Starting ADT

[Tied2work]

How soon after starting ADT can I expect to see side effects?

[6357axbz]

In my case it was between 1 and 3 days if I remember correctly. Hot flashes

[tallguy2]

Within a few days to week. You will most likely have hot flashes and sweats.

I use the generic antidepressant venlafaxine to minimize those side effects.

[BigTom123 in reply to tallguy2]

TallAllen, did it work?

[Tall_Allen]

There is no timetable. I've seen guys have no side effects.

[Schwah in reply to Tall_Allen]

You’ve seen guys on ADT they did not even lose their sex drive?

Schwah

[doc1947g in reply to Schwah]

I do not think that he meant for the sex drive,The main effect of ADT id to stop the testosterone which will stop the libido.

I started to have hot flashes 3 months on ADT.

I was stopped after my secong 3 months injection as my PSA went to <0.03 µg/L and 11 months later is <0.01 µg/L which is my NADIR.

[Tall_Allen in reply to Schwah]

One guy on another forum made an effort to keep things up with his wife. He had a penile implant and used a lot of porn. He also tried apomorphine and cabergoline. Estrogen patches may help too.

[Meadowbank in reply to Tall_Allen]

A cancer patient finishing radiation tteatement with a young wife was recommended Non-Surgical Treatments | Penile Injections on prescription in AU and it made a great difference to his life.

[Kentucky1]

I guess I'm one of the sensitive ones. Nausea within the first 2 weeks, now after almost 3 years, increased blood sugar, sarcopenia( lost 20 lbs), thinning of skin, easier bruising, swollen feet, some minimal cognition issues, lymphopenia, mild anemia. I'm also on abiraterone so some of the SE may be attributed to it. Also, had transient elevation of liver enzymes along the way which have now returned to normal.But sure beats the alternative.

[Hidden in reply to Kentucky1]

I just found the high sugar problem. My first a1c ever. 10. Took me 3 months to get down to 6.6 with trulicity. I’ve stopped the drugs trying to keep it down without them. October 14 will tell the story

[Hidden in reply to Kentucky1]

Lupron plus imrt plus Tak -700 put me on my belly but fortunately it stuffed my pc back into it’s ugly hole . For now .. beats pushin daisies! ✌️😎

[Kentucky1]

Forgot the hot flashes

[dac500]

As TA points out there is no timetable. However, most people on ADT start seeing side effects within a few days.

In 2016, a few days after my first Firmagon shot I had the most intense hot flashes, sometimes 20 times a day. I was on ADT for nine months from October 2016 to April 2017 during my cyberknife treatment for an extra-capsular recurrence.

From November 2018 I am on Lupron for my metastatic disease with two breaks. First break was for nine months and I am in the middle of a second break since June 2021. My major complains included hot flashes and fatigue. I never saw any increase in weight. My mild anemia started before my ADT treatment and didn't change much during ADT treatment. I find my side effects tolerable.

[Meadowbank in reply to dac500]

Coming off 30 radiations to my postrate with no side effects except bad bladder control then put on Lucrin 22.5 mg 3 monthly injections my side effects were similar with tiredness, hot flushes 6 times a day in summer in AU and had to carry a hand towel to wipe the persperation away, this all happening a few days after receiving the 1st 3 monthly injection, 2nd lot of injections i had no side affects except tiredness and now on the 3rd lot injects i note minor hot flushes now and then only but still tired of a day. Gained no weight from the Lucrin up 2kg since in 2018 getting first 2 primary lung cancers, the Chemo actually shrunk the prostrate and my Oncologist thought all safe, still on immunotheropy the prostrate expanted and went to the bones. For depression I started taking anitriptyline 25 mg tablets with great surcess and Doubluts to retrain my blader

My other medication I recommend is Eat vegatables and 1 good meal daily, exercise and smile,

I wish all good luck with your chalanges but keep smiling no matter how unwell' it does work .

[mrscruffy]

Didn't have symptoms for 6 months. First to appear was hot flashes but was unaware because I live in AZ and life is one giant hot flash. The others came shortly there after

[Boywonder56]

7 mos......but if you start excersisng...can be delayed some....but lifes gonna change..

[Wassersug]

Many ADT side effects are age dependent and influences by aspects of one's overall health beyond just PCa status. I've talked to men who have claimed that they have had none (usually over age 80) and those who believe they have had them all (usually under 55).

Also the drugs make a difference. The side effects will come on faster if one is starting on an LHRH antagonist, like Firmagon. They will emerge slower if one starts on an LHRH agonists, like Lupron or Zoladex, and has had a couple of weeks of the anti-androgen Casodex before that. [See LIFEonADT.com]

Richard W,

[No17]

In my case 4 to 6 weeks, dizziness and fatigue mostly. Hot flashes started around 8 weeks It kind of flattened after 4 months

All the best. Hang in there !

