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ADT ideas on comparisons please?

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User
Posted 29 Nov 2025 at 14:50

Husband is currently taking Bicalutamide before the ADT injections.

He has booked in at GPs for 1st one in just over a week. 

We have had no discussion about any of this, just been handed general leaflets off the Internet that I'd already researched anyway. There seems to be 3 choices, Zoladex, Prostap, Decapeptyl. At the moment he has expressed a preference for Zoladex because they have a monthly injection available and that seems easier if it disagrees badly with him ( hopefully not) 

1. We obviously want most effective in dampening testosterone before radiotherapy, but assume they all will do that.

2. Are any slightly better tolerated than the others? 

3. Our sex life. Despite both of us, stressing it was very important to us, an integral part of our well being, and despite our advanced years, very active , successfully, twice a week, nothing was offered. 

4. Does anyone have a better testosterone recovery rate? This would give us hope for the future at least. 

I am at least in a better place, largely thanks to the wonderful outspoken people offering advice and suggestions on this forum. I'm still afraid, just not terrified out of my wits 

Edited by member 29 Nov 2025 at 16:11  | Reason: Add drug names information I'd omitted

User
Posted 29 Nov 2025 at 16:50

I was on zoladex for two years. It's a pellet injected under the skin, which dissolves over three months. No problems with that.

I think prostap is a powder which is injected and then forms a gell under the skin, which disolves over three months.

I think some people have had more issues with the injection site from prostap than zoladex. I'm just one sample on one of your choices, hopefully others will chip in.

Dave

User
Posted 29 Nov 2025 at 20:10
I've commented before relating to my treatment-3 yrs Zoladex (plus abiraterone,enzalutimide,prednisolone for 2 of those years on trial) with 32 sessions of RT.

I was younger, 59, than your husband when treatment started for my locally advanced G9 PCa. I did suffer plenty of side effects as was expected from the HT, tried keeping active, no problem with 12 weekly implants.

I guess its not possible to predict recovery of testosterone but my level recovered to 20.4 two years after treatment finished, it seemed to happen suddenly rather than gradually. Other effects faded gradually, its said that recovery takes as long as the HT was given, that wasnt too far off.

Knowing what I know now I'd be happy having same treatment again, obviously the current succes of the treatment affects that comment.

I do seem to still have couple of hot flushes altho treatment finished 2018.

Peter

User
Posted 30 Nov 2025 at 13:16
Throughout our journey, our relationship has evolved and continues to evolve. We are married and in love. My husband really tries his best to stay healthy and fit. He is fit and looks very handsome to me. He has gained a bit of weight, but that simply means there is a little more of him for me to hug and hold close. I think it is normal as a wife to constantly worry about what you might lose. I worry about this as well. But I do not want to have regrets. I know I would regret not appreciating every minute I have with my husband and helping him make the most of his time.

He still works more than full-time. We have travelled and walked a great deal since his diagnosis. We even travelled during his radiotherapy for a weekend, and we have not stopped since his treatment ended. He can walk all day, although it is best to plan rest days too. He goes to sleep earlier than before. Looking back, the prostate cancer was already causing him to go to bed much earlier before he was diagnosed, so we didn’t notice much change after he recovered from RP and RT and adapted to ADT.

Many men on here have managed to come off ADT and, over time, regain their capacity. That is very good news for you as well. The medication affects everyone differently, not only in terms of performance but also mental health and energy levels.

We are constantly adapting. We have been grateful for how many of the things we enjoyed before we can still do, and we have made the most of that. The more you can focus on being grateful for and making the most of what your husband can do, rather than dwelling on what he may not be able to do (hopefully not in the long term, in your case), the more opportunity you have to grow closer in new ways. At least, that is what happened for us — thank goodness.

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User
Posted 29 Nov 2025 at 16:50

I was on zoladex for two years. It's a pellet injected under the skin, which dissolves over three months. No problems with that.

I think prostap is a powder which is injected and then forms a gell under the skin, which disolves over three months.

I think some people have had more issues with the injection site from prostap than zoladex. I'm just one sample on one of your choices, hopefully others will chip in.

Dave

User
Posted 29 Nov 2025 at 16:54

Thank you . That's useful. Yes I've seen a few people say they've tolerated it not too badly. 

User
Posted 29 Nov 2025 at 20:10
I've commented before relating to my treatment-3 yrs Zoladex (plus abiraterone,enzalutimide,prednisolone for 2 of those years on trial) with 32 sessions of RT.

