I am 85 and stage 4 with bone mets. I am presently taking Nubeqa and ADT injections every 6 months. After over a year and a half, I am responding well to treatment, side effects are minimal and manageable and my QOL is good.
All that said, the idea is very appealing to me to have an orchiectomy instead of continuing Lupron. I would appreciate your insight about this… good idea or not, and why.
Hello,
At 85 responding to treatment well and your QOL is good why would you want to go through surgery? In my humble opinion an orchiectomy is not a good idea. Stay the course there are other options ahead.
If I may… there is evidence of decreased cardiac issues and fractures as compared to ADT. As for the surgery, that’s not an issue for me.
Actually, I should apologize for posting my question… this has been asked and answered several times. 😞
NO apology needed.
Soon to be 75yo and next month it's 10 years for the boys disappearance. Bicycled 101 miles yesterday and glad i have NEVER been on ADT meds.
Lighten the LOAD and go for it.
Thanks for the encouragement 😄
Today marks four years since I had a bilateral orchiectomy. I have had no follow up meds and very minimal side effects (hot flashes--which seem to be decreasing). For me (currently age 68) it was, I believe, the best decision I could have made.
I had the boys snipped a couple years ago. I don't miss the shots. I was stage IV was told ADT for life. Exercise daily, still work, (not quite 65), and I think the hot flashes decreased a bit. It was uncomfortable for a few days, no lie.
Congratulations on your status. I switched from quarterly Lupron shots to daily Orgovyx pills mainly so I wouldn't be tied to getting to a facility if I was traveling. Last month I stopped ADT, Lupron and Prednisone (an ADT vacation) to cut the side effects from those drugs. I really don't expect my testosterone to come back after 3 years on the stuff but I do have that option which I would not have had after orcho.
In a side note I had 5 months of Taxotere chemo which really booted my QOL and am eagerly awaiting those side effects to go away.
My shorter answer to you is, in your case, I would stay the course.
If they decide to give me a holiday, there's always patches. 
I still remember what the NCOs used to scream at us during basic training, it was:
"SOUND OUT LIKE YOU GOT A PAIR". I kept mine so I could yell at my ex-wife.🤡
Good Luck, Good Health and Good Humor.
j-o-h-n
I find this study very interesting. Seems to provide statistical support for the surgery:
jamanetwork.com/journals/ja...
Down in the report, we read:
Results Overall, 3295 men with a primary diagnosis of metastatic PCa treated with GnRHa or orchiectomy were identified between years 1995 and 2009, and in adjusted analyses, patients who received a bilateral orchiectomy had significantly lower risks of experiencing any fractures (hazard ratio [HR], 0.77; 95% CI, 0.62-0.94; P = .01), peripheral arterial disease (HR, 0.65; 95% CI, 0.49-0.87; P = .004), and cardiac-related complications (HR, 0.74; 0.58-0.94; P = .01) compared with those treated with GnRHa.
That’s a statistical advantage that’s hard for me to ignore
The ‘impossible to ignore’ statistical advantage of orchiectomy is understandable, and is a great option since you seem to have no potential misgivings about doing it. This is obviously important.
Hopefully you are also committed to regular exercise-both cardiovascular and weight training-which gives an advantage against fractures and CVD far more significant than method of castration.
Well, I have been committed since early last July to something of a “gym routine.” Three times a week (MWF) I go to the gym and do 40-minutes on a recumbent bike with moderate resistance (gets my heart rate up), and then three exercise machines; essentially for upper body. The weights are pretty light, but they are weights that I can do.
I think its great to have the boys removed.. I am a 29 year PC survivor & had it done in 2019 & have no regrets.. A couple of years ago I went to Froedert in Milwaukee & talked to a Doc who was an Onco & Hemo & a Professor at the Medical College of WI.. He told me I made a good decision to have the Orchy & that I will most likely live longer than the guys that are on long term Lupron.. He said those guys are coming in with various issues that make for a lessor quality of life for them & his dept is now recommending the procedure to patients even though they have to send them off to a Urologist to have it done.. Bye the way I'm now 81 years old & have been through 9 Doc. over the years but still hanging in there.. Good Luck
At 85 the risk of any surgery is greater than at a younger age. I ha my orchy at 67 and do not regret it. It was explained to me that it is simple surgery and low risk. Ask if it can be done with local anesthesia or a nerve block? I wanted to be conscious as it would have been fun to watch but that did not happen.
I understand your observations about surgery at 85, it certainly is a consideration. Maybe I am fooling myself, but I am in pretty good condition other than this cancer-s***. I have excellent blood pressure . No diabetes or other comorbidities. I will certainly discuss this with my doctor beforehand. Thanks!
Pinkyboy wrote -- " .... I am in pretty good condition other than this cancer-s*** .... "
How about some Orchieeee humor to lighten things up 😀
After my surgery the pathology report said no testicular cancer AND the Pathologist mentioned ---*I can officially confirm that 10 pounds of BALLS can fit in a 5 pound sack*
I am confused. Wouldn't the cancer continue to spread from the 4 bone metastasis. That is. these would have to be zapped or ADT continued.
I understand that, but you implied you still had 4 active bone metastasis and the ADTs you are taking may have only put these into senescence. My thinking is that unless these are killed off then they may shed further cancer cells into the blood stream. If an orchiectomy starved off active metastasis, we would all opt for it. I will certainly start looking into it. I'm 80 and fed up with the lethargy.
No, my introductory sentence in this thread said I am 85, stage 4 with bone mets. I didn’t state the number of bone mets because I don’t know; there are many.
My present treatment consists of ADT (Lupron or Eliguard to supress production of testosterone) and oral Nubeqa (an ARPI - androgen receptor pathway inhibitor - to keep any minuscule amount of testosterone from bonding to cancer cells). I have been on this treatment protocol for nearly two years and am responding well.
So, ADT supresses production of testosterone by the testicles, an orchiectome just removes the testicles. Different approach; same result.
ADT or Orchiectomy & side effects
Orchiectomy 
Considering orchiectomy 
Androgen blocker Vs ADT
