Handling Cognitive issues assuming fr... - Advanced Prostate...

Advanced Prostate Cancer

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Handling Cognitive issues assuming from Hormone Therapy

Yorkielover2 profile image

Doesn’t seem to be much addressing this subject. My husband has been on Lupron since 12/2016 then Zytiga till 5 months ago! Just had 4th treatment of Xofigo! his memory recall is not what it was. Gets some confusion when doing tasks! I don’t mention it now as he got upset when I tried to help! Do men understand this is happening or not! Is there anything that can be done? He is not driving anymore partly because of this. License expired so that helped.

39 Replies

Plenty of threads on this topic....there are some steps he can take...not guaranteed but may help.

1. Exercise...very important.

2. Plant based diet

3. Anti-depressants can help....I'm on lexapro..some take zoloft, etc....It helps with the mood and ADT side effects. (hot flashes)

Fatigue, IMHO, is the culprit and can be ameliorated with these 3 steps plus some others that members reply with....there may be supplement or two that may help.

Good Luck

Speaking for myself I do realize that there is some disruption in my thought process and memory . I write myself more notes and keep a written calendar along with the calendars in my tech devices. I have taken to asking for help from all who offer reminders on appointments and important events. With all of that I still forget little day to day things and I think like most of us I try to just gloss over it and if no one notices I generally don’t bring it up. My answer to your question is yes for me I realize my memory has been affected by my 2 years of adt. This disease and it’s treatments destroys physically our masculinity and mentally, emotional control and memory all of which for a time we can keep hidden but eventually all is laid bare and it isn’t pretty. Best wishes

Thanks! My husband is 74 Construction engineer very proud! I am working on slow responce when I notice.Strong relationship do not want cancer to rob us of this.

Bunkerboy profile image
Bunkerboy in reply to Caseykane1

Good answer. After six years now fatigue, memory loss, anxiety, very emotional, balance etc list goes on. My wacky sense of humour keeps me sane🤓. For now anyway👍🏻😳

Lulu700 profile image
Lulu700 in reply to Bunkerboy

Way to go Bunkerboy!

Couldnt agree more ....now for the labor day top 100

I’m 67 and only 11 mos into this. First on Firmagon and Xtandi, now on 3mos Lupron and Zytiga-pred. I often have issues finishing a sentence or remembering a place we just visited. Brain Fog/Chemo Fog are very common. Yes frustrating. Yes requires patience from our spouse. But we are all trying to live here. Tall Allen and PJ will add that there are one or two that do not cross the blood brain barrier, and may be worth trying. Best of luck🍀 Mike

Hello Yorkielover2 - My husband has finished his 2nd xofigo. He is exercising a ton but loosing too much weight. Plant based diet will not work and he will not consider an anti-depressant. I do notice and not on a regular basis that he does forget a few details and he tries to spin them on me that I did not remind him. I will try and do better by writing details down and see if this helps??? I do not let my husband drive at night. My husband is 60. How old is your husband??

He is 74. Very indepent and still working with our son in law who admires his knowledge in constrution projects. Yes agree wives have to walk softly! He know has a great Uber driver to take him where he needs to go! It helps him and me. Not sure what we do after Xofigo luckly no side effects from this! Good luck.

I am only 53 and since I began Lupron I do suffer from this every couple of days but then it goes away for a few days but always comes back now and then. I exercise and take Concerta (like Ritalin) and while this helps, it's not a 100% cure.

With regards to your husband, I think it is wise not to bring this up too often unless he becomes a danger to himself or others.

He probably feels very diminished and hurt by his condition. In programming meetings I used to be the smartest guy in the room and now I often find myself unable to concentrate so it's a hard pill to swallow. My wife and kids are demonstrating a lot of support when I get frustrated and (rarely) depressed by my new reality and that helps me so much. So my suggestion to you would be to provide your husband with as much emotional support as you can and to not remind him that he is a little lost because, believe me, he already knows that and is likely saddened by his condition.

Best wishes to you and your husband.


Thank you. Absolutly right. Doing all I can to make sure he is supported also great family helping.

Lulu700 profile image
Lulu700 in reply to Mascouche

Great response ! He knows! Great advice . Compassion

On this site, there have been several posts about Estradiol patch helping reduce brain fog and other ADT side effects. My doctors told me it would not hurt and might help. I started with .025 mg patch twice a week. After two months, I believe the patch has helped me a lot! Hot flashes have been reduced to manageable levels, and the brain fog is gone. To stay sharp I do Sudoku puzzles each day and play dominoes and card games with neighbors and family, who have noticed the recent improvement in my cognitive skills. Cheers William

Thank you will look this up.

VHRguy profile image
VHRguy in reply to lopwillie

Completely agree. I've no doubt made some of those posts. It works great for me.

I second lopwillie. Switched from Firmagon to Estradiol patches no brain fog after 10 months of ADT.

Try to get him to do aerobic and resistance training. There are numerous studies supporting the beneficial effects on body and brain. I can verify this in my own case.

Thanks! He walks always has! I think he is only person I know never stepped foot in a gym.

He doesn’t necessarily need a gym, but he does need strength training. Walking is not enough! The drugs will take his bone density away to the point of serious risk of fracture. You do not want this. The loss of muscle mass creates the fatigue and it becomes a vicious cycle.

