Hello All, please I need help making a decision. My dad got diagnostic stage 4 prostate cancer, it went to the bladder and liver. The urologist offers orchiectomy ( removing both testicles ) to stop the production of the testosterone and stops the growing of the tumors. He just started taking hormones pills and the urologist says this will be the same results but with no side effects comparing with the hormones. Please, does any one did this procedure and really helps?
thanks
Sam
Its not true that orchiectomy will not cause any side effects. All the side effects which come with very very low levels of testosterone WILL BE there with Orchiectomy.
With metastatic prostate cancer, the goal of treatment is to take testosterone level to below 20 ng/ml
Generally speaking, Prostate cancer cells can not survive and multiply if they can not feed on testosterone.
You can achieve less than 20 testosterone either by orchiectomy or by ADT such as Lupron injections.
Side effects caused by low testosterone will occur in whatever way you go to deprive cancer cells of testosterone.
Side effects are the same for "chemical" castration (shots) vs. surgical castration. The only considerations are: cost - surgical castration is much cheaper over the long haul. Convenience - surgical castration is a one-time procedure vs. going in for shots on a regular basis. Temporary vs. permanent - surgical castration is permanent whereas chemical castration (shots) can be stopped although at some point it is more or less irreversible.
Been cut and don't have to worry about side effects other than no T. Had Rarp 6 mo. earlier with no nerve sparing, so sex not an issue. With lupron all I had was 2 jelly beans in my sack anyhow. Undiscussed before, need Gold Bond powder acct. empty scrotum sticks to legs.
I was getting lupron shots every four months, with zytiga, prednisone, flomax, and losartan. I l decided on the orchiectomy and had it done in May 2019. As my lupron wore off, I noticed my leg strength got much better. It had been really hard to get up off the floor or from kneeling. With all the medications I am taking, I decided it would do me good to get off the lupron at least, and I didn't like getting that big shot with the fancy device they use to stick it in. The procedure was really easy as they knocked me out, and I only had minor discomfort next day, taking just ibuprofen. Much more comfortable sleeping now on my stomach! Glad I went that route.
Thinking it through..some have very few side effects with absolutely no serum T while on ADT etc. I’m much healthier and stronger than untreated. I’m driving the golf ball longer than I have in decades....and with a cure or improved treatment...dare I say a cure..ADT can be reversed in days with testosterone treatments.
I wouldn’t consider an orchiectomy given the state of SOC. Yes I’m prejudiced favoring ADT....it’s worked like a charm.
But liver and other visceral Mets are something that should perhaps involve more immediate intervention..perhaps chemo might be a better starting point?
To me it is a case of fighting or surrendering. We who still have ours (they are shrunken but still there) hope one day to get off all the cancer medications and get back to a normal life, even if sex is not part of it.
I guess it is also expectations of life to come. The fighters always assume there is 20 years still to go, the last half (or more) of that cancer free. If you assume there is only 4 years to go, getting the "snip-snip" would make those 4 years more comfortable as the hormone injections are a "low grade" poison that builds tummy fat while wasting away the muscles (plus a few other things we live with and ignore).
The question should be how old is your father? I had the orchiectomy but I was 47. If your father is much older go with the ADT drugs.
My dad is 55, he hesitate to do the surgery and prefer the lupron
At 55 I might suggest the orchiectomy. But Lupron is still a good option. It's all in what you feel comfortable with.
I like the estrodiol (estrogen) patches instead of Lupron. No hot flash side effects, no stomach issues taking oral ADT meds, 1 negative side effect is breast enlargement. Positive effects better memory, helps joints, overall feeling better. Baby aspirin recommended.
I would be concerned that it would be as effective as ADT. Abiraterone stops an additional source of testosterone from the adrenal gland, whilst an Orchiectomy leaves that as a source of testosterone, which could help the PCa to mutate and spread. I’d go with ADT including Abiraterone.
My husband selected orchiectomy over Lupron shots at age 53. As others have said, side effects are still there especially hot flashes. His surgery resulted in swelling which took about a week to resolve but otherwise no complications. Good luck with the decision your dad needs to make.
Thansk a lot for all the message replied. Does anyone know about this :
telegraph.co.uk/lifestyle/w...
I friend if mine mentioned to me and her husband is taking this cocktail of pills for his cancer too. Please, let me know if anyone has some information about it .
6 of one or 1/2 dozen of the other. Have your DAD go with the meds.... he can always have his balls removed.
Please tell us more about your Dad. Age 55, Location? Treatments to date? Treatment center(s)? Doctor's name(s). All info voluntary but helps us help him and helps us too.
Thanks...
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 09/11/2019 5:22 PM DST - Another day to remember.
Hello Jhonn
We live in Maryland USA, and he just got diagnosed 1 month ago, we are trying to get and schedule in Jhon Hopkins hospital . We haven’t start any treatment at the moment due to waiting for the appointment
My husband had waaay fewer side effects after orchiectomy. ADT caused high blood sugar, high blood pressure, muscle weakness, etc. He felt much better after the orchiectomy.
Me too! Almost normal now. Just working on my head now, and the fact I will be living for ever!
Too early for a decision? Try the hormone therapy first? Can't change your mind on this one. Enjoy.
There is no advantage to do this surgery Take 3 Casodex 50 mg daily (all at once),Zoladex shot once per month starting right now and 5mg of Finasteride daily or equivalent dosage of Avodart. This is if and only if he is hormone sensitive. If he is not hormone sensitive even the surgery will not work. It seems logical if this option was given he is hormone sensitive. His T and DHT will drop quickly and radically. All good. Forget the side effects.. nothing compared with if you do nothing but surgery.
The hormone number will plummet to castration range and go below that too.
Castrate is is 20ng per deciliter.My PSA went from 3 or 4 to .005.
And as is said here the castration will cause the same side effects. I did this for 18 months and would do it again to save my life. It has kept PSA low for 14 years.
Further the medical castration is entirely reversible. The surgery is not.
You can use Lupron as well. I used Zoladex. Either one.... its up to you.
Thanks a lot for this . I’m making notes and see how my dad react with the lupron shot
The chemical solution is reversible. If it comes to that, I'm keeping mine. Ouch.
Hello, Yes, He did not get his balls off. What do you mean that 98% are cause by viruses ? do you have info about it ? thanks !!
Progressing metastatic prostate cancer
Orchiectomy 
Prostate Cancer Second Time
Advanced Metastatic Prostate Cancer
Advanced prostate cancer
