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Hormone therapy duration

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User
Posted 23 May 2022 at 23:26

I have been having prostap injections for 18 months my PSA has reduced from 95 to almost zero my oncologist has said that I can choose to end the hormone therapy now as  it is most effective in the first 18 months and  less effective thereafter the choice is now mine …. I said I would have the July injection which would take me up to 21 months of therapy , would it be better to continue with ht for the 3 years will the cancer return  if the injections stop? Male age 57 . curative. good general health 

User
Posted 28 May 2022 at 12:16

Talking with some oncos who deal with high risk cases, they do use 3 year HT in some cases as they see a benefit in outcomes. The situations which tend to point to using 3 years are high risk cases (obviously), PSA not going extremely low after RT, and fit men who are unlikely to suffer significant comorbidities arising from the hormone therapy itself.

I haven't talked to my own onco about his criteria, but this might well be what he did with me. At the outset, he said I would be 18-36 months. When I was coming up to 18 months, he said I could stop at 18 months if I wanted to, because my PSA was <0.01. If my PSA had been still 0.5 or higher, he would have wanted me to do the full 36 months. I elected to go on to 22 months, as the HT wasn't causing me any issues which I couldn't put up with for a bit longer.

Time limited hormone therapy is always a balance between improving cancer outcomes, versus QoL reduction and risk of comorbidities arising from the hormone therapy itself (things like metabolic disease, heart attack, stroke, osteoporosis/fractures, impact on sexual function, etc). I think the key thing here is shared decision making - letting the patient know how much their chance of a cure increases, versus their chance of heart attack, stroke, etc which is calculable based on BMI, blood pressure, cholesterol, blood glucose, etc, and their own perception of QoL on HT. It is a personal decision.

User
Posted 31 May 2022 at 18:04

I was on prostap for 36 months, then came off it a year ago. PSA was 0.1, now 4.2. With added testosterone I became a teenager again, sweaty, smelly, greasy, spotty, hairy. Now going back onto prostap, but not sure how long for as they are going to give me 6x chemo in the near future.
I found cyproterone helped control the sweats that I got from ht.

**edit** also wanted to say that my uncle has been having prostap jabs for over twenty years.  He's ninety now.

Edited by member 31 May 2022 at 18:06  | Reason: forgot a comment I wanted to make!

User
Posted 13 Jul 2022 at 11:43

The length of time on the injections does take into account the time for Testosterone to recover, as it's based on outcomes.

Having said that, the time to get Testosterone back is quite variable - anything from 6 to 15 months. I've not seen any research on factors impacting this, but length of time on the injections is probably a factor.

Return of Testosterone isn't the end of it. After 22 months on injections, my Testosterone returned quite suddenly at around 9-10 months after the last injection ran out, and has been back for 9 months now, but my body is still recovering. I exercised before, during, and after HT, but I still lost muscle on HT, probably less than I would have if I hadn't exercised. I have almost managed to put that back on in the last 9 months, but as yet, none of the fat gain has shifted, so my BMI and weight are still going up. Body hair is slowly recovering but not back to pre-HT levels (not very hairy anyway). Sexual function all works, lots of surprise erections, but strangely libido might not be back to pre-HT levels, or it might be that I've forgotten a bit what libido is.

User
Posted 19 Jul 2022 at 18:27

Originally Posted by: Online Community Member

Thanks for the post, I had prostate cancer 8 years ago in 2014 I was 59 years old and I flatly refused hormone treatment because I was terrified by it and the side effects. my oncologist understood and arranged for me to have RT and brachytherapy. it worked and I had 8 years of remission. It is now back with a vengeance and has spread to my ribs and lymph nodes. The oncos are saying I must have the HT, but I am still s*** scared of it and don't know what to do, and don't know If I can face the horrible side effects.

It would be better if you started your own thread Nick so that we are not cluttering up someone else's information but I do wonder how realistic you are being. You have advanced prostate cancer with bone mets; any side effects from the hormone treatment will be nothing in comparison to being terminally ill with bone mets - loss of mobility, possible paralysis due to dpinal cord compression, trying to breathe with rib mets, inability to urinate leading to permanent catheterisation, odema leading to possible heart or other organ failure, it can be a fairly awful death. And if it is loss of libido that worries you, once those bone mets take hold you probably wouldn't be able to have sex anyway due to the pain and risk of breakages and, as the disease progresses, you would be far too ill to feel randy. 

