It is permanent. If, down the road there becomes a treatment that allows us to live a quality life without the side effects of current Hormones, Chemo, Radiation, Immuno therapies (in any order above), then you would not have the ability to return to former Testoserone glory. On the other hand, it is much less money. And, from what I understand, is effective at lowering Testoserone. Maybe first investigate any National Financial Assistance programs that will take you until age 65 and Medicare which is 80/20 on expense?
I have had both. I had an orchiectomy back in 1992. I had some regrets at first but I am good with it.
Xofigo is not as bad as it sounds. And it worked for me.
The orchiectomy will stop the need for all of the gonadotropic meds. You may still need zytiga, casodex or xtandi in the future. There are organizations that will help you pay for these drugs.
I had Orchiectomy after about 6 months of Eligard injections. For me, I feel much better now, than on injections, hoping for fewer side effects in years to come.
It is irreversible, but after years on injections your testes are about dead, they aren't coming back. Testosterone patches are cheap.
I had an orchiectomy to avoid an endless series of Lupron injections. One and done. For those on permanent testosterone suppression it is a cost-effective solution. It is a minor surgery, and most people recover from it easily. There's a psychological impact, and a lot of men can't deal with the idea.
Low dose estrogen can mitigate the side effects of having no testosterone.
All the best to you! It's a tough disease when this step becomes a good option!
Where would be a good hospital, etc. to have an orchiectomy. I had thought that even with surgical castration one sometimes need to take some hormone therapy meds??? Thanks,
If you are anywhere near Toronto, I can recommend Dr Yonah Krakowsky, at Women's College Hospital. He does about 3 or more orchiectomies every day he is in theatre. He is a Urologist specialized in Trans gender surgery.
This is my hint, to find a good Dr, for Orchiectomy, look up your local Gender reassignment surgeon.
If you have advanced Stage 4 disease such that you have no hope of remission and taking a holiday from ADT, or you must remain on ADT for a long time => 3 years then it is not a bad choice.
You will have the side effects of no testosterone but the ADT drugs do bring their own problems that you will avoid.
If your case has the possibility of moving towards remission, or you may not have to endure extended ADT, then it may be worth considering keeping the lads. Having some testosterone has beneficial effects in terms of overall health and some men do feel happier with the old jungle juice in their veins.
My sexuality has not really recovered after nineteen months of Firmagon but eighteen months later I feel more alert, fitter, etc as my testosterone levels have pushed back into the lower end of the normal range.
I have a photo of me after twelve months on the drug and I look like old man Steptoe from Steptoe and Son, UK TV drama, now I look more like a 60 year old, my real age is 58.
Yes, the effects of Lupron, Firmagon, orchiectomy, etc are broadly similar as they reduce testosterone to the castrate level < 10 ng/L , however it is noticeable that they all have their little 'twists', there is also quite a bit of variation from one patient to another.
A lot of doctors do not care about this, so they bill them as all the same, they have a tendency to a one size fits all approach to menopause as well.
Having Zero T is a disease all on its own, with the effects of muscle mass loss, Osteoporosis, etc, but if you have the Luprolide shots in addition, it is another layer worse.
CS, if i understand correctly, you had the ‘lads’ removed after being on ADT...wasn’t the ADT doing its job? Being doubling castrated seems like a lot...What are the side effects doing to you now?
At this point i don’t know much until i see the uro on Friday...IOWs, how are you doing?
Billy, yes I was on Eligard for about 5 months, at which time I decided lets drop the balls, discontinued injections. I am sure you have seen the reports, of less long term side effects from Orchie vs Luprolide. PSA dropped from 300 to about 0.1 in 6 months, which is great. Since Orchie, another 6 months, it dropped even lower to 0.01.
Brain fog much less, my mood is better. I think I have more energy now, but I still have significant fatigue. Penis is way better now. On Eligard my dick was dead. No response to sensual touch, just shrinking over time, same as my balls. Now it often responds to touch, and I get a mild erection. My wife plays with it every night in bed, lol. The Caverject works better too. I feel happy with my decision. After long period of ADT injections, Testes are basically dead, not coming back, hence the cut was my choice.
CS, I am facing the prospect of ADT and when i mentioned Orchie to the urologist, he said it’s not done that much now. With that said, as you point out above, i would be looking for the right doctor, hospital etc.. Didn’ talk about this with my RO...
I’m still not sure what direction i’m going in!
With the shots, as you did, i may stop if the SEs are too much.
My RO says he can do either monthly or 6 month shots... What seemed odd was that the shot dose either way would be the same dose -seemed strange hearing that...didn’t ask him why! Does that seem right to you?
Anyway, What the heck is the Caverjet?
Thanks...
P.S. you’re a lucky guy, I don’t have anyone to play with my balls at night...🙂.
I took the monthly Eligard shots, not the 3 or 6 month versions. I had no problem with these shots. But there is a report out that shows the 3 and 6 months versions take much longer to wear off. I think the huge dose of drug, just causes higher variations, than a steady delivery of a small amount every month.
Choosing between Shots, or Orchie, unfortunately it is not a landslide win for either argument, if you are going to be on it for life. Orchie in my mind has an edge, due to lower side effects. In particular lower risk of fractures, and some benefits in heart problems. Don't be fooled into thinking Luprolide has no side effects of its own. The side effects of Luprolide are masked by the intended effects of ADT.
Anyway, for me my pens is much more alive again, which is a good thing. Having a response when my wife plays with her toy, is a good feeling.
Caverject is an injection for an erection. I don't use the thick needle that comes in the box. I use a very fine Insulin needle, and with a nice new needle, I have very minimal pain on injection. I have the dose dialed in now, so I get a good erection that is hard but not like steel,( Painfully hard) that lasts around 45 min.
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PSA down but mets increasing?
Psa down on no intervention 
Orchiectomy 
Orchiectomy