Walking is good but pace, terrain etc must be challenging for best effect.

Strength training and cardio that keeps the heart rate at 70% of maximum or above will do more for him than all other solutions combined-this includes the cognitive impairment. The more he does, the more enhanced the effect.

Thank you. He has been on Exgeva also Calcium with D supplement!The saying comes to mind here You can lead a horse to water but can’t make him drink. Wish I could

Oh I know, and I am sorry to hear that. The Exgeva and supplements help with one thing, the exercise helps with everything and does a better job of it.

Sometimes a trainer can motivate…especially if he really knows deep down how important it is, but just can’t seem to get started.

Gentlemen! Look at the exchanges between wives! A good partner will do whatever’s necessary, it’s incredible. Do your part and exercise, it’s the least you can do. More exercise for you means less work for them, and you’ll be nicer too.

I certainly do what I can to make his life easier! All men fighting this beast are warriors Good luck to you all.

Lulu700 profile image
Lulu700 in reply to Yorkielover2

A typical male😂

I also have memory/cognitive issues from ADT. I’ve been on Lupron and Xtandi for about 8 years now. Exercise helps, Ritalin which was prescribed by my MO also helps with both cognitive issues and fatigue. I don’t put a lot of weight in supplements but I recently started taking Fisetin after seeing another person whom I respect post about using it here. After a couple months I seem to notice a difference, so maybe it does help? I’ll keep taking it in case it does. As always check with your MO before taking any supplements.


I’m 56 now, been doing adt for 10 years. 55 months solid on xtandi, Lupron, Xgeva, Megace. There is zero doubt I have been in a general cognitive decline. My wife of 32 years notices it bigly. Just a general loss of acuity, and it’s gradual. I did aerospace engineering for 31 years so kind of proud and not willing to give up so I pretend I’m just as sharp as I used to be but it’s getting hard to cover up. I’ve always been emotional but the longer I go now I can cry at the drop of a hat, so easily. But we fight on because life is worth it.

Lulu700 profile image
Lulu700 in reply to Survivor1965

Since 46? Wow You give hope to the newbies What an early onset? Ouch . You’re still a kid . Keep rolling ! 👍

I have short time memory problems.I'm on ADT (Trelstar), second 6 months.

I'm 80 and assumed it was just due to old age.

Lulu700 profile image
Lulu700 in reply to dixiedad

Probably not? 🧐

. Lupron or Luppeyron I call it ,did the same to me . Spacey then mad or frustrated at my failing abilities . I did shots from 15-17 .Then an orchiectomy that allowed me to drop the shots . No looking back and glad I did that . I think exersize helps clear everything out .. Take care 2

I learned to call both my wife and my girl friend "Honey".....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 09/04/2021 7:58 PM DST

MateoBeach profile image
MateoBeach in reply to j-o-h-n

My wife calls everybody, male and female alike, “sweetheart”. Should I be worried? No! Happy for her whatever that means. But don’t think I could get away with it. 😆💞

j-o-h-n profile image
j-o-h-n in reply to MateoBeach

No worry, she calls me sweetheart too.........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/05/2021 2:00 PM DST

j-o-h-n profile image
j-o-h-n in reply to MateoBeach

BTW sweetheart tell your sweetheart that anyone who calls everyone sweetheart must be a sweetheart.....So consider yourself a lucky guy.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/05/2021 2:27 PM DST

I have great difficulty in listening to my wife while attempting to do other things. In other words, multi-tasking is much harder. It's also somewhat humiliating for a man to give up his traditional masculine role and takes some getting used to. Give him time and try not to talk while he's focussing on something.

Thank you. Understandable how hard this is on men. Your insight does help. Stay tough ion your fight.

In addition to the other helpful and compassionate suggestions here, I want to second the idea of a trial of estradiol patches to see if that helps. It did for me, clearing at least 50 to 60% of my previous brain fog from ADT. Seems we need to have some sex hormones for optimal functioning. And if cannot have testosterone then estrogen seems beneficial. Does not adversely effect PC treatment for most. Just continue to monitor PSA

Thank you! My husband’s PSA is almost 500 We are not suppose to worry about that while doing Xofigo. Patches would probably be a hard sell to him. The Pallative care PA has started him on Mirtazapoine at night to help with sleep but it may help with other things.Thank you for your information. I do understand that we are on an uphill battle here as many are. Just want as much info as I can find to help him through with compassion and dignity.

Estradiol transdermal (skin) patches can help with the side effects of having no testosterone. Bone density, hot flashes, fatigue, mental fog, and many more.

I've been on them for almost 2 years now, with no testosterone, and I feel GREAT.

Something to talk to the doctors about. They'll be reluctant, for reasons that don't really hold up to scrutiny. You may need to talk to more than one doctor to find one willing to help.


Dr. Charles "Snuffy" Myers used them with his patients on long term ADT. His approach was to use low dose estradiol patches, 0.025 - 0.05 mg/ day patches, changed twice weekly. Post menopausal women aim for around 50 pg/mL blood E2, estradiol . Not total estrogen, but specifically estradiol.

It seems to be a bit "out of the box", but is not unknown.

Yorkielover2 profile image
Yorkielover2 in reply to VHRguy

Thanks! I have his book. Will look at it. Never know.

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