My husband started bicalutimide 5 weeks ago and decapeptyl injection 3 weeks ago. He hasn't had much in the way of side effects other than a few hot flushes, has lost a stone and is walking our very large 14th month old Bernese twice a day...which is quite a workout as this dog's hormonal exuberance knows no bounds! He is also doing an exercise programme with weights a few mornings a week. Libido is good though suffering substantial pain after orgasm (any advice please??) which is sadly making him wary of engaging in too much hanky panky!!
He went to see the oncologist yesterday who was happy with how things are going. PSA down to 0.55 and no adverse side effects. T not tested. Bone profile good.
The oncologist mentioned that recent studies suggest that front loading treatment by adding Enzalutamide (normally saved till after cancer becomes castrate resistant) into the mix at the start of HT gives a significant boost to overall survival.
He thinks it might be useful to try but it isnt something that we have to do given that there would be a higher possibility of cognitive impairment with enzalutamide. As my husband is a structural engineer, with his own company, we need to think about that.
Am I correct in thinking this is similar or the same as Complete Androgen Blockade? My husband was inclined to be in favour of trying it last night. I was more sceptical. I can't seem to find much about it though I did find one extract and emailed requesting the study....which I probably wont understand!
I have so many questions.
How long would he need to take it? Will he get all the side effects we have so far avoided? Will it damage quality of life and if so will the extra time be significant enough to be worth that?
What exactly do they mean by cognitive impairment? How bad is it? Do 57 year olds get it or mostly older men?
If he starts can he give up if necessary or would that make things worse? Is cognitive impairment reversible if he did get it and he subsequently gave up the enza?
Finally his best friend (also a structural engineer) quipped that my husband is so clever he'll still be ahead of the posse even if he has some impairment! Does it work like that? Or will my guy who is used to being the sharpest tool in the box...suffer that loss terribly, in a way that some men suffer the loss of sexual function very badly. (My guy would be less upset by that I suspect!)
I know nobody here can be fortune tellers. Just wondering if anybody knows more about the front loading strategy or has had it at any stage? Also any advice on the significant pain after orgasm? Doctors had nothing to offer...it goes on for days and days "like getting kicked in the nuts" I am reliably informed!
Thank you in advance