It is easy to compare life as it is now with your greatest fears about life as it might be on treatment but that is flawed thinking - the comparison should be between what life is going to be like without treatment v what life could be like with treatment. Better perhaps to have the hormones, control the cancer and negotiate yourself a decent quality of life for as long as possible followed by an end of life in which the worst bits have been avoided / controlled? 

Edited by member 19 Jul 2022 at 18:58  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 May 2022 at 23:32

The research data is that there is no benefit in continuing beyond 18 months.

If the cancer was to return, it would do that regardless of whether you have 18 months or 3 years. 

Edited by member 23 May 2022 at 23:33  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 May 2022 at 12:05
Years ago, when I first joined this forum, most men had 6 months but some EU data had indicated that 3 years was better. Around the same time, research showed that a high % women with breast cancer had a recurrence as soon as they came off the HT (those who have some of the same hormone treatments as men with prostate cancer) so advice changed to women should stay on HT for 10 years ... that didn't last very long as, for many women, the QoL issues were too significant. Subsequently, a number of hubs started looking at whether 3 years HT for men was actually worth it.

In 2017, data was published showing that 18 months was just as good as 36 months but with a significant reduction in QoL issues, then in 2018 the RADAR trial showed that 6 months isn't as effective as 18 months. Since then, there have been trial reports all over the world that 24 / 36 months HT provides no additional benefit that justifies the prolonged side effects.

I don't know why some oncos still go for 24 / 36 months - perhaps just a bit stuck in their ways?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 May 2022 at 01:31
It is a bit different for you Jasper as you have advanced PCa. I have no idea why anyone would have told you that you could only have a maximum of 3 years but assume that this was either before you knew it was advanced or they were just confused.

Some oncos are fine with intermittent HT when the man has responded well and his PSA is stable for a long period of time; others are frightened that it will end badly, I guess, or that when you restart, the HT will not be effective. It depends now on how strongly you feel - you could arm yourself with facts and figures before your next appointment. Apart from George, two other members for you to look up are Topgun (who did extremely well with IHT) and Si_Ness (whose onco really didn't want to do it but changed his mind when it turned out okay)

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Jun 2022 at 20:31

My onco started me on Zoladex January 2020, six months prior to starting RT.  I have to stay on it till January 2023.  It's a bummer due to the fatigue, flushes and weight gain.  That said my tumours (Gleason 6 and Gleason 8) are non-secreting so while I still have regular PSA tests they're not really in themselves an indicator as to the state of my cancer. My PSA has never been outside the "normal" range in the four and a half years since I was first diagnosed.  I have to have annual bone scans and thorax/abdominal CT scans too.  So I guess the 36 months HT is necessary in my case just to be on the safe side. 

Have mixed feelings about coming off HT to be honest.  Would love to be free of the side effects, but it does rightly or wrongly give me a sense of security.

User
Posted 13 Jul 2022 at 16:29
As with so much with PCa, one can't give a categorical answer to the posed question because it depends on the way an individual responds , his histology and the ways a particular Onco sees it for the individual. 18 months is a likely sort of time for the majority of cases though now.
Barry
User
Posted 16 Jul 2022 at 16:10

Hormone therapy for too long is like killing a Ant with a sledge hammer!!

I have been on hormone therapy for 18 months my psa is now 0.01, I have asked to stop the hormone injections 6 months early they are saying maybe to replace injections with tablets which are kinder to my body with less side effects the tablets will allow my testosterone to come back slowly to help to get some sexual function back hopefully. 

User
Posted 22 Oct 2022 at 14:09

It is a little unusual, but not a problem. HT is most important before and during HT, after HT it adds diminishing benefit. Treatment to cure prostate cancer is about 70% successful, stopping HT early might reduce that to 65%. 

At 78 you have to accept your life expectancy is about 10 years, if the cancer returns it will be about 7 years. Another 2 years of HT with side effects would reduce your quality of life now, for the potential of giving you an extra couple of years in a nursing home.

No way of knowing what your actual future holds with or without HT, but on balance I think you are better without it at your age and with your side effects.

Dave

User
Posted 27 May 2022 at 16:55

Hi Lyn my Onco has had me on HT for 44 months now and he's keen to keep me on it. In the early days a couple of guys on the forum told me I could only have it for 3 years maximum.

It's become a way of life for me now. When I mentioned hormone holidays like George has to him he simply poo-pooed it.

What do you reckon?

 

 

 

 

User
Posted 01 Jun 2022 at 08:21

I guess we're all different.

