Hormone therapy before radiology

[Man64uk]

Hi

I'm in the UK, 70 years old, Gleason 7, last psa 9, cancer contained in capsule ...been on Active Surveillance for 7 years.

Decision made to treat few months ago .. my preference was for brachytherapy, but after investigation it was decided I wasn't suitable due to large prostate and restricted urine flow ...( The videocam down my dick was the worst aspect so far ! .. cant believe some guys do it for pleasure (well not with a cam )

So .. its gonna be external radiotherapy in the autumn. To prepare for it I have been put on Prostap sr (hormone that inhibits testosterone production)

Any one experiance of this? .. Im putting on weight round the belly and getting hot flashes.. No desire or erections... But the worst part is I feel very odd!!! Even more moody than usual .. tired, but cant sleep .. also short periods of over activity followed by irritation

Any one got any experiance they can share or able to offer advice?

Graham Hill

[Tall_Allen]

Graham-

I marvel at men who take pleasure from sounds, just as I marvel at he wide variety of sexual experience that gay men take enjoy.

With a Gleason 7 (Was that 3+4 or 4+3 - and what percent of the cores were positive?) it doesn't seem at first glance that adding hormone therapy is appropriate for you. If you provide further details, I can help you with the evidence.

There are actually two kinds of brachytherapy - high dose rate (temporary implants) and low dose rate (permanent implants "seeds"). A large prostate (anything over 45 cc) rules out seeds, although the hormone therapy you currently plan to take anyway will shrink your prostate so you CAN get seeds. HDR-BT does not have any prostate size limits. Peter Hoskin at Mt Vernon Cancer Centre is one of the world experts in this technique. It would only involve one or two trips if this is far from home.

The other therapy you should look into is SBRT. SBRT is a kind of external beam radiation that is accomplished in only 5 treatments. The results are as good or better than the typical 40-44 treatments you are currently planning. I know they offer it at Royal Marsden Hospital, and perhaps at other places. I suggest you set up a consult there.

The other advantages to either HDR-BT and SBRT is that they have the highest documented rates of potency preservation. size of the prostate is not an issue, and there has never been found to be any advantage to adding hormone therapy with either of them. I chose SBRT for myself and am fully potent with no lasting side effects of treatment. However, except for a few lucky guys, you can count on your semen disappearing with any kind of radiation.

[lavis]

Hi Graham!

What you are experiencing is common with those types of drugs.

However, your Urologist should have given you something to avoid so much pain before, inserting the camera in, your penis.

It would have made your experience much less painful.