Hi Steve,
Sorry you find yourself here, but it sounds like you are in good hands.
Prostate cancer is driven by testosterone, the hormone which switches on the prostate in terms of generating PSA and other products and growing. Hormone therapy stops testosterone from getting to the prostate, to switch the prostate off and prevent growth, particularly of the cancer cells. There are side effects from hormone therapy, because it switches off everything driven by testosterone, but this takes a while, and hopefully you won't be on it for long.
Bicalutamide is the hormone therapy. This one is known as an anti-androgen, which means it stops the testosterone in your body from activating any testosterone receptors. It doesn't stop your body producing testosterone, but stops you body from being able to use it. (There are other types which stop your body producing testosterone, but they're better suited to longer term use.)
The tamoxifen is to avoid one of the side effects. With your testosterone effectively invisible, your normal background level of female hormones might predominate, and this can cause breast growth (gynecomastia) and nipple sensitivity. Tamoxifen should prevent this (it's more usually a drug to prevent breast growth in breast cancer patients). Out of curiosity, what dose are you on?
There are a number of hormone therapy side effects. Different people get different ones, and no one gets them all. Some may be unnoticed, but do require action...
The first one often goes unnoticed, which is loss of nocturnal erections within days. These are important for maintaining penis health, so you do need to make sure you get regular erections at other times. That might sound easy at the moment, but you will also have a reduction in libido, and therefore a reduction in interest in having erections, so you may have to put more effort into this than you imagine at the moment. Hormone therapy doesn't prevent erections, but the loss of libido can have quite an impact on it, and you will need to concentrate more on doing so. There are techniques and drugs to help if necessary. Some of this is very similar to the penile rehabilitation you will be doing after the prostatectomy. 5mg daily Tadalafil may provide some protection of the penis having fewer erections, and help you to get regular erections, so you could try asking your GP for that. Not all GP's will oblige, sadly. (Sildenafil which they might offer instead is better than nothing, but not as good as Tadalafil for this purpose, unless it enables you to get regular erections and Tadalafil didn't.)
Second one which will be unnoticed is more applicable to longer term hormone therapy, that of loss of bone density. This is countered by exercise and Calcium and Vitamin D supplements (such as AdCal-D3). On hormone therapy, the supplements mainly work during bone stressing exercise. Check with your GP in case you have any comorbidities which might cause a problem for taking Calcium. Exercise is important to prepare for surgery too, making it easier for the surgeon and faster recovery for you, so this is an excellent opportunity to get in shape. Exercise is also the antidote to fatigue and muscle loss which hormone therapy causes some people.
Other side effects will be more obvious and can be tackled if you get them.
On the plus side:
You probably won't need to use deodorant after a few weeks, or wash your clothes so often.
Any balding will stop, and may recover.
It looks like you will become 4x less likely to get (but not completely immune to) COVID-19, and if you do get it, the infection will be a lot less severe, but no one knows how long this effect takes to kick in, so don't put yourself at any extra risk.
(There is also some thought, but less evidence, the Vitamin D will further help with this too.)
Edited by member 13 May 2020 at 12:21
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