I was diagnosed in 2017 age 59 with stage 4 metastatic Gleason 9 PCa, and started Prostap jabs.
Severe acute idiopathic pancreatitis in November 2018 - considered unlikely to be associated with the Prostap, but possible. A very nasty life threatening event which saw me opt for a bilateral subcapsular orchidectomy in February 2019. The Consultant Urologist said castration was all they used to do. They have plenty enough practice both back then, and with testicular cancer now. He said they’d not been asked for it for about twenty years for PCa, but commented that he thought they ought to do more of them. They don’t bother to offer the option as so very few would take it.
I remember a retired GP on here a few years ago who was determined he wanted it. He didn’t like pharmaceuticals. Ironic.
The very vast majority of the subcapsular tissue is the glandular testosterone making stuff. They may or may not even bother to leave to remaining bit that make sperm at the end; Rendered useless anyway.
At first the capsules are engorged with blood, and it’s like being billy big b*ll*s, however this subsides slowly - it takes months, maybe a year or so, and there’s not much left then to be honest.
It all carries on shrivelling away to nothing anyway just the same as the jabs.
One doctor told me that she thought orchidectomy has fewer side effects because all chemicals have other side effects that those intended, although of course the main “side effects” of the treatment are simply the effects of no testosterone.
Personally I don’t think it makes much difference really. Bear in mind, it’s not quite the minor procedure you may think it is, and it may take a few weeks to fully recover. It’s not hard core, but distinctly uncomfortable if you cross your legs wrong etc., for a while.
My PSA has been on the rise, and I’m quite poorly now really. I’ve had my maximum two high dose pelvic palliative radiotherapies, and am on Enzalutamide. Consultant Onco. says it’s a matter of symptom control now.
Fortunately the nasty symptoms are a bit better now than they were in November-December, and I don’t know, but after that bout of real awfulness, I do wonder whether if, or when, the time comes when I want to throw the towel in, I’ll regret having had surgical castration…?
All in all and in my opinion, I don’t think it makes much difference really which you choose. Either works, it’s the same treatment. It’s not wrong to have castration, it’s the most common form of treatment worldwide.
Edited by member 21 Feb 2022 at 14:59
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