I have metastatic cp to the bone. I have been on Lupron Xtandi and Hi dose Vitamin C for the last 19 months my current PSA is <0.1 and has been for the last 6 months. I am 83 years old and am in reasonable good health, other than pc. I have read that having an orchiectomy would yield longer life. Also I could get off of Lupron.
Please give me your thoughts on having the Orchiectomy. Thank you
pubmed.ncbi.nlm.nih.gov/212...
According to this article, they’re equally effective, neither is better at prolonging life.
There’s no scientific evidence that it improves quality of life, but some of the more vocal guys here who’ve had one insist they feel better with no testicles than they did on Lupron.
Orchiectomy may be a less expensive route if survival is expected to be longer than a year. That’s from the article, but I would say that probably depends on what your insurance is, and if you have co-pay or out-of-pocket.
At your age orchiectomy might make sense just for convenience, but keep in mind it can’t be reversed, which is why I personally can’t understand why anyone under 70 considers it. Getting the orchiectomy removes any chance of an ADT holiday if your disease progression might allow it. Also, it would be a damn shame to have your testicles removed, and then, a year later they come up with a cure. Granted that’s not likely but I wouldn’t take that risk.
From the article conclusion:
Conclusions: According to available studies, there is clear evidence for the equivalent effectiveness of LH-RH analogues and orchiectomy. Until now the studies - due to immense methodological restrictions - could not supply sufficient scientific evidence concerning the aspects of quality of life. In cases of a remaining life expectancy of more than one year, the orchiectomy is the more cost-effective alternative of therapy.
I enjoyed reading your response. I am 63 and my MO says I’ll be on ADT for life. Orchiectomy is something I’m thinking and studying on. I understand your point about ‘what if they find a cure’. With respect, I don’t ever remember a time in my life that a cancer has been cured.
No it doesn't give you longer life. It gets you off Lupron and its side effects. For me, still have some hot flashes on rare occasions but glad to be off Lupron. Of course I'm still on ADT (Abiraterone) but one ADT vs 2. I have no regrets.
No longer life, but a lot less itching.....
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 11/22/2023 11:00 PM EST
GL144 says if they come up with a cure. That's not going to happen in any of our lifetimes. Also, you can get TRT if it does happen. I'm considering it too.
I’m considering it. Mainly because after DXed with PC 2017 I was diagnosed with NHL on 06/2023. Left testicle was removed, followed by six cycles of R-CHOP. chemo plus two cycles of CNS prophylaxis. There is a risk of recurrence in the remaining testicle. So removing this one too would reduce relapse risk of NHL and would get me off Lupron.
Interesting. Probably the only treatment option I never hear anything about. Not sure why you'd wanna have surgery instead of your lupron injection every so many months. Chemical castration versus physical seems to be that trend these days
The Docs Never give it as an option
Hi Carplake. One SE of Lipton is it vastly reduces testosterone, which is candy for prostate cancer cells. Think of Lupron as a drug induced orchiectomy. When I had radiation for recurrent prostate cancer diagnosis at age 70, I was on Lupron for just 6 months. It cratered my T to well below 100 and my PSA became undetectable. Now a year later, my T is about 80, way below the normal range, and the PSA is still undetectable. So far, so good. I think it is best to avoid surgery because of unexpected consequences like infections. If you can tolerate Lupron and its SEs, that should give you the same result as an orchiectomy on your cancer without surgery.
Orchiectomy - Are you happy with the results?
Lupron vs Orchiectomy
Orchiectomy rather than chemical castration?
Orchiectomy--any considerations that might be overlooked?
