SUPER fit 66 year old. Only symptom was slow urine for past couple of years ( assumed due to age ). Take NO meds and have NO medical conditions. Went to for testosterone pellet for better daily gym weight lifting and running and had a PSA of 100. WTH?
Then the journey started. MRI showed Pca and some regional (2) nodes affected. Gleason of 9. ALL other scans negative. Took 30 days casodex and just got second Lupron depot injection. PSA now 2. Will repeat all labs and scan in November. Plan is RT for 5 weeks.
Questions:
Treatment for hot flashes ? Treatment for no libido and no erections since first casodex pill ?
Any other advice is appreciated. Signed, Still in shock. Hoping for full recovery.
Your sex life is not over, unless you choose it to be, we still have sex 3-4 times a week. start thinking about orgasms' and intimacy as the goal, not ejaculation.
You should have checked for distant mets with a PSMA PET scan before starting therapy. If there are no distant mets, you will need whole pelvic radiation and at least 2 years of hormone therapy.
We have asked for a PSMA PET but oncologist does not feel need for that since PSA now 2 from 100. How sensitive is the PSMA and should we pursue getting one ? Radiation scheduled to start for prostate and 2 LNs in November. Would think we should know before RO starts in case some smaller areas need zapping.
It's not for "zapping," it's for futility that you should know. If there are distant metastases, there may be no need for whole pelvic radiation. You can still "debulk" the prostate with radiation.
You wrote "Radiation scheduled to start for prostate and 2 LNs in November." Just zapping the 2 LNs is a BIG mistake, imo. Once again, this highlights the importance of getting a PSMA PET scan to eliminate the diagnosis of distant metastases. If there are no distant metastases, you are potentially curableWHOLE PELVIC radiation and 2 years of hormone therapy. If you only zap the 2 LNs I can almost guarantee that you will not be cured.
PSMA PET was approved for high risk patients like yourself because it can find them. The longer you wait, the less chance that the PET scan will find any metastases, so it is a self-fulfilling prophecy.
The whole pelvic field was expanded last year. Make sure your RO knows that.
Your ability to achieve erection will likely be overtaken by the inevitable zero libido characteristic of ADT. You can work on getting it back later.
The Trimix does work well, but erections with no libido is a bit weird and definitely not for everyone. Just have to try it, everyone responds differently.
Your best defense against all the side effects is your fitness, but if by ‘fit’ you mean cardiovascular fitness, endurance good VO2 max etc that is good but you will need to lift also.
Whole body. No lifting on ADT spells trouble-rapid onset muscle wasting, usually accompanied by persistent fatigue.
If you already lift great, keep it up no matter what.
Hi. Just one I picked at random from lots of info online. Not that all is true in the depths out there! However links to this sort of report are in there too.Whilst this is actually reference prostatectomy....principle applies.
You didn't ask, but may wish to also consider taking the medicine, Tamoxofin or having your breasts radiated to prevent "manboobs". Many men, maybe all, develop gynecomastia as a result of ADT. I did and was unaware of the above-mentioned treatments when I began ADT 10 years ago. I guess I am vane, but I refuse to take me shirt off in public anymore because of my "manboobs".
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