My prostap started in June '18 and I had 37x RT in October/November '18 while still on the HT.  Came off prostap after June '21 jab, will restart it along with 6x chemo at the end of June '22.  Change of oncologist in Jan/Feb of this year has triggered a complete re-assessment of my case I think.

User
Posted 13 Jul 2022 at 07:43

Hi I have been having prostap injections for 18 month now, my psa was 7 when I started ht, had 20 Rt treatments 7 months after I started , my testosterone was 0.45, bit annoyed now that my testosterone level wasn't checked before I started hormone therapy!!!.

My Psa is now 0.02 7 months after finishing Rt  I was first told I needed to be on Ht for 2 years I want to know if I can now come of the Ht after 18 months, I have been told it takes 30 months for a man of my age of 71 for the testosterone to come back to normal levels  so why do I still need Hormone injections?

Any thoughts please.

User
Posted 13 Jul 2022 at 15:41

I watched an American video where the onco said HT was 4 months prior to RT, 6 weeks during RT, 18 months after for high risk patients and less for lower risk patients.  There was talk about simultaneous use early on of two HT types with Chemo for high risk patients.   

It was also said recovery after HT varies depending on age and a man of 70 could take 3 years to fully recover after 18 monhs of HT and he would make sure the patient knew that as it might influence whether the patient wished to carry on that long.

Edited by member 13 Jul 2022 at 15:42  | Reason: Not specified

User
Posted 16 Jul 2022 at 16:32
Mingman, I doubt 6 months will make any difference to your cancer, it could make a massive difference to your life.
User
Posted 18 Jul 2022 at 17:24

Hi Nick been on decapeptyl 14 months found it tolerable 👍

User
Posted 20 Jul 2022 at 19:41
Libido still good 18 months into Decapeptyl. Erections fine and useable. But pretty much lost the ability to orgasm myself but doesn’t stop some fun.
User
Posted 22 Oct 2022 at 13:01

Started zoladex Jan 2022 following diagnosis with T3b N0M0 gleason 9 at age 78. RT at Royal Surrey May/June,60 gy in 20 fractions. Saw oncologist Sept 2022, psa now 0.08 a d told I can stop zoladex now after 3 implants  As side effects not good I am happy to do this. Is this short duration HT usual?

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User
Posted 23 May 2022 at 23:32

The research data is that there is no benefit in continuing beyond 18 months.

If the cancer was to return, it would do that regardless of whether you have 18 months or 3 years. 

Edited by member 23 May 2022 at 23:33  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 May 2022 at 08:48

Originally Posted by: Online Community Member

I have been having prostap injections for 18 months my PSA has reduced from 95 to almost zero my oncologist has said that I can choose to end the hormone therapy now as  it is most effective in the first 18 months and  less effective thereafter the choice is now mine …. I said I would have the July injection which would take me up to 21 months of therapy , would it be better to continue with ht for the 3 years will the cancer return  if the injections stop? Male age 57 . curative. good general health 

I'm in a similar position to you and I've decided to stop the ADT at 2 years. One thing I can't pick up from your profile, have you had RT yet? I couldn't see any mention of it.

 

Edit: I see you finished your RT mid 2021, so you're about 1 year post that. Opinions on whether the duration of HT should be counted from the time you first started it before RT or from the time your RT finished.

Jules

Edited by member 24 May 2022 at 08:52  | Reason: Not specified

User
Posted 27 May 2022 at 11:23

Hi Lynn.

I've read a lot about duration of adt and it all comes back to this sweet spot of 18 months.

So whays the rationale of 2 or 3 years?

I also read last week ( Lancet) that 12 months is ok if tri-modal therapy ht. Brachytherapy.  Radiation 

I've only been on it for 6 weeks and I hate it already!

 

User
Posted 27 May 2022 at 12:05
Years ago, when I first joined this forum, most men had 6 months but some EU data had indicated that 3 years was better. Around the same time, research showed that a high % women with breast cancer had a recurrence as soon as they came off the HT (those who have some of the same hormone treatments as men with prostate cancer) so advice changed to women should stay on HT for 10 years ... that didn't last very long as, for many women, the QoL issues were too significant. Subsequently, a number of hubs started looking at whether 3 years HT for men was actually worth it.

In 2017, data was published showing that 18 months was just as good as 36 months but with a significant reduction in QoL issues, then in 2018 the RADAR trial showed that 6 months isn't as effective as 18 months. Since then, there have been trial reports all over the world that 24 / 36 months HT provides no additional benefit that justifies the prolonged side effects.

