Managing side effects of ADT

[Scout4answers]

I have found that Richard Wassersug has many blog postings related to ways to manage ADT side effect on the LifeOnAdt.com website.

I also found the new version of his book has a great section on dealing with relationship issues. It was very helpful in keeping my relationship with Coco on track when I was having emotional mood swings.

[Mike1971]

Thank you

[joeguy]

Does he mention anything to help with frequently crying for no real reason? I suspect after years of ADT it has to do with having more estrogen than testosterone. Basically turns a man into a menopausal woman. It annoys the hell out of me.

[Scout4answers in reply to joeguy]

I don't know as that was not the issue I have been dealing with.

[Wassersug in reply to joeguy]

Joeguy,

What you are describing is called "emotional lability" and, yes, it is discussed in the new edition of the ADT book. How though did you decide that it was due to having more estrogen than testosterone? If anything, standard ADT with drugs like Lupron and Zoladex, lower both testosterone and estrogen.

I would be curious to know if the book is helpful for you in making what you feel is spontaneous tearfulness more tolerable. Feel free to message me individual if you want to talk about it after seeing whether the book helps.

Richard W.

[joeguy in reply to Wassersug]

Thanks Richard, the estrogen/testosterone comment was just a thought I had since ADT wipes out T and emotional things like crying are more associated with females. You have to admit with all the feminizing effects of ADT like growing breasts, it certainly sounds reasonable. I will certainly check out your book, but does it actually offer a solution to the tendency to cry will under the influence of ADT, or does it just discuss it as one of the potential side effects?

[Wassersug in reply to joeguy]

Hello Joeguy (et al.)

In the ADT book and elsewhere, where I have published on emotional lability and ADT, my coauthors and I don't offer an explicit "cure" for that side effect (SE). To get the endorsement of the book from the medical community that we have, the info the book provides is very strongly "evidence-based." In that regard, I don't know of any specific RCT that have looked at the suppression of emotional lability. However, as a theme for the book, the more one knows about the SEs of ADT, they more manageable they are. And we have published RCT data on that!

Some other comments:

1. When I see on this thread someone saying "I've had ADT SEs xx, yy, zz and feel overwhelmed by them" and someone else says, "Well, I've never had those side effects at all" I suspect that age is a factor. SE burden is typically greater in younger men. So, I encourage folks who are concerned about ADT SEs to tell us: 1) their age 2) how long they have been on ADT and 3) what ADT agents they are on....when discussing ADT's SEs.

2. ADT with only an LHRH agonists and antagonist drug, causes little gynecomastia. Anti-androgen monotherapy and high does estradiol are much more likely to cause some gynecomasita. [Again, this is covered in theADT book.] But it is an example of where it helps to know what drugs one is on to make snese of postings here that discuss SE burden and SE mamagement.

I hope these comments are a bit helpful.

Richard W.

[joeguy in reply to Wassersug]

Thanks Richard,

I am currently on Orgovxy with Nubeqa, but I have been on most of the ADT drugs over the years with the exception of Zytiga. Had to discontinue Firmagon or Eligard with Xtandi years ago due to toxicity to heart and cognitive problems. I have been mCRPC for 5 years, so ADT seems to have little effect on the cancer these days.

[Wassersug in reply to joeguy]

Joeguy,

That is rough. Sorry that you have had to go through so much in trying to manage PCa.

If the ADT book doesn't provide the help you are looking for managing the emotional and psychological side effects of ADT, feel free to message me privately. We can then find a time to talk about other options.

Richard W.

[Leeroy21]

Seems side effects effect each one of us a little different. It's been 2 years since 44 radiation treatments and 3 lupron injections and Erleada (3 months). My emotions are much better ( I think) ... I still have hot flashes/melt downs (sweat) through out of the day and night. I take oxybuten (sp) for sweating. It helps some. Oh yes......when I have a flash, it makes me pee...doctors don't seem to know why??? I exercise and eat well. I'm not over weight. I kept hoping these life changing effects will end... It gets very discouraging..... I'll will keep fighting.... what choice do we have.. best to all in this war.. On a good note treatments are working, PSA .447, (Gleason was 9, PSA was 37.)

[RayF in reply to Leeroy21]

Leeroy 21, I called them heat bombs, I would sweat so much it would drip from my fingers. The good news, after two years the hot flashes had mostly disappeared. Now at five years, I get occasional hot flashes very much reduced in intensity. Hopefully it will work out that way for you too

[Leeroy21 in reply to RayF]

RayF. Thanks for sharing. That's encouraging. I experienced all the SE's but a couple. One being death.....sorry not funny.... I know that I will not do Lupron again... My energy level varies from day to day..... my T is up from 0 to 178, low normal is around 200?? I read your bio, cool.. I'm 69, retired after 30 plus years at Kennedy Space Center. I started as a tech illustrator turned engineering CAD Jockey. Currently I spend a lot of time with my mother (92). I go to the gym so I have endurance to surf... It's physically demanding at my age. (any age) I'm into remote control, video/ picture drones, planes, cars, boats.... All good fun...take care, stay safe!

[joeguy in reply to Leeroy21]

How uncommon to meet a fellow technical illustrator considering it is now an extinct occupation. I was a tech Illustrator in the defense industry in Dallas back in the 80s..... I work as Manufacturing engineer these days..... 60yrs old, still working....

[RayF in reply to Leeroy21]

I'm turning 69 in a week. When I was diagnosed in 2018, I didn't think I would last a year, the docs were not optimistic. I told myself if I got 5 years, I would be very thankful, and I am. I've learned to plan for the short term and the long term.I workout in the gym, spin, walk, bike. Photography is my vice, new equipment is always coming out. I'm looking at the Nikon Z8 right now.

Edit: looking at the DJI Mini Pro 4, seems like a great starter drone.

[Leeroy21 in reply to RayF]

Yes to being grateful. Yes to Nikon Z8. Can't go wrong with DJI, go for it...

[Leeroy21]

Joeguy. Thanks for the shout out. I started out doing proposals. Typesetters, wax, pen and ink on mylar, fun times. Then the first Apple CPUs. We've come a long way baby...Did a lot of graphics for space shuttle and boosters etc. Transitioned into the CAD world. It's been a good run. I have a friend who does contract work using Photoshop, Adobe etc. Mostly proposals. He does well. I got to say I don't miss the rat race....keep the faith. We all got to go, but not today👍

[joeguy in reply to Leeroy21]

Oh yes, I used to do Isometrics of planes for military maintenance manuals. I remember the days of pen and ink on mylar..... just had to remember to put little pieces of tape under all your ellipse templets and triangles so the ink didnt bleed all over...

[Darryl Partner]

youtu.be/zYWbaEx4x4U?si=6BY...(Not working as expected?)

[swwags in reply to Darryl]

I was a bit disappointed in the video Darryl. I would have preferred a more structured series of questions in chronological order in terms of how ADT impacts us and when. The interviews seemed a bit circular. Love the guests and also enjoy the channel. This one didn't do much for me but I did buy and read Richard's book.

[Darryl Partner in reply to swwags]

Sorry to have disappointed you. Glad you like Dr Wassersug's book and the other (250+ ) videos on the channel. Many more to come!