How long to recover T post-ADT?

[Handdrummer777]

Does anyone in my age group (I'm 68) have experience in T recovery after ADT concludes? I worry that it may take several years, which is depressing to think about. I know there's controversy over using T therapy in cancer patients, but there are some promising studies that show little increased risk of recurrence. I would be very interested in anyone's experience with this. Thanks to this group of caring guys!

[AlanMeyer Moderator]

As I understand it, the length of time for recovery is proportional to your age, your length of time on ADT, and your normal testosterone level. I had four months of Lupron (a 30 day injection and a 90 day injection) at age 57 as part of my radiation treatment. A blood test at five months showed that my testosterone was going up. At about 5-1/2 months my libido began to return. Maybe at six or so months I was feeling like I used to feel. You might require more time than I did at my young age and after only 4 months of Lupron.

Good diet, exercise, adequate sleep, and maybe other things can help. There are also drugs that can stimulate the production of testosterone. Search Google for "treating low testosterone" for more info. I would suggest trying the healthiest, most natural methods first and only try drugs if you've been off ADT for a long time and are getting nowhere.

We usually say, "ask your doctor" before taking any drugs, and of course you can't get prescription drugs without asking a doctor. Realistically however, I think it might be difficult to find a doctor who has any experience with stimulating testosterone production in a man previously treated for prostate cancer. Most of them give the knee jerk (and not necessarily wrong!) opinion that stimulating testosterone production sounds dangerous to them.

Good luck.

Alan

[Handdrummer777 in reply to AlanMeyer]

Thanks Alan for your input and experience. I really appreciate it. 18 months of ADT for a 68-yr old guy; going to the gym more regularly than ever before and feeling good with that. Hopefully within a year, some T will return. I'm fortunate that I have preserved a functioning libido and at least some measure of sexual ability during ADT. The controversy rages over giving T therapy post-ADT, so I'll just see what happens with ongoing studies and so forth. Thanks again for your encouragement, Alan.

[semorglas]

As Alan has said there are many factors to consider and each individual is different. In my case I was prescribed 2 years of ADT and radiology. I came off ADT after 18 months and am now 7 months off ADT completely. T has come back, PSA up slightly. Due to length of time on ADT venuous leakage seems to be my most difficult hurtle but erections are getting stronger with the return of nocturnal tumescence. I agree with the good diet, and especially exercise is the way to go.

[Handdrummer777 in reply to semorglas]

Thanks semorglas for your comments. Kind of intimidating, the idea that it will take til I'm almost 72 to recover from RT/ADT. What's nervewracking for me is that there will be a certain amount of tissue damage no matter how proactive I'm being. But meanwhile I'll keep eatin' the superfoods, exercising and managing my staye of being the best I can. Take care!

[Hidden]

I do not know. My oncologists the other day provided this rule of thumb: whatever treatment you take, double the length of treatment and that is about what time you need to recover from the effects of the treatment. That is their rule of thumb; seems reasonable to me. Also one of the reasons that thus far I have _strongly_ resisted ADT. I may need to change my stance in the future, of course, but I thought they were a bit too eager to put me on ADT and a bit sparse in talking seriously about the side effects.

[Handdrummer777 in reply to Hidden]

Yeah, I got sparse talk from the oncologist. He flatly said I wpuldn't have erections during ADT -- proved him wrong there. Later when I expressed how critical it was for my psychology to keep etections going, he suggested I not worry about it and let the libido (and sexual activity) "go to sleep." NO! Recent studies and penile rehabilitation programs all point to being proactive, and that's where I'm at.

With a PSA of 18 and a Gleason 4+3, avoiding ADT was not an option. But I'm going with the urologist's recommendation of 18 months instead of the oncologist's of 24 months. Thx dadzone for your comments!

[semorglas in reply to Handdrummer777]

The first time I went to the urologist I had a PSA of 39, he told me we'd do "watchful waiting". A year later my PSA was 58. He said that I would start Lupron today and in 3 month start radiation. He left the room as I finished pulling up my pants when the door reopened and he said oh by the way you may have ED problems then left. That just isn't right I think we men deserve more. At that point I went home & got onto every site I could and read everything I could get my hands on. Sites like this have helped me immensely through this ordeal.

[Handdrummer777 in reply to semorglas]

That isn't right. They need to step up their game -- and learn how important penile rehab is to prostate cancer patients!

[Handdrummer777 in reply to Handdrummer777]

Correction -- he flatly said that I'd be impotent (95% chance) not that I couldn't get an erection.

[Hidden]

UR welcome. The newer recommendations are for 18 months. Used to be 36 months.

He is not comfortable talking about your sexuality and libido and erections so he tells you to "put it to sleep." I think there is room for a bit more empathy there. But he is who he is.

While I believe that I am more than my cock, libido and sexuality are important to me. My goal is to learn alternatives for intimacy while waiting the two years it may take for those nerves to "wake up." The Men's Health Program (really just penile rehabilitation) that is affiliated with the oncology program I use has an active program of rehabilitation with penis pumps, with gels to increase blood flow, with injections to do the same and with pills like Viagra and Cialis. I am three months since surgery so it is still early days for me. I am really sorry that ADT so greatly affects your libido. You may not have any alternatives in terms of your doctor(s) but you do not have to accept their inability to talk to you about your libido.

[Handdrummer777]

Actually I've managed to save my libido.. and erectile functioning...during ADT. I could NOT have done this without utilizing an absurdly simple device I made years back before diagnosis. I now rely on this device to give me multiple erections a day if I desire. Again, this would not be possible otherwise, because there would be inadequate erextile response, and libido would suffer. I do appreciate everything you said, dadzone. Thx again.

[Handdrummer777]

So by doing the opposite of the oncologist's uptight "advice", I've protected my state of being. I am prone to severe anxiety and depression.

[Handdrummer777]

Btw I do greatly respect my oncologist, who has a stellar reputation personally and professionally. Maybe it wasn't so much uptightness as failure to keep up with the latest aporoaches to RT & ADT-induced ED. He did offer congrats to me for being able to hang onto both libido and a good measure of erectile functioning. I feel relieved and blessed at that ongoing situation that's holding steady.