I don't know why some oncos still go for 24 / 36 months - perhaps just a bit stuck in their ways?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 May 2022 at 16:55

Hi Lyn my Onco has had me on HT for 44 months now and he's keen to keep me on it. In the early days a couple of guys on the forum told me I could only have it for 3 years maximum.

It's become a way of life for me now. When I mentioned hormone holidays like George has to him he simply poo-pooed it.

What do you reckon?

 

 

 

 

User
Posted 28 May 2022 at 01:31
It is a bit different for you Jasper as you have advanced PCa. I have no idea why anyone would have told you that you could only have a maximum of 3 years but assume that this was either before you knew it was advanced or they were just confused.

Some oncos are fine with intermittent HT when the man has responded well and his PSA is stable for a long period of time; others are frightened that it will end badly, I guess, or that when you restart, the HT will not be effective. It depends now on how strongly you feel - you could arm yourself with facts and figures before your next appointment. Apart from George, two other members for you to look up are Topgun (who did extremely well with IHT) and Si_Ness (whose onco really didn't want to do it but changed his mind when it turned out okay)

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 May 2022 at 12:16

Talking with some oncos who deal with high risk cases, they do use 3 year HT in some cases as they see a benefit in outcomes. The situations which tend to point to using 3 years are high risk cases (obviously), PSA not going extremely low after RT, and fit men who are unlikely to suffer significant comorbidities arising from the hormone therapy itself.

I haven't talked to my own onco about his criteria, but this might well be what he did with me. At the outset, he said I would be 18-36 months. When I was coming up to 18 months, he said I could stop at 18 months if I wanted to, because my PSA was <0.01. If my PSA had been still 0.5 or higher, he would have wanted me to do the full 36 months. I elected to go on to 22 months, as the HT wasn't causing me any issues which I couldn't put up with for a bit longer.

Time limited hormone therapy is always a balance between improving cancer outcomes, versus QoL reduction and risk of comorbidities arising from the hormone therapy itself (things like metabolic disease, heart attack, stroke, osteoporosis/fractures, impact on sexual function, etc). I think the key thing here is shared decision making - letting the patient know how much their chance of a cure increases, versus their chance of heart attack, stroke, etc which is calculable based on BMI, blood pressure, cholesterol, blood glucose, etc, and their own perception of QoL on HT. It is a personal decision.

User
Posted 31 May 2022 at 18:04

I was on prostap for 36 months, then came off it a year ago. PSA was 0.1, now 4.2. With added testosterone I became a teenager again, sweaty, smelly, greasy, spotty, hairy. Now going back onto prostap, but not sure how long for as they are going to give me 6x chemo in the near future.
I found cyproterone helped control the sweats that I got from ht.

**edit** also wanted to say that my uncle has been having prostap jabs for over twenty years.  He's ninety now.

Edited by member 31 May 2022 at 18:06  | Reason: forgot a comment I wanted to make!

User
Posted 31 May 2022 at 20:38

Not sure there was a response to Jules post above ( 24 May) about whether the count  ( be it 18 or 36 months) starts from the  first dose or the end of RT.

 I have vested interest since I was 2 years in on HT before I was able to start my RT! 

Ron

User
Posted 31 May 2022 at 23:01
I asked the onco this very question regarding OH. He said the count will start the moment RT is over.
User
Posted 01 Jun 2022 at 01:53

Originally Posted by: Online Community Member

Not sure there was a response to Jules post above ( 24 May) about whether the count  ( be it 18 or 36 months) starts from the  first dose or the end of RT.

 I have vested interest since I was 2 years in on HT before I was able to start my RT! 

Ron

My onco said it's the total duration of HT, but this was in the context of me having delayed my RT by a couple of months.

User
Posted 01 Jun 2022 at 08:21

I guess we're all different.

My prostap started in June '18 and I had 37x RT in October/November '18 while still on the HT.  Came off prostap after June '21 jab, will restart it along with 6x chemo at the end of June '22.  Change of oncologist in Jan/Feb of this year has triggered a complete re-assessment of my case I think.

User
Posted 02 Jun 2022 at 20:31

My onco started me on Zoladex January 2020, six months prior to starting RT.  I have to stay on it till January 2023.  It's a bummer due to the fatigue, flushes and weight gain.  That said my tumours (Gleason 6 and Gleason 8) are non-secreting so while I still have regular PSA tests they're not really in themselves an indicator as to the state of my cancer. My PSA has never been outside the "normal" range in the four and a half years since I was first diagnosed.  I have to have annual bone scans and thorax/abdominal CT scans too.  So I guess the 36 months HT is necessary in my case just to be on the safe side. 

