I had my final Zoladex/ADT implant in July 2017 having been on it since November 2016. The good news is that my PSA is now undetectable at 0.03, the less good news is that my testosterone is stuck at 0.05 some 7 months after my last Zoladex/ADT implant. I think I have possibly had all of the side effects in the ADT book. In order of severity and impact to me, these include:
Physical fatigue (variable and unpredictable)
Cognitive deficit/poor concentration/poor memory
Depression and anxiety
Crying for no reason
Hot flushes/night sweats
Aching bones and joints
Feeling the cold more (in winter) and heat more (in summer)
These side effects are much worse and are knocking me over way more than any I experienced following either my prostatectomy and the 33 rounds of adjuvent radiotherapy that followed. I have tried to discuss the side effects with my Oncology team at the hospital where I was being treated up 'til very recently but the endless round of changing specialist registrars have shown little or no interest and have essentially told me I should be pleased that my treatment has worked and my PSA is now undetectable.
Given this lack of empathy I made the decision to seek a second opinion and am now under the care of a Senior Oncologist at a different hospital. Fortunately the new Oncologist completely gets my situation and how all of the side effects are seriously affecting me on a day-to-day basis. It's so bad now that I have been signed off work indefinitely.
Oh and for the record, of course I am delighted that my treatment is working and my PSA is undetectable. I would have thought that that goes without saying!!
My new Oncologist has told me that it is almost impossible to determine when the body will start to produce testosterone again following a course of ADT. She told me some men start producing it on the fourth month after the last quarterly implant, other men take a lot longer, months or years. She hinted at the possibility of low dose testosterone replacement therapy if nothing had started to happen at around the 18 month mark. She didn't seem keen on it though and I get the reasons behind this.
For information my relevant bloods are as follows:
Serum testosterone (pre-PCa diagnosis) 29.4 nmol/L
Serum testosterone (17/02/2018) 0.50 nmol/L
Serum LH (12/01/2018) 0.10 u/L
Serum FSH (12/01/2018) 4.1 u/L
Serum prolactin (12/01/2018) 350 mu/L
GP and Oncologist between them have, they think, ruled out any other issues that could be causing these side effects.
I'd love to hear from anyone experiencing similar issues and will happily keep you updated with progress (or otherwise) with this situation.