I think this is in my profile, but: Gleason 8 (4+4), RP done 5/2022 showed ECE and a positive lymph node. PSA rising by 6 weeks post-op. ADT started 8/2022 and he had radiation 9-11/2022. After some ups and downs with his liver values, he is currently taking Orgovyx, Abiraterone, and Prednisone. PSA and T are undetectable, and he is doing as well as can be expected.
Now, my husband is in “cruise control” mode (his MO’s words). We’re of course hoping that at some point he’ll get to come off ADT. He had been taking Cialis back before radiation, but I think his RO told him to stop it. Someone did, we can’t remember if it was urologist or the RO. Anyway, since there’s still a ways to go on this ADT journey, I wanted to see if he should be back on Cialis again. We saw the MO this week, but he didn’t know anything about using Cialis/Viagra to maintain penile blood flow (he says penile atrophy & loss of blood flow shouldn’t be a problem for my husband, who is 54 and otherwise in excellent health??) but would be happy to prescribe if he found some literature. Or, hubby could go back to the urologist.
My husband does have a pump, but doesn’t use it much. Does anyone have any papers that show the meds improve blood flow, or should we just make an appointment with the urologist or ED clinic associated with it? Or, any other suggestions? I tried to do a search, and couldn’t come up with anything that showed it preserved blood flow. We’re not currently trying to use it for intercourse.
Thanks, everyone!
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Tigger2022
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OK, thanks. I found this article on my search, but was wondering if there was anything newer, or with Cialis. Do you know why it seems like many men are taking Cialis/Viagra but there is little research to recommend this practice? My husband’s MO sounded like he’d literally never heard of someone taking it, and MO did not seem concerned that he would have atrophy. Felt that because he was “young and healthy” that it would bounce back right away.
I'm mid 50's, started on the same Org/Zytiga/pred treatment in January 2022, have undetectable PSA and T, and work out regularly. I have experienced significant shrinkage. It is only thanks to this forum/group that I was made aware of Cialis benefits and just recently started taking it.
Cialis can help, I can’t imagine why he would be advised to not take it. Penile rehab matters more, and the cialis pairs with it much better than alone. Sexual function on ADT is a challenge, especially for those who experience significant loss of libido (most). It’s hard work but well worth it if it’s important to you. Great luck to you!
Totally makes sense to me, but I wonder where are the actual research to recommend it. Is it just something all urologists know and understand? We haven’t seen my husband’s urologist since the post-op visit, when he was running super late, and just dropped the bomb of the 0.94 Decipher score on us, and the “don’t worry, there’s lots of treatments that can be done when it keeps popping up in the future” when we were still hopeful for cure. Ugh. Anyway.
Many urologists do not know and understand, often by their own admission. I suggest seeking out a urologist who is also a sexual health expert if you are invested and can swing it. Dr Rachel Rubin in the Washington, D.C. area is but one example, one I know personally.
The contrast between a rushed urologist who tells you 'lots of treatments can be can be done' on his way out the door and one who specializes in sexual health and will take their time with you is as obvious as it sounds!
It is well known that a low does Cialis/Viagra helps with penile health. Why he was told to stop is not correct unless there are issues associated with taking it. Yes he is young, but that will not matter when he has been on ADT for a while. And the changes may be permanent. He should use the pump often. I use mine at least five days a week and it really helps. I take daily Cialis and have noticed a better blood flow. You can also take the Cialis at regular strength at anytime and enjoy!
daily low dose cialis helps by maintaining “natural” nocturnal elections. Those regular erection are necessary for penile health in EVERYONE. I wish doctors would just say “I don’t know” when they don’t know
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