I have no plans to have an orchidectomy but I’m curious why some men do get them.
I get that it allows one to avoid needing the periodic injections. But as I understand it one still has to take something to deal with the testosterone that is still produced by the adrenal glands even after the orchidectomy. And there are still many of the same SE’s that are experienced with ADT.
Aside from avoiding the injections are there other advantages of getting one?
Are there certain situations that make an orchidectomy a preferable treatment choice?
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fireandice123
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I was told ADT for life. As a healthcare provider, taking a drug to stop production of something I can surgically remove didn't make sense. It's been almost one year for me. I feel my hot flashes are less intensity and fewer in number. I remain NED.
Everything that TA posted. Lupron is in my rearview mirror. Honestly, I wish I'd done it sooner. Erleada for the adrenals and yea, the side effects of that suck. There's no cure coming any time soon, certainly not in the next ten years that I can see.
8 years ago last month on a TUESDAY morning my BOYS and I hit the road on my bike's saddle for our last ride together. 5 hours after THAT RIDE they were gone and the resultant side effects were nothing compared to what I read about PLUS there were no chemicals taken to eliminate what their exit easily did.
Just so happens that my doctor of treatment choice believed in adding the Injection of Cypionate to return the *BIG T* once my treatment was done and that's what he did 9 months later. Having never read about the currently trialed BAT procedure, I began my own on-off-on-off-on---cycling of *T* when PSA dictated and after a recent time off that brought down my T<2.5ng/dL, I began injections again and will have another on Thursday and every other week with monthly PSA and *T* testing. NOT a true BAT procedure but it's my own experiment until I require something different should my GL10 returns.
Approaching 2:30AM as I type and I'm almost ready to head out for a 30+/- mile bicycle ride before the Sun rises
I am also a cyclist and do not miss my "boys" we were together for enough time and it was time to say goodbye. Two main reasons for my decision to have and orchiectomy: I live 4 to 5 hours from where I would get lupron shots. Some times possible to schedule with other visits but some times not. The main reason however is that some side effects (still have the effect of no T) are substantially reduced. These include cardiovascular effects and fractures.
My co-pay was minimal so cost was not an issue but why give big pharma any more than necessary?
spencoid2 wrote -- " ....... Two main reasons for my decision to have and orchiectomy: I live 4 to 5 hours from where I would get lupron shots. Some times possible to schedule with other visits but some times not. The main reason however is that some side effects (still have the effect of no T) are substantially reduced ...... "
That's 2 very good reasons. 👍👍
A couple of my reasons -- Quick 10 pound weight loss *5lbs /ball :0)* so hill climbing was much faster and without those suckers hanging around my saddle time was lots more comfortable on a typical 100+ mile ride.
Mine have been gone 4 years now, and I'm very pleased. Eliminating the fuss and expense of Lupron or its kin, plus reducing side effects (as noted in TA's link), made it a solid choice for me. Either way we deal with loss of T, but by surgery there are no side effects due to any ADT drug.
With a recurring case of locally advanced G9(5+4) that was treated by ADT and IGRT originally, I was looking at a lifetime of ADT in some way. I never enjoyed the Lupron shots, and the cost is astronomical (even if covered by insurance).
I asked my oncologist why the surgery is rarely done, and he said it's mainly because guys just would NOT do it! It's a lot to wrap one's head around, but ADT is chemical castration anyway. I'll also admit some cynicism, in that pharmaceutical companies and doctors make a LOT of money injecting people with ADT drugs for years.
I also take estradiol by skin patches to offset the loss of testosterone. Primarily it's to protect my bone density (severely affected by my original ADT course). Also, to relieve the many unpleasant side effects of losing T (I can scarcely believe just how good I feel, no hot flashes, good memory, plenty of energy, strangely enhanced sense of smell, and more). Dr. Wassersug has videos about this estradiol (active part of estrogen) backfill concept.
My PSA was 0.008 ng/mL at last check, and has been <0.1 since the boys were evicted. So for years now I have felt great and kept a nasty PCa case in control.
Oh my, sorry I missed your question here. I got my first breast enlargement when the Lupron wore off. The sudden rise of testosterone apparently triggered my sluggish body to metabolize some of it into estrogen, causing (to me) pretty noticeable growth.
A couple years later, after orchiectomy and starting estradiol, they did grow some more. So... yes indeed I have had breast enlargement. Now, about half the guys over 50 have some degree of that anyway, and I'm not chasing girls on a beach either. But still, yes, it is a potential side effect. I'm not comfortable even in a locker room without a shirt on anymore. They're... quite noticeable.
Now that I'm past all the treatments (there is 30% chance Pluvicto might add 3 months if it becomes available again) I'm so glad I don't have to take Lupron shots any more. I do do Xgeva every 3 months just to keep bone strength up. But now things are so much nicer without the SEs. Hot flashes are rare and last a minute or two -- nothing like they were before.
I hope this isn't a dumb question, but here goes.Is there any phantom pain after removal? The only reason my PC was found was because of testicular pain. After 4 hernia surgeries since my early 20's and some mesh shifting after RP 6 years ago my pain is back. It just feels like I got kicked. I finished radiation and a 4 month Eligard shot about a year ago, so far zero Psa. Testing again in September. I may consider this procedure rather than more Eligard if needed.
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