Have mixed feelings about coming off HT to be honest.  Would love to be free of the side effects, but it does rightly or wrongly give me a sense of security.

User
Posted 13 Jul 2022 at 07:43

Hi I have been having prostap injections for 18 month now, my psa was 7 when I started ht, had 20 Rt treatments 7 months after I started , my testosterone was 0.45, bit annoyed now that my testosterone level wasn't checked before I started hormone therapy!!!.

My Psa is now 0.02 7 months after finishing Rt  I was first told I needed to be on Ht for 2 years I want to know if I can now come of the Ht after 18 months, I have been told it takes 30 months for a man of my age of 71 for the testosterone to come back to normal levels  so why do I still need Hormone injections?

Any thoughts please.

User
Posted 13 Jul 2022 at 11:43

The length of time on the injections does take into account the time for Testosterone to recover, as it's based on outcomes.

Having said that, the time to get Testosterone back is quite variable - anything from 6 to 15 months. I've not seen any research on factors impacting this, but length of time on the injections is probably a factor.

Return of Testosterone isn't the end of it. After 22 months on injections, my Testosterone returned quite suddenly at around 9-10 months after the last injection ran out, and has been back for 9 months now, but my body is still recovering. I exercised before, during, and after HT, but I still lost muscle on HT, probably less than I would have if I hadn't exercised. I have almost managed to put that back on in the last 9 months, but as yet, none of the fat gain has shifted, so my BMI and weight are still going up. Body hair is slowly recovering but not back to pre-HT levels (not very hairy anyway). Sexual function all works, lots of surprise erections, but strangely libido might not be back to pre-HT levels, or it might be that I've forgotten a bit what libido is.

User
Posted 13 Jul 2022 at 15:41

I watched an American video where the onco said HT was 4 months prior to RT, 6 weeks during RT, 18 months after for high risk patients and less for lower risk patients.  There was talk about simultaneous use early on of two HT types with Chemo for high risk patients.   

It was also said recovery after HT varies depending on age and a man of 70 could take 3 years to fully recover after 18 monhs of HT and he would make sure the patient knew that as it might influence whether the patient wished to carry on that long.

Edited by member 13 Jul 2022 at 15:42  | Reason: Not specified

User
Posted 13 Jul 2022 at 16:29
As with so much with PCa, one can't give a categorical answer to the posed question because it depends on the way an individual responds , his histology and the ways a particular Onco sees it for the individual. 18 months is a likely sort of time for the majority of cases though now.
Barry
User
Posted 13 Jul 2022 at 17:40

Thanks Andy, and what is your age?

User
Posted 13 Jul 2022 at 17:47

Exactly my problem, 18 months on prostap my psa today was 0.01. I asked if it's possible to finish the prostap injections now  was told maybe be able to have tablets instead which are meant to work differently and my testosterone levels will start to raise up to a better level for sexual function to start to come back.

User
Posted 13 Jul 2022 at 19:46
I'm coming up to 18 months on Zolodox and had radiation (6*6) last October and Enzalutomide (daily 4*40). My PSA and testosterone have been undetectable 9 months. I have 3 monthly telephone chats with oncology department but there is never much to report - fatigues, loss of libido, no weight gain, feel OK. Last time I met with the oncologist I asked him what the future held in terms of the hormone treatment and whether I would be able to come off it - to which he replied with a firm no.
User
Posted 14 Jul 2022 at 01:09

I was 56 when I started HT.

User
Posted 16 Jul 2022 at 16:10

Hormone therapy for too long is like killing a Ant with a sledge hammer!!

I have been on hormone therapy for 18 months my psa is now 0.01, I have asked to stop the hormone injections 6 months early they are saying maybe to replace injections with tablets which are kinder to my body with less side effects the tablets will allow my testosterone to come back slowly to help to get some sexual function back hopefully. 

User
Posted 16 Jul 2022 at 16:32
Mingman, I doubt 6 months will make any difference to your cancer, it could make a massive difference to your life.
User
Posted 18 Jul 2022 at 17:19

Thanks for the post, I had prostate cancer 8 years ago in 2014 I was 59 years old and I flatly refused hormone treatment because I was terrified by it and the side effects. my oncologist understood and arranged for me to have RT and brachytherapy. it worked and I had 8 years of remission. It is now back with a vengeance and has spread to my ribs and lymph nodes. The oncos are saying I must have the HT, but I am still s*** scared of it and don't know what to do, and don't know If I can face the horrible side effects.

