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Post Orchiectomy treatment options

Posted 13 Jan 2023 at 21:10

I have had an orchiectomy. It was about 18 months ago. I had been on hormone therapy for 3 years prior. I found the highs and lows of hormone therapy bothersome. My PSA count has remain stable at about 0.4 

I’m 72 years old and decided after some heart to heart chats with my wife to have the operation. I immediately felt so much better. Gone are most fatigue issues, hot flashes etc.

I should say I do Tai Chi and about an hour of exercise 5 days a week, & ride my bike about 15 km daily so am relatively fit.


I’m curious to learn what will my choices be once my PSA starts to climb again. 

There seems to be very little published info on what the options are. I would appreciate learning about information on what options are available.

Ted R


Posted 14 Jan 2023 at 00:48

Hi Ted R

I’m really sorry I can’t help with your questions but hope someone else can.

A really interesting post though as I personally haven’t come across anyone on here yet having had this operation. So pleased that it has been beneficial with regards to HT side effects. Thanks for posting.

Wishing you all the very best 


Posted 14 Jan 2023 at 02:48

Hi Ted,

as I understand it. if your Prostate cancer becomes castration resistant, Abiraterone is still available to assist with tumour suppression followed by the chemo options like Docetaxel.

Like you I chose orchiectomy for ADT when my cancer was upgraded as advanced early last year. I am 65 and had the op in June 2022. Like you I feel much better than when I was on Zoladex. I am surprised how good I feel! I still exercise regularly, run, lift weights etc things I couldn't do easily on Zoladex. I was going to post on my experience but had intended to wait until 12 months following op.

Regards John

Posted 15 Jan 2023 at 01:28

I had the orchidectomy as well.  I was getting hot flushes and aches and pains on prostap injections. However, my biggest reason for the op, was because I  was told that as I had advanced prostate cancer I would be on hormone therapy for the rest of my life.  With this in mind, why bother with the injections with possibly varying levels of testosterone over each three months?

So now I'm just on apalutamide.  Consequently, I've still got the hot flushes and tiredness, but the aches have mainly gone and I can lead an almost normal life.

As per worries about castration - chemical or surgical it's all the same, so why not keep it simple.  Yes your libedo disappears, but my wife's vanished with menopause so there was no loss for me or her!

So future options for you if you're not already on an ADT hormone treatment, might be something like apalutamide or enzalutamide.



Edited by member 15 Jan 2023 at 01:30  | Reason: Not specified

Posted 15 Jan 2023 at 12:56

Interesting, I have bumped in to a few guys who've gone for bilateral orchiectomy, thinking it would get rid of some of the symptoms such as hot flushes, only to be a bit disappointed it didn't.

Posted 15 Jan 2023 at 13:48

I always thought it was the lack of Testosterone that caused the hot flushes rather than the drug itself, so it wouldn’t matter which route you took?

Edited by member 15 Jan 2023 at 13:48  | Reason: Not specified

Posted 15 Jan 2023 at 18:25

It didn't stop the hot flashes for me and I didn't expect it would, maybe the frequency is a bit less though. Other QoL issues are definitely better so far. No emotional fragility, no aches and pains, no bad fatigue, less impact on libido funnily enough, can still have orgasms though less desire.........


Posted 17 Jan 2023 at 16:29
If your PSA started to rise again post orchiectomy, your options would be broadly the same as any other man who became castrate resistant / hormone independent .... possible bicalutimide for a few months followed by bicalutimide withdrawal, the addition of stilboestrol, chemotherapy and / or one of the second generation drugs such as abiraterone, enzalutimide or apalutimide. Other new treatments are also in final stages of approval and will be coming onto the menu soon.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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