I was younger, 59, than your husband when treatment started for my locally advanced G9 PCa. I did suffer plenty of side effects as was expected from the HT, tried keeping active, no problem with 12 weekly implants.

I guess its not possible to predict recovery of testosterone but my level recovered to 20.4 two years after treatment finished, it seemed to happen suddenly rather than gradually. Other effects faded gradually, its said that recovery takes as long as the HT was given, that wasnt too far off.

Knowing what I know now I'd be happy having same treatment again, obviously the current succes of the treatment affects that comment.

I do seem to still have couple of hot flushes altho treatment finished 2018.

Peter

User
Posted 29 Nov 2025 at 20:28

I really do appreciate these comments. I know the HT is heavy duty but if life can be manageable it's giving me hope. He's got a personal trainer booked for after Christmas, walks a big dog for a neighbour 3 or 4 times a week and is generally fit for his age. So I'm hopeful 

User
Posted 30 Nov 2025 at 07:45
I'm on lifetime HT been on Prostap since 2018.

Keeping fit is key, I always walk 10k steps a day even during the rotten weather at home.

Currently in Spain where winter walking is more pleasant and I'm doing 15-20k steps a day to keep fit and restrict weight gain.

User
Posted 30 Nov 2025 at 10:33

Hi that's really good to hear. I'm fairly confident he'll be OK with exercise, he's walked the Coast to Coast , and although it's many years ago now, he did the High Peak Marathon,  40 miles through the night in teams of 4. He's also done the 4 peaks in 48 hours, Scafell Pike, Ben Nevis, Snowdon  and then Caron Toohil in Ireland. I may have spelt that wrong. He's not so active now at 73, but does long walks about 4 or 5 days a week . He will never boast, but I will !  We going for one now ! Have  a lovely holiday in the sunshine. Thank you for the reply 

User
Posted 30 Nov 2025 at 10:42
The only study I came across that looked at testosterone recovery after ADT with different agents is this one: https://www.canjurol.com/abstract.php?ArticleID=&version=1.0&PMID=34378507 (you can click on the PDF box to download the complete paper).

We did the Tour du Mont Blanc exactly one year after I finished ADT. And we are off to the hills now for a walk in the sunshine (same age as your husband).

User
Posted 30 Nov 2025 at 11:02

I really appreciate this! Anything that makes you feel positive and hopefully is good. He'd love to do that! I'm not such a good walker but can go a little way. Still haven't got out into thus beautiful blue sky in Oxfordshire today.  Just going take care and have a good day 

User
Posted 30 Nov 2025 at 13:16
Throughout our journey, our relationship has evolved and continues to evolve. We are married and in love. My husband really tries his best to stay healthy and fit. He is fit and looks very handsome to me. He has gained a bit of weight, but that simply means there is a little more of him for me to hug and hold close. I think it is normal as a wife to constantly worry about what you might lose. I worry about this as well. But I do not want to have regrets. I know I would regret not appreciating every minute I have with my husband and helping him make the most of his time.

He still works more than full-time. We have travelled and walked a great deal since his diagnosis. We even travelled during his radiotherapy for a weekend, and we have not stopped since his treatment ended. He can walk all day, although it is best to plan rest days too. He goes to sleep earlier than before. Looking back, the prostate cancer was already causing him to go to bed much earlier before he was diagnosed, so we didn’t notice much change after he recovered from RP and RT and adapted to ADT.

Many men on here have managed to come off ADT and, over time, regain their capacity. That is very good news for you as well. The medication affects everyone differently, not only in terms of performance but also mental health and energy levels.

We are constantly adapting. We have been grateful for how many of the things we enjoyed before we can still do, and we have made the most of that. The more you can focus on being grateful for and making the most of what your husband can do, rather than dwelling on what he may not be able to do (hopefully not in the long term, in your case), the more opportunity you have to grow closer in new ways. At least, that is what happened for us — thank goodness.

User
Posted 30 Nov 2025 at 14:06

I feel you have echoed me exactly. We have been married 50 years, and he just looks so handsome to me! No other man can come near. I wake up each morning thinking how lucky I am.  It was love at first sight for me at Uni, and I feel very little different now than 50 years ago., just even more appreciative of him a hundred times. He is very kind, gentle but very steadfast. He is a wonderful father and grandfather, very hands on. We have weathered hurricanes , our son was mentally ill for 12 to 15 years with hardly any support.A living hell. We worked as a team. When he was sectioned he finally got treatment and is well and stable. We weathered it out and I'm sure we will this too. Keeping a sense of humour too. I'm finding support, and encouraging words like yours,  is keeping me steady, so I don't let him down. X 

 
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