User
Posted 18 Jul 2022 at 17:24

Hi Nick been on decapeptyl 14 months found it tolerable 👍

User
Posted 18 Jul 2022 at 17:40

I was on HT for two years it was OK. Now if someone said, you will have to go on it for life, I would have to give it a lot of thought.

It might be worth you starting a new thread, because I'm sure this will start plenty of discussion and I'm sure you will be here a few more years yet.

Dave

User
Posted 18 Jul 2022 at 19:11

T

Thanks Dave!!

User
Posted 19 Jul 2022 at 18:27

Originally Posted by: Online Community Member

Thanks for the post, I had prostate cancer 8 years ago in 2014 I was 59 years old and I flatly refused hormone treatment because I was terrified by it and the side effects. my oncologist understood and arranged for me to have RT and brachytherapy. it worked and I had 8 years of remission. It is now back with a vengeance and has spread to my ribs and lymph nodes. The oncos are saying I must have the HT, but I am still s*** scared of it and don't know what to do, and don't know If I can face the horrible side effects.

It would be better if you started your own thread Nick so that we are not cluttering up someone else's information but I do wonder how realistic you are being. You have advanced prostate cancer with bone mets; any side effects from the hormone treatment will be nothing in comparison to being terminally ill with bone mets - loss of mobility, possible paralysis due to dpinal cord compression, trying to breathe with rib mets, inability to urinate leading to permanent catheterisation, odema leading to possible heart or other organ failure, it can be a fairly awful death. And if it is loss of libido that worries you, once those bone mets take hold you probably wouldn't be able to have sex anyway due to the pain and risk of breakages and, as the disease progresses, you would be far too ill to feel randy. 

It is easy to compare life as it is now with your greatest fears about life as it might be on treatment but that is flawed thinking - the comparison should be between what life is going to be like without treatment v what life could be like with treatment. Better perhaps to have the hormones, control the cancer and negotiate yourself a decent quality of life for as long as possible followed by an end of life in which the worst bits have been avoided / controlled? 

Edited by member 19 Jul 2022 at 18:58  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 20 Jul 2022 at 05:18

Originally Posted by: Online Community Member
Sexual function all works, lots of surprise erections, but strangely libido might not be back to pre-HT levels, or it might be that I've forgotten a bit what libido is.

 

Interesting observation Andy. Like most ADT people I expect, libido vanished almost instantly for me when I started on zoladex. Strangely [to use your word] I was still able to have orgasms up until about 6 months ago [a year and a half from the start of ADT]. Now, at 2 years, I can't. It seems that although testosterone libido drops off fast, there's some sort of "mental" libido that persists while the brain still remembers.

Nothing new in the observation that libido isn't locked to testosterone but the extent to which libido is a mental thing is not to be understated and your observation that you might have forgotten what libido is, sounds spot on to me.

 

Aaagh, if it's not difficult enough rebuilding physically, it's another little challenge that libido might need to be treated sensitively and with empathy 😀.

 

Jules

User
Posted 20 Jul 2022 at 12:38

Hi, Thank you for your very clear reply, I am new to this forum game & I did not intend to clutter up anybody else's stuff & am sorry if I did. I  will start a new thread. I am trying to be realistic but it's hard when you are scared. thanks, NICK   

Edited by member 20 Jul 2022 at 12:50  | Reason: Not specified

User
Posted 20 Jul 2022 at 19:41
Libido still good 18 months into Decapeptyl. Erections fine and useable. But pretty much lost the ability to orgasm myself but doesn’t stop some fun.
User
Posted 22 Oct 2022 at 13:01

Started zoladex Jan 2022 following diagnosis with T3b N0M0 gleason 9 at age 78. RT at Royal Surrey May/June,60 gy in 20 fractions. Saw oncologist Sept 2022, psa now 0.08 a d told I can stop zoladex now after 3 implants  As side effects not good I am happy to do this. Is this short duration HT usual?

User
Posted 22 Oct 2022 at 14:09

It is a little unusual, but not a problem. HT is most important before and during HT, after HT it adds diminishing benefit. Treatment to cure prostate cancer is about 70% successful, stopping HT early might reduce that to 65%. 

At 78 you have to accept your life expectancy is about 10 years, if the cancer returns it will be about 7 years. Another 2 years of HT with side effects would reduce your quality of life now, for the potential of giving you an extra couple of years in a nursing home.

No way of knowing what your actual future holds with or without HT, but on balance I think you are better without it at your age and with your side effects.

Dave

 
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