Should I have orcyectomy (im sure i spelled that wrong)!

[Kell_11]

Hi its Kell, my urogist wants to do this because my testosterone is at 53 and its not coming down. I was dx. a year and a half ago w/ stage 4, gleason 5+4, mets to bones. Im 56 yrs. old, had 6 rounds taxotere up front chemo and am on adt, 50 mg. casodex daily and monthly lupron shots. Last bone scans showed awsome results. Psa is undetectable. Is anyone else in a similar situation or have any advice?

[Tall_Allen]

The only reason not to have an orchiectomy is if you are on INTERMITTENT ADT and want a break every so often.

[billyboy3 in reply to Tall_Allen]

I totally agree, do a combo while on IHT to reduce the test level, it will come down!!!

[Kell_11 in reply to Tall_Allen]

Im on steady adt, casodex daily & shots

every month

[RyderLake2]

If you are on monthly lupron shots you are probably on Firmagon (degarelix). I am not sure why you would want to undergo an orchiectomy if your PSA is undetectable and the last few bone scans show "awesome results". Perhaps you should suggest to your urologist that you discontinue the Casodex and see what happens to your testosterone level. You might also want to find a good medical oncologist for a second opinion.

[David2703]

My diagnosis is less than and I had castration. They take out the testicles and leave the sack. If you want you can have them put in plastic testicles as replacements. The sack swells a lot for a few weeks.

[j-o-h-n in reply to David2703]

Ping Pong balls? I think l'll pass thank you, cause my wife has a few paddles...😖😖😖

Good Luck and Good Health.

j-o-h-n Friday 08/31/2018 6:25 PM EDT

[Kell_11 in reply to j-o-h-n]

I have some old marbles, probably cheaper😁

[Hidden in reply to David2703]

I didn’t have much swelling or discomfort. Just lucky I guess. Ping pong balls.? . maybe needed if you’re a porn star. Why put something foreign in the way down there? No balls ! No problem . My doc said “ who’s going to see it anyway? I had normal sized balls to begin with but after chemical castration they were tiny and at times painful. That’s gone. Growing up male macho and thinking that I was invinsable I had figuratively big balls and few fears if any. Now I’m a member of the no baller club .. it’s just an afterthought.. addios juevos! Hola life! Survival is our basic instinct. Like the guy with his arm trapped by a boulder in Zion. He cut it off, he lives , he’s a hero. Orchiectomy under anathesis pales in comparison . That guys a hero. It the same thought however. Wishing to live another day..

[Hirsch]

the production of testosterone from your testes is effectively being blocked by the ADT

therapy.. the extra testosterone is probably coming your adrenal glands.

Thats why we have Zytiga which cuts down the production of testosterone from the adrenals..

Recommend a med oncologist specializing in prostate cancer..

good luck..

[noirhole]

Thinking about the same issue. 6 month shot of Luorin costs 12,000 and my copay is $950. Most likely never going to stop the shots.

[Drgucancer in reply to noirhole]

U should consider talking to ur oncologist/urologist about paying cash. Cost to a practice is around $200 for a 3 month depot inj. There are also foundations that can be used to cover the lupron.

[Hidden in reply to noirhole]

What a party?

[Grumpyswife]

Most MO discourage orchiectomy. They lose income from injections. Your urologist is a surgeon will make money from your orchiectomy.

Our MO said orchiectomy was kind of barbaric. TA gave the best reason not to but choose your surgeon wisely as ours screwed up.

If you search orchiectomy on here quite a few men have had it.

[Drgucancer]

In my opinion I would not recommend orchiectomy. Testosterone is also made~20% outside of the testicles. So removal of the testicles isnt a guarantee to take you less than 50. Also the testosterone lab is not an exact test it can vary significantly. The difference in outcome from a patient with a testosterone level of 53 vs 23 is going to be negligible. If you wanted one option would be to use a different adt injection ie degarlix or trelstar instead of lupron. Or change the casodex to zytiga which lowers all 4 sources of testosterone in the body ( testicles, adrenal glands, cholesterol conversion, and eventually the cancer producing its own internal testosterone)

[petercraig2]

In my opinion orchiectomy sounds radical.