[EdinBmore]

As noted, impact of ADT varies significantly among us; number of side effects, intensity, duration. For me, side effects kicked in within days and new ones reared their ugly heads as time went on (towards the end of treatment, joint pain became prominent. Even had a trigger finger.) Name a side effect, I had it. And, they lasted for more than a year after the last injection. I was not a happy camper. And, some of the side effects linger - increased wt, muscle mass, increased BP. The only thing that seemed to help was exercise; high impact plus treadmill (an appropriate metaphor, methinks). T never returned to pre-treatment level and pre-treatment level was nothing to write home about (250ish).

But, you may be one of the lucky ones who escapes all of this. Good luck to you.

EdinBaltimore

[Tied2work in reply to EdinBmore]

How long were you on ADT?

[EdinBmore in reply to Tied2work]

One month of Firmagon. Then, 3 three month injections of Lupron (btw, I chose 3 mo injections because I felt like I could endure anything for 3 mos. Some men choose longer duration injections; fewer doc trips and a "get it over with" mentality.) The last injection was in May 2019. It should have started to lose its potency in August 2019. I really didn't begin to feel better until Aug/September 2020, but the residual side effects lasted into the winter. Many men weather this much better than I. I hope that you're one of them. You did not ask about sexual side effects but they, too, were pretty devastating for me: zero sex drive; genital shrinkage (which does not return, btw); lower T; hair loss - not on the head but pubic, arm pit, legs. Perhaps what made this so difficult was how quickly it all occurred and how it was made worse by the emotional roller coaster that accompanied the physical changes; depression, despair, numbing fatigue. I hope you're one of the ones whose experience is much better than mine was.

EdinBaltimore

[ck722]

3 weeks here.

[fireandice123]

For me the side effects started in about a month. Hot flashes first. Then slow but steady weight gain - about 15 lbs this time. This is my second bout of ADT and I gained close to 30 lbs during the first round which I quickly lost when my ADT vacation started. I had increasing fatigue as time went on. Not exactly debilitating fatigue but strong enough to affect my activities. Very annoying.

[Magnus1964]

Everyone responds differently. I remember my first night on xtandi. I woke up drenched in sweat.

[JPnSD]

Took a few weeks before the hot flashes set in at the intensity that they remained.

[London441]

While everyone does respond differently, it is not purely random, not even close. If you are overweight, or diabetic, or have high blood pressure, or circulatory issues, heart disease, a poor diet, excessive alcohol intake or undue stress you are much more susceptible.

Fatigue, muscle wasting, fat gain, increased blood sugar, mental fog, hot flashes, bone density loss, all of it.

If you do not exercise, you are much more susceptible also. If you do cardio but do not lift weights you will lose strength rapidly and gain fat. This will create or exacerbate all the side effects also.

I took ADT, chemo and abiraterone simultaneously flowed by radiation post RP as part of a clinical trial. I had very little problem with side effects.

In addition to the exercise, a poor diet or even a good diet can be a problem if you don’t watch your intake due to slowed metabolism. This is another reason exercise is so important.

I talk about it all the time, and you will see it referred to in some of the comments. I still don’t think it’s talked about enough for a question like yours.

You have a excellent chance to greatly reduce or or even eliminate ADT side effects with dedicated exercise habits. If you are starting ADT and are sedentary you are headed for trouble, that is basically inarguable.

If you exercise already, do more. ADT is swimming upstream. Even moderately good prior habits are not enough.

Exercise works! It’s the most important of all factors by far. Admittedly not easy, but totally in your control. If you want to thrive on ADT it’s non negotiable.

As Dr Mark Moyad says, if exercise were invented as a pill, it would win the Nobel Prize tomorrow.

[leo2634]

I've been on it four years now the side effects are many and lifestyle changing for sure but the key word there if Life ! If you keep active and fight it the side effects become tolerable. Never give up Never surrender. Leo

[j-o-h-n]

Soon...............

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/20/2021 7:24 PM DST

[Hidden]

Some say that they never had side effects ..I think that is rare.. ? I did . I walked out the icu after a week with tubes a foley and 3 bags to carry . Walked next door got my first shot and #4 dx at the same time …. Adt and imrt put me into a clear status for six years now . You’re not in that condition . I was able to lift more than 10 lb for 18 due to the tubes into ach kidney? I got hit hard by sarcopenia = lost all muscle , then osteopenia . Both painful . If you can work out often and do weight bearing and cardio often, then you might stave off these two complications . Adt use drives heart and bone depletion . Stay strong and active when you feel least like it . Without t there can be a lack of drive or ambition to workout . Lethargy and fatigue put me down my first years .. Good luck ! Scott

[meowlicious99]

fatigue starting ~ 3 weeks.

[Joecarver]

I had fatigue, brain fog and sudden diz,y spells. Feels as if a faucet running and somebody turns it off for 60seconds then slowly turns it back on, scary feeling.

[gamemaster34]

For me it was a week or two. Yes fatigue and hot flashes. It's manageable if you stay busy and have a fan blowing on you while you sleep at night.