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Orchidectomy or stick with hormone therapy?

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User
Posted 17 Jul 2024 at 18:42

I have metastatic prostate cancer. After an initial course of chemo and seven years of Decapeptyl I still have an undetectable PSA. Long may it continue. I am considering having an orchidectomy to save the bother of injecting Decapeptyl every six months.  My oncologist says there is no reason not to choose to be castrated physically rather than chemically and the choice is mine to make.  He says he is never going to recommend a ‘holiday’ from having hormone therapy so I am on this stuff for life and I don’t particularly like injecting drugs into my body if it can be avoided.  I am 78+ and in good general health and physically active. Any thoughts or advice would be appreciated. 

User
Posted 17 Jul 2024 at 18:42

I have metastatic prostate cancer. After an initial course of chemo and seven years of Decapeptyl I still have an undetectable PSA. Long may it continue. I am considering having an orchidectomy to save the bother of injecting Decapeptyl every six months.  My oncologist says there is no reason not to choose to be castrated physically rather than chemically and the choice is mine to make.  He says he is never going to recommend a ‘holiday’ from having hormone therapy so I am on this stuff for life and I don’t particularly like injecting drugs into my body if it can be avoided.  I am 78+ and in good general health and physically active. Any thoughts or advice would be appreciated. 

User
Posted 17 Jul 2024 at 22:40

Hi Nevis,

This is a question I ask myself if I ever need to be on HT for life. I guess I would base my decision on how bad the side effects are if you are on HT. Have you escaped lightly? Or like me, have you suffered? Would having an orchidectomy have less side effects than HT?  In my view yes, because I only stopped HT 2 weeks ago and my side effects are significantly improving, thank goodness. But my libido hasn’t returned so I believe my testosterone levels are still low…I’m of the opinion that I lot of the side effects are down to the drug rather than the lack of testosterone. many would disagree however.

The only thing that would bother me is that if I chose that route and a new treatment cam along that meant I wouldn’t need HT for life then I would miss out on that chance. I also want my sex life back to a better level even if it’s only for a while.

I guess I’ve not really answered your question(should have been a politicianšŸ¤£) but that’s the way I look at it.

All the best with your decision and whatever it is.

Derek

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User
Posted 17 Jul 2024 at 22:40

Hi Nevis,

This is a question I ask myself if I ever need to be on HT for life. I guess I would base my decision on how bad the side effects are if you are on HT. Have you escaped lightly? Or like me, have you suffered? Would having an orchidectomy have less side effects than HT?  In my view yes, because I only stopped HT 2 weeks ago and my side effects are significantly improving, thank goodness. But my libido hasn’t returned so I believe my testosterone levels are still low…I’m of the opinion that I lot of the side effects are down to the drug rather than the lack of testosterone. many would disagree however.

The only thing that would bother me is that if I chose that route and a new treatment cam along that meant I wouldn’t need HT for life then I would miss out on that chance. I also want my sex life back to a better level even if it’s only for a while.

I guess I’ve not really answered your question(should have been a politicianšŸ¤£) but that’s the way I look at it.

All the best with your decision and whatever it is.

Derek

 
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