Medical OR chemical castration

[Stevegr]

Hi All,

Ok I am 79 and still in great physical condition. PR and ADT for 2 years. To date no unusual physical side effects other than zero sex drive. It looks as thought I will be on ADT until I die. PSA increasing monthly so I will try other chemicals.

I want to remain in good shape until my number is up. My question is should I get medical castration to reduce the side effect of extended ADT injections or continue with the ADT.

Does medical have less side effects? I understand that I may also need a penal implant.

[Tall_Allen]

In a retrospective study, compared with those treated with GnRH agonist (like Lupron), patients who received an orchiectomy had significantly lower risks of experiencing:

• any fractures (-23%)

• peripheral arterial disease (-35%), and

• cardiac-related complications (-26%) .

• no statistically significant difference for diabetes and cognitive disorders.

GnRH antagonists (like degarelix or relugolix) seem to be more similar to orchiectomy than to GnRH agonists in cardiovascular side effects.

jamanetwork.com/journals/ja...

However, in a randomized clinical trial, fat accumulation was higher for orchiectomy :

bjui-journals.onlinelibrary...

Chemical castration may get testosterone levels lower:

ncbi.nlm.nih.gov/pmc/articl...

[Stevegr in reply to Tall_Allen]

I appreciate your feedback and as with life I will have to wait & see what I will eventually decide. The fact that I have had none of the side effects from ADT weigh high on my decision

[addicted2cycling in reply to Stevegr]

April 2015 my urologist began explaining the ADT Drugs that were my option. Before he could complete HIS JOB I stopped him and said "I did not want DRUGS put in my body, I wanted the offending BOYS REMOVED." 24 hours later my Orchiectomy was completed. Almost 65 then and 73 now with not a single regret.

caveat - My treatment doctor(NOT the urologist but Dr. Gary Onik) performed his job and in 2016 prescribed (contrary to SOC GL10 treatment protocol) testosterone injections.

[spencoid2 in reply to addicted2cycling]

so nice cycling without balls no regrets here either

[addicted2cycling in reply to spencoid2]

My longest nut-less ride was in 2016 of 307 miles in under 20 hours

[spencoid2 in reply to addicted2cycling]

how long would it have been if you were still nutted?

[LifeQuality in reply to Tall_Allen]

Tall_Allen, I'm wondering what the studies you cited here convinced YOU to do. Does it come down to whether you're more worried about fractures, arterial disease, and cardiac complications vs. fat accumulation and lower testosterone levels?

[Tall_Allen in reply to LifeQuality]

I didn't have to make that decision. Every man can only decide for himself, given what is known.

[billy1950 in reply to LifeQuality]

LifeQ,

Read your history…i had EBRT in 2004-5…i have a BCR…Did you have any side effects when taking Lupron ? Did you have your nuts removed ?

Billy

[Ian99]

Re your concern about bone health, you don’t mention it but a Dexa scan is usually recommended.

[Stevegr in reply to Ian99]

Yes I did all ok . Due for another this year.

[FourString]

Had my orchiectomy immediately upon diagnosis. Only regret is that I didn’t get on Estradiol patches immediately. Talked my MO into that 5 yrs later.

[bean1008]

I’ve had chronic testicular pain since my RP in 2019. I’ve been so tempted to do the orchiectomy! My MO said I could drop the current Lupron (3 years now) but would stay on Abiraterone. And that the pain I’m having is likely nerve pain which could continue even if I had surgery…kind of like phantom syndrome. So I drug my feet on doing it.

[billy1950 in reply to bean1008]

Hi bean, Curious if you decided in having medical castration or still on Lupron ? If on Lupron, are you having any side effects ? Thanks, Billy

[bean1008 in reply to billy1950]

Hi Billy! I’m off all ADT drugs as of last February. Testicular pain is completely gone…coincidence? And as of last week my testosterone has gone from zero to 150.

Best wishes!

[j-o-h-n]

Try the Medical first, if that doesn't work go for the Chemical.....

At 79 years old you're asking about a penal implant? Excuse me sir, but I'll have what for you're smoking.........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 10/29/2023 3:14 PM DST

[Stevegr in reply to j-o-h-n]

No need for the blow either. I have been active sexually at least 2x a week up until I started the ADT 2 years ago. My wife is also close to my age & we live a very healthy happy life. We do not look or feel our age EVER and I believe this is due to not living in the USA for the past 35 years and never eating any fast or packaged foods. I have been very close to calling all this drug related therapy quits and letting the cards fall where they may.

[j-o-h-n]

Well Stefanos, I think you know I'm an American Greek and understand that eating Hellenic style is good for your "temper"..... Yiasou....

I will tell you a short and a real story/ using phonetic Greek) (which may make you smile). I was born here and spoke Greek at home (and went to Greek school in NYC) so my Greek was so/so "spasmena" (Broken Greek). Well we had a relative here in the US in his early fifties (Michali) a bachelor who decided to have a "proxenia" (arranged marriage /introduction in Greek) marriage with a woman he was fixed up with who lived in Greece. So he travels back to Greece, marries the woman and brings her here to the US. So one day that newly arrived woman (without Michali) visits my Meterra to meet her for the very first time.

So as I came home from school (14/15 years old?) I walked into the Living Room where that lady who just got married and my mother were having Turkish coffee. So as my mother taught me to be a well manured Greek boy I said hello to the woman and I meant to say "pous kannie oh Michalis? (what's/how is Michalis?)" however I added one little word that changed the whole sentence/meaning of what I meant to say. Instead I said "pous "TO" kannie oh Michalis?" .

The woman stood there aghast as did my Mom. And me standing there trying to figure out what did I say that was so bad.....Anyway take care and to Ms. Stevegr "pous TO kannie oh Stefanos?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 10/29/2023 5:43 PM DST

[Stevegr in reply to j-o-h-n]

Yes, I can REALLY relate to that as I still do the same even after all these years. Nice to hear from you,

[billy1950 in reply to Stevegr]

Stevegr,

Would like to know what you decided? I have my doubts about either way to go…

Thanks, Billy

[Stevegr in reply to billy1950]

I will go medical for now. I just started Xthand today so time will tell. My wife doesn't want to hear about not doing anything to stay alive. Ha Ha but HOW ALIVE is the question