Considering orchiectomy?

[Woodman33]

I’m considering an orchiectomy instead of continuing expensive medical castration treatments. Any advice/experiences with one vs the other? I’m 71 and Gleason 7/8.

[Magnus1964]

I had an ochiectomy back in 1992. At that time it was one of the only options. At first I regretted it. But I am good with it now.

[Woodman33 in reply to Magnus1964]

Thanks for your response 😁

[Shooter1]

Best decision for me. No more lupron for life with my Gleason 9/10, wide spread cancer.

[Woodman33 in reply to Shooter1]

Thanks for your feedback!

[MrDon2]

I am seriously considering the same procedure as I am 73. Still seeking information.

[Woodman33 in reply to MrDon2]

Good luck with your decision! I think, based on these responses, I’m going ahead with this procedure.

[Tall_Allen]

The big difference is that after orchiectomy, you can't take a "vacation." Other differences are below:

In a retrospective study, compared with those treated with GnRH agonist (like Lupron), patients who received an orchiectomy had significantly lower risks of experiencing:

• any fractures (-23%)

• peripheral arterial disease (-35%), and

• cardiac-related complications (-26%) .

• no statistically significant difference for diabetes and cognitive disorders.

jamanetwork.com/journals/ja...

However, in a randomized clinical trial, fat accumulation was higher for orchiectomy :

bjui-journals.onlinelibrary...

Chemical castration may get testosterone levels lower:

ncbi.nlm.nih.gov/pmc/articl...

[Woodman33 in reply to Tall_Allen]

Very helpful response...Tall_Allen! Thank you!

[Hidden in reply to Tall_Allen]

Great info ! Thanks

[JWPMP in reply to Tall_Allen]

Does this surgery prevent the cancer from becoming castration resistant? Or is it an option to avoid the side effects of ADT? My husband had testicular cancer 29 years ago and had one side removed. He is 65 now. Wondering if there would be an advantage to finishing the job now. It has not even come up in conversation. He is Gleason 9, and 2 suspicious pelvic nodes, seminal Vesicle Invasion. CT scan and Bone scan clear. PSMA scan next week. His PSA dropped from 51.3 in December to 0.8 in April on Lupron & Abiraterone

Thank you

[Tall_Allen in reply to JWPMP]

No, it does not prevent castration resistance. Most of the side effects are due to lack of testosterone.

In your husband's case, cure is still a possibility so orchiectomy makes no sense.

[JWPMP in reply to Tall_Allen]

Thank you.No sense in bringing it up then.

[Hidden]

I did it last December…age 56. It sucks, but better than a lifetime of shots…at least in my humble opinion. I’ve already physically lost so much because of the diagnosis almost 4 years ago.It’s nice not getting those shots anymore…especially when going through chemo as I am now.

I figure if I’m ever lucky enough to get a “break” I can get a prescription for testosterone.

[Woodman33 in reply to Hidden]

Thanks and I pray that you handle the chemo treatments well!

[greatjohn]

The surgery was a breeze ..the night after surgery I felt slight discomfort, but by the second or third day I didn’t even notice anything was missing. It was great to get one piece of treatment eliminated.... Freeing up more time to “enjoy the day”

[Woodman33 in reply to greatjohn]

Very helpful response! I’m pretty sure I’m going ahead with this procedure!

[addicted2cycling in reply to Woodman33]

Woodman33 -- 6 YEARS AGO LAST MONTH my wife and I sat down with my urologist on a MONDAY MORNING to discuss my biopsy and scan results. BLAH + BLAH +++ you have a choice of types of ADT ( BTW - back then I'm almost 65 AND dx GL10) He begins to explain the differences in ADT reaction times AND I STOP HIM MID SENTENCE and tell him I WANT AN ORCHIECTOMY. but--But--BUT!!!! with his mouth wide open, THAT'S WHAT I WANT and a few hours later I was at the hospital for Pre-OP tests with the BOYS GONE before 24 hours passed.

Best thing I did and never any unexpected side effects. BTW -- getting my bicycle ready for heading out around MIDNIGHT for an age distance ride of 71 miles or more before the sun comes up. (caveat -- I am an experiment of ONE regarding treatment having had Cryo + immuno injection +++ TESTOSTERONE INJECTIONS every other week since Jan. 2016 )

GOOD LUCK

[Woodman33 in reply to addicted2cycling]

Thanks and good luck with your 71 mile ride!

[treedown in reply to Woodman33]

He doesn't need luck this is a short one for him.

[noahware]

The only reason I would not do this is I plan to try intermittent ADT rather than continuous. If you are committed to a "Lupron for life" approach of staying on ADT for the duration, then I cannot see why surgical castration wouldn't be the better option: cheaper, easier, and "one-and-done" peace of mind.

Even if you change your mind about the zero-T approach, you can always consider adding back T (or estrogen) by way of gels, patches or injections.

[lespaul123]

I was considering this procedure - it was taken care of by my ex-wife's attorney...

[Woodman33 in reply to lespaul123]

Hah! Love the humor!!😀

[Hidden in reply to lespaul123]

😂👏🏼

[VCinTx]

I am 1/4 thru my radiation treatments (with a Gleason of 6) and I have agreed to be on ADT for a total of 2 years. After six months of PSA testing, if it is increasing I will get an orchiectomy. I don't want the possibility of early Dementia or early onset Alzheimer's.

[Woodman33 in reply to VCinTx]

See Tall_Allen’s response to my post...he states ADT vs Orchiectomy found “no statistically significant difference for diabetes and cognitive disorders.” Thanks for your feedback!

[addicted2cycling in reply to VCinTx]

VCinTx wrote >>> " ... I am 1/4 thru my radiation treatments (with a Gleason of 6) and I have agreed to be on ADT .......... I will get an orchiectomy.... "

Seems pretty intense for GL6 😕. Good luck.

[treedown in reply to addicted2cycling]

I was thinking that as well but I am just the next step up G7 (3+4). PSA real high at 156 though.

[addicted2cycling in reply to treedown]

treedown wrote >>> " ... G7 (3+4). PSA real high at 156 though."

Must keep in mind that PSA level is only 1 piece of the equation especially since it does not have to be PCa related.

[j-o-h-n]

Caution: You'll have to change your UserID to Woodwoman33.....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 05/05/2021 10:47 PM DST - Cinco de Mayo

[Woodman33 in reply to j-o-h-n]

Good point 😜

[addicted2cycling in reply to Woodman33]

me thinks that *WOODEUNUCH33* wood bee more apropos

[Woodman33 in reply to addicted2cycling]

Like it even better than Woodwoman!! 🤣

[elvismlv123]

its not necessary to do it. and I dont know how effective it is.