost dieing of kidney failure. For me it’s all palliative care just living alongside APC and Living for today.