When a man is diagnosed with PCa, especially metastatic PCa, the first go to for oncologists is usually Androgen (Hormone) Deprivation Therapy (ADT) which can be accomplished in men one of two ways: 1) orchiectomy or the surgical removal of the testicles or 2) taking drugs that turn off the production of testosterone. Fortunately, most patients choose the 2nd option.
When I was diagnosed in March of 2014, I was told in no uncertain terms by more than one physician, that I had an aggressive PCa and it was already in both lungs as well as pelvic lymph nodes and seminal vesicles. I was initially offered ADT using Lupron, which was administered 2 times over the 8 months I took it. I handle injections and blood draws like a champ, but the Lupron injection was unusually painful both times.
At the end of the year, after an 8 month trial as well as going through 6 rounds of newly approved chemo for PCa with mets, I decided I would no longer take ADT. It was simply too rough on me physically but even more so, mentally. The malaise, the depression, the loss of muscle and gaining of body fat, the hot flashes, the cold flashes and my emotions run rampant as well as cognitive dysfunction...all of these things proved too much for me to consider living with the rest of my life.
Did it negatively affect me sexually? Yes. After about 3 weeks of being on it, I had no sex drive or desire. I didn't even think about it and had to literally write myself reminders to be intimate with my husband. But that wasn't THE major reason I wanted my testosterone back.
"Fatigue, loss of muscle mass and bone density, loss of body hair, emotions played havoc with, weight gain, hot sweats and flushes. Effectively it feels like you’ve become a menopausal woman overnight, and that simply magnifies the loss of masculinity."
A female oncologist I consulted with a couple of years back before SBRT treatments made the statement to me that you "can't take a relatively young man's testosterone away and expect him to thrive. It's an important hormone for more than just sex."
I may have to go back on ADT at some point as a palliative measure if/when my unwanted resident decides to metastasize to my bones and my palliative doc and I have discussed limited use of it.
But only if I see no other way.
Meanwhile, I am quite empathetic with menopausal women.
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