I suggest try Estrogen patches as they pretty much stop testosterone production from testes as well as hypothalmus.

I am 56 had radical surgery as well as radiation. I have been on Estrogen patches for a year and PSA from 12.5 to .047 and Testosterone is pretty well non-existent at <.1.

No significant adverse effects, very cheap (C$200/month) and is scalable so I can increase or decrease number of patches depending on results my monthly Lifelabs blood test.

With estrogen loss of muscle and bone mass is very limited and lower cardiac risk than most ADT therapies so I can still do all of my normal heavy work without problems

Let me know if you would like more info on this

Peter

[E2-Guy in reply to petercraig2]

I second Peter's reply! I am also experiencing positive results with tE2; however, instead of "patches", I'm using the gel which I find very easy to use and at a cost of ~ $9.00 US/month. I suggest you try this therapy before getting rid of that 'extra weight on the drag strip'.

My/our best to you,

Ron

[Jack71 in reply to E2-Guy]

Where can you get the gel in the US? Is it even available?

[E2-Guy in reply to Jack71]

It (Oestrogel) is available on Ebay and Amazon for $40.00 w/o a prescription. With an undetectable PSA this just might be a viable alternative to the ADT drugs you are now taking. If you are interested in trying this, Richard Wassersug, PhD is the master...he discusses this regimen in great detail in his 'second edition' of "Androgen Deprivation Therapy". I'm thinking about advertising it on the Net at a much lower price. I need to check what the shipping charges would be to the US.

Give it some consideration...good luck, Ron

[spikezoey]

Adding avodart to ADT (per Dr. Snuffy Meyers) has been known to help drop T further, is my understanding. I'd say try some other drug combos and get an MO before you do something radical that can't be undone. Good luck!

[Hidden]

Orchiectomy, as everyone knows, is final and irreversible. I wouldn't rush into it if you have other options.

[billyboy3]

keep your balls pal!! and follow the above smart boys on our site

[Hidden]

Orchiectomy? Who even heard of that word before entering the pc zone? Not me for sure. I know it well now . Had mine 9-16. No complications. In fact it was a relief of sorts. No more shots. Although I’m still on a pill test adt drug until failure. I’ve had no Psa or T for 3yrs.. riding the gravy train with the guys that experience this type of reprieve.. walking on eggshells in a broken male form .. whatever it takes to live is the motto. For me becoming an “Orca” was a no brainer.. i did suffer some dark thoughts and suicidal thinking seeing my self as not worthy of taking up this worlds precious resources. That left me after a few months. Only thing is if you experience a long term no Psa and decide to take an adt vacation you’ll have to inject “ T “ because the factory is shut down for good. No going back on this decision. Riding a bike with no balls is a joy.. gave up the family jewels in order to live. That’s a commitment to life. Not for all. I’m happy I did it.. Good luck and live long.. quality of life is everything..

[Shooter1]

They are gone and I am off ADT drugs for life. No regrets. Two jelly beans in a sack weren't worth much anyway.

[VHRguy]

If mine recurs, my only recourse is HT. It will be early, and continuous, based on the studies I've seen for cases like mine. If that is the plan, I'm going with the surgical route. I already did 3 years of Lupron+Casodex in primary therapy, so I know what it's like to live without any T. It's not good. But the every 4 month (or 6) Lupron shots were expensive. Easy, but expensive. Some studies favored surgical vs medical, showing somewhat less risk of side effects. Good idea to talk to my uro about it. The MO is likely to want the continued income stream from routine Lupron shots at a few kilobucks each.

The gum drops I have left after 3 years of no testosterone aren't worth preserving anyway.

[GeorgesCalvez]

Orchiectomy is an option worth considering if you are never going to go off ADT or you are likely to be on ADT for so long that you will not recover worthwhile amounts of testosterone.

It is hard to put a limit on this as it is age dependent, etc, but I would say that a good guess is something like three years

If it is likely that you will go into remission or move to intermittent ADT then it is not such a good choice. Having some testosterone in the system has benefits from the point of view of physical and psychological health.