Why suffer the side effects of adt if you can get to 0 in 6 hours with minimum side effects? I'm BRC with <6 months doubling (0.06 - 0.27) post RP. I'm trying to get in the Progenic PET F11 imaging trial. Drs may not approve...they want Lupron and salvage Ra now! Your thoughts...
thanks, Geo
Niether chemical or surgical castration brings your testosterone to 0. The typical number is around 15. If you are going to be permanently on ADT, orchiectomy can make sense. Eventually, the cancer evolves to need a smaller amount of male hormones to reproduce (castrate resistance).
The side effects are the same for either method of castration.
Great response, certainly age and other factors would weight in. For me ADT is like software, can be updated and/or replaced at any time in the future, while Orchiectomy is etched in stone, final.
I am on Estrogen patches and testosterone is <.1 and FSH <.1 which are both as close to zero as testing can show.
Estrogen confuses the hypothalmus and pituary glands and stop production of FSH as precursor to creation of testosterone primarily in the testicles.
As as consequence the effect of estrogen patches is to stop productin of FSH and Testosterone from all sources including the adrenal glands.
It's cheap, no night sweats and minimal risk of heart attack as with identified most ADT drugs.
My PSA has dropped from nadir of 12 to now .01 and still falling after 18 months. I get monthly test for PSA, FSH and testosterone to monitor progress and every theree months for DHT and Chromogranin A as they can be very early indicators of metastaic activity before any symptoms are evident.
Peter
Adrenal glands still produce T and Zytiga is used to reduce that. An orchiectomy will just remove the testicles and not the adrenal glands
Had mine. Non- nerve sparring RRP and Gleason 9/10 in all nerve bundles out of area and nothing down there was ever going to work again anyhow.
There are other hormones in addition to testosterone that contribute to tumor growth so T is not the only one. In addition the tumor cell can produce T itself from other molecules in the body, this is known as intracrine or paracrine production of hormones. If only it were so simple to eliminate just the one.
With me it's a psychological thing. Since I'm castrate resistant anyway it wouldn't make any difference. I can accept chemical castration mentally but I couldn't accept surgical. My T is as close to zero as it can get with lupron, but my cancer goes roaring along anyway. I'm seriously considering going off lupron since it doesn't seem to inconvenience my cancer very much and that way I could get rid of some of the side effects.
Great questions and great answers, all! Very informative thread.
Maybe you can try one at a time.....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 02/03/2019 5:21 PM EST
I really like it when I laugh out loud. Maybe Tom Brady could just under inflate your balls.
Hey guy . As one that almost lost the initial match with APC I would not recommend playing with it for..long Yes adt sucks .So does APC gone wild.. I was in kidney failure with pc tumors blocking urethra . My choice was to live or die.. I got my first shot of firmagon as I exited the I c u and recieved my dx # 4 non- op t-4 aggressive . after two years and many shots I opted to chop the boys. I was chemically casterated by that time anyway. It can be common to have suicidal ideation after. I did. Then I adjusted no more shots but if you ever think you want an ADT vacation from adt then you’ll need to take testastone injections you’ll have to inject T. I’m
Not there yet. Over 3 yrs no visable signs and my PSA has held near .04 After my first firmagon shot.. I then did Lupron until surgery 9-16 and I’m
Still on another adt test drug although the test drug as stopped. Do not let APC get stronger. Better to knock the crap out of it. Initially .. I’m no doctor but Personal opinion .Side effects from Lupronn or castration are similar. But I am happy not to be getting shots. I think there is more heart issues probable on Lupron. It’s a hell of a life.. side effects exist for most of us.. it’s about choosing life.. do what’s best for you.. Scott
I've made that decision already. After 3 years of chemical castration, and now 3 years off of it, I very much understand the effects of castration. If I ever have to go back on ADT (very likely), I'm going to have the surgery. Lupron shots are pretty easy, but they have some level of extra side effects, and are ridiculously expensive. After castration, I plan to follow Sr Snuffy Myers's recommendation of low level (0.025 or 0.05 mg/day dose) estradiol patches to prevent hot flashes, fatigue, and loss of bone density.
The boys shrunk about 75% on 3 years of ADT, and have not gotten any bigger since. It's like they're not there anyway, so I've already dealt with that sense of loss.
If you are in a situation where you have to consider ADT for life then surgical castration is a viable alternative.
If you hope to step off the bus at some time in the future with the possibility of being able to recover some level of testosterone with the health benefits that follows on from that then it is best to stick with the hormones.
Neither course of action gives you 0 testosterone but they do both give you low and comparable values.
Testosterone patches after finishing adt
High testosterone = very bad ADT side effects?
Does testosterone fluctuate after ADT ends?
Considering orchiectomy 
Why continue LUPRON when ADT not working?
