Ending hormone therapy after Radiotherapy

Steve

i wont go through my journey but ours has been very similar. i had very strong emotional instability in the first 4 months of Triptorelin HT. in some ways i also felt a little guilty as my wife had been ”encouraging” me to get a PSA check for 6 months since we heard my brother was diagnosed Gleason 3:4 T2c

The 20 fractions of RT involved a lot of time travelling, waiting around and expense. But the end justified the pain

 I finished RT on the 7th Sept  and waited the standard  8 weeks to see my Oncologist. We had a full and frank discussion on HT and QoL. 

My PSA on diagnosis was 38, then 6 just before my RT after 3 months on Triptorelin, then 0.5 8 weeks after RT

I had read numerous papers on 18month vs 36month HT and the outcome is there is less than 5% risk on taking the lesser period. Now every person and their PCa is different and differing %ages on the effectivness of 18 vs 36 are published by different researchers, but the variance is negligable.

My Oncologist agreed that taking my QoL needs into consideration and  the fact i had responded so well  to HT and RT she agreed 18 months posed  no significant danger to me

Since my post RT review  in November, i get 4 monthly PSA checks for a year, what this means to me is that 3 significant increases in a  row means my PCa  may have returned, if so then I would of  course go straight back on HT for the rest of my life probably.

I started Triptorelin April 2018, so my last injection will be July this year, which will run out October 2019

I am of course aware that  Triptorelin will have supressed my PSA  and the real proof of my ”cure” [remission?] will come in a PSA test April 2020  when my testosterone will have recovered, probably  as much as its going to at age 66

Steve, good luck with your post RT  review, the 8 weeks wait  are  a very nervous time. You should never feel guilty about getting PCa my friend. My emotional issues have resolved after my review and I am on Fluoxetine a mild anti depressant, that is also an ssri that helps with hot flushes.

Hi Steve, I just get back from seeing my counselor today too , and she is requesting permission for more sessions ( I've had 16 so far). This is far in excess of the normal cancer diagnosis number, which is around 4. This is due for me to the HT dragging up some bad stuff from an 'interesting' childhood. Its an interesting journey to say the least.

Is it my past , the present , my future or most likely a combination of all three that is causing me the biggest head ache. All I do know is its very hard to get through as I thought all this childhood stuff was dead and buried.

I do know that my emotions are all over the place at the moment. But my counselor says she thinks my emotions may have been suppressed during childhood and so i have to deal with these 'normal' emotions I've not had before.

All too much for my poor intellect to deal with .....

I don't think much has been made of on here about the mental effect of the HT although i am sure it is different for all of us. I have the depression, anxiety and insomnia and the bringing back of old memories, which is likely linked to the depression. But.... i am lucky not to get any physical effects from the HT or the RT , so I have to count my  blessings. Oh of course i forgot the PCa .... hopefully it is now gone forever - fingers crossed, that's a bonus which not everyone gets and i appreciate that.

I have started using anti-depressants (Mirtazapine) which also really helps with the insomnia. Maybe something to discuss with your counselor and doctor.

From what i heard , especially from Mr Angry, now departed from this forum, who i shared some similarities in our childhood with, was that after finishing the HT it does eventually get better. He told me to hang in there, and that is what I am trying to do. I have till October now for the my last injection (Prostap) and I will have a damn party when the effects wear off.....

My counselor said to me today that if i feel like crying then I should cry. Not so easy at work or in a cinema though but i get the meaning. We have to accept these heightened emotions as much as we can without the aid of pills if we can. I am on min. dose for the Mirtazapine and don't want to up the dose if i can help it.

One thing i do is try to distract myself and keep busy. I still work full time and have started back at the gym and running and have entered a Tough Mudder in May. I think making plans for the future helps too so your brain realises that there is a future ahead, may be a different future to the one you planned but it is there.

And lastly, you are not weird. Well , i suppose we all are in a way  ....

Good luck Steve, pm me if you wish.

Hi Ian

Thanks for the reassurance.  I read yours and other replies last night and they really cheered me up.

Kind regards

Steve