M64 (live in the UK). Diagnosed on 17.9.24 with PCa Gleeson score 3+4. PIRADS 3/4 and T3a, 'a few' cancer cells touching the capsule.
Decided to take the Radiotherapy route. Met with with my Oncologist today, 1/10/24. I was pleasantly surprised that Radiotherapy is now 4 weeks instead of 7. What I was unpleasantly surprised about is that I have to stay on Hormone Therapy for Two years.
I work in IT as a contractor, but will retire in a year's time. My question is, how do you guys on short or long term Hormone Therapy cope with the side effects while working. E.g the hot flushes, frequent trips to the loo, the tiredness and the mood swings.
Will appreciate any tips.
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Pythian99
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Your major work problem will be the congnitive impairment, aka brain fog, caused by the lack of Testosterone in the brain. There is a general "fetish" with chemical castation that you will hardly evade. The alternative is the Anti-Androgen (AA or ARSI or ARPI same thing) path that on the contrary increases the Testosterone supply to the brain as it puts road blocks towards the Androgen Receptors (AR) of the cancerous cells. The family of drugs that works this way are classified as *lutamides. Hence, you may suggest to your doc to put you under AA instead of ADT. I can visualise the scene and his reaction: "Excellent idea, we will proceed with double therapy ADT plus a second gen ARSI". Told you they have a weird preference for ADT. ADT Uber alles. FYI, my Sudoku solving capability gained two levels after starting taking a miniscule dosage of Bicalitsmide that caused my Testosterone to go up by more than 50%.
I’m an IT contractor as well. I only work part time however, my choice. I find that as long as I keep busy I don’t really feel undue fatigue. When things lag I feel the fatigue. Frequent trips to the loo aren’t a problem. I get a few hot flashes but they aren’t intrusive. Working off hours as in an on-call situation is a problem. I just don’t have energy in the evening to stay mentally sharp to deal with work. That’s my experience but everyone’s experience is different.
Do you work on-site or can you work remotely? I can work almost 100% remotely and that helps on the off days when I’m feeling a bit off.
For me the key was to pace myself. I started ADT at age 57 and had been pretty active working out, working, and playing in a band. I found that I could only two of the three well in a given day. So with a little thought and planing, I could make it work. The hot flashes are for real but this too shall pass. Best of luck to you.
i am taking radiation and hormone therapy. I am on my 10 th trip for RAD This morning. I do get tired and irritable at times but you just learn to deal with it. I have had low T all my life so I guess I am use to it. There are many possible side effects. I have had mild stomach pain, loose bowels, mild head aches. Feeling sun burned from the RAD( use lotion). Raise in blood pressuer. My biggest issue is my liver enzymes went very high from the Zytiga (Abiratrone hormone meds). I am on hold with it untill my liver gets back to normal. Oh, frequent urination is problem I deal with. Just part of it. God Bless and good luck.
Hi Pythian, I'm in the UK as well (near the S coast). I have Gleeson 4+5, PIRADS 5, T2c/T3a. I had 7 weeks or RT and am on ADT (prostap) for 2 years which I started nearly a year ago. I'm recently retired as a management consultant but now do a lot of work in archaeology.
I have found that exercise makes ADT a lot more acceptable. I go to exercise classes 5 times a week. These typically involve both aerobics and weights. Being in a class pushes me a lot more than doing it on my own. I don't get hot flushes, I do get achy muscles. I get limited brain fog, though I did give a 1 hour talk a couple of days ago which went fine and I remembered nearly all I wanted to say! It does take me about 10-20% longer to do the puzzles in the paper but that could just be as I'm getting older. But all in all, I feel fine most of the time.
Your choice of RT is the way to go. I strongly recommend you look at exercise and also diet (a Med diet seems very effective) to both ease the symptoms of ADT and reduce the risk of mets.
You are a great candidate for transdermal low-dose "add-back" estrogen therapy (Patch or Gel) to treat the hot flashes and reduce osteoporosis. If your MO won't prescribe it, then ask your GP or PCP.
I was 65 when first diagnosed - G 4+5. ADT 18 months, EBRT 24 sessions, and then Brachy. ADT was odd and a mild distraction. Hot flashes at night were a pain butt not awful. One thing that kept me sane was keeping up my exercise regime. I was already pretty darn active (climbing, mt biking, backcountry skiing) but took on a trainer for weight 1x a week and lifted another day a week on my own. It kept me from loosing muscle mass and kept my weight gain down to about 6 lbs.
I'd strongly recommend a trainer to lift. I had mine for 2 years and learned a lot. After the radiation and Brachy I had about 2 months or so of having to pee a lot, especially at night. My sleep was not good. But what helped was taking my 2 doses of Tamulosin at night instead of one in the morning and one at night. I was very reluctant to seek out more drugs to counterbalance the ADT effects, figured my body was dealing with enough disruption and I'd just hang in there.
Took about 6 months after last dose of Lupron (3 month dose + 3 month recovery) before my T reached normal and I felt back up to it all.
I am now retired on SS Disability in the US. I retired in part because I was unable to do my work effectively, due to fatigue. I think exercise, diet and getting enough sleep all figure into helping with the fatigue. I never really had many hot flashes though.
For me, it was a balancing act that I maintained for about 8 years but eventually I felt I was unable to do my job. My job required me to do a lot of coordinating of the project team and QA for their work. If my own quality of work was subpar, I did not feel I should be checking other people's work.
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My RO Wants Me to Do_ADT, HDR & EBRT
Biochemical Recurrence: Radiation 
Trying to get to retirement before HT
Recovering from prostate cancer 
High risk treatment - go conventional or experimental?
