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Locally advanced to one node treatment

User
Posted 06 Feb 2026 at 11:18

Husband is on Decapeptyl,  9 weeks in, and doing quite well. Keeping active, walking as usual. The plan is to put him on Apalutamide too before RT in June/ July, 20 sessions. Two years of HT hopefully. 

After just 21days on Decapeptyl his PSA had dropped from 7.1 to 1.7

However he had an annual review at the GP and they are trying double the dose of Ramipril for his BP, from 5mg to 10mg. He takes his BP himself and chats to the pharmacist. 

He had an oncologists appointment a few days later and explained this, and was told they'd just leave the Apalutamide for a while until his dose stabilised. Since then, nothing. He has got an appointment with the pharmacist to discuss how thats going next week, and generally it is now in the normal range. ( BTW I have a severe phobia about BP, can't look at the machine, and have a very understanding GP, same one  as husband, who I've asked not to tell me the numbers. So I'm trying hard not to project my phobia into this situation.)  

How is the BP on Apalutamide controlled? Presumably differently for different people.  I feel it's best he takes it to help the treatment a success and we'll tackle the side effects.

Also if anyone else has concerns about their love life, that is going as well as possible. As a wife of someone on HT, I still feel loved and wanted. I am reassured all the time. The fact he just uses the pump, etc to me shows a commitment to keeping our relationship going, and also helping keeping healthy for the future. We need to stay positive through this.

He's mentioned it several times to clinicians at the hospital and been ignored totally, and so have I, but last time a different consultant did acknowledge his feelings. We'd agreed to focus on his PC treatment,  and at the end my husband added he wanted to keep his sexlife going as much as possible as it was important to both of us, and he listed what he was doing. Sildenfil from GP, a Somaerect pump he bought himself, and the NHS Squeezy app.  All information found and instigated  by ourselves. Consultant said it all seemed very sensible and was something he would discuss again. 

Nurse we saw ignored it and almost laughed. She actually said, "well you've still got the radiotherapy, and you can always have a cuddle. "  She was a masterclass in trivialising a patient's serious legitimate concerns, and insensitivity.  

User
Posted 06 Feb 2026 at 19:09
Not quite same situation, I was on Zoladex (with additional abiraterone,enzalutimide,prednisolone on trial)for my locally advanced to seminals PCa. I wasnt on any BP treatment prior to my cancer treatment. When diagnosed put on HT right away, first biopsy when it came was postponed due to BP, started on tablet, settled, had biopsy as normal. After starting trial treatment had BP problem, referred to cardioloogist, checks done heart good&strong, recommenced trial treatment after being prescribed 2 more BP tablets. Situation remains same now,treatment finished summer 2018, but can't really complain.

Thankfully i havent discovered any phobias, must be quite hard at times.

Peter

User
Posted 06 Feb 2026 at 19:42

Antoinette, also on decapeptyl and apalutamide getting the BP under control is a nightmare. I have been taking blood pressure medication for forty years.

Before starting on apalutamide I was taking Ramapril and feledopine. Since starting apalutamide they have doubled the feledopine and allopurinol gout meds. Then I was prescribed 4 mg doxazosin then 8mg the 16 mg. Just over three weeks ago the oncologist stopped the apalutamide and the GP added cardie SR.. I have also cut down on my intake of black coffee. 

Pre the last meds and while still taking 240 mg of apalutamide my BP was averaging 160/91, sometimes reaching172/121. 

Now after one week on 60mg and 15 days without any apalutamide my BP this morning was between 121&138 sys and between 70&76 dia.The target is 135/85.

I see the oncologist in 6 days time ,that is going to be an interesting conversation.

Thanks Chris 

Edited by member 07 Feb 2026 at 00:05  | Reason: Not specified

User
Posted 07 Feb 2026 at 09:04

Well husband BP is high without the Apalutamide! Certainly more stable on the 10mg of Ramipril.

He taught for 40 years, and we had a living hell from 2000 to about 2014, with our son, who had severe mental health problems, returned very ill from Uni, and who the Mental Health system totally failed. It was only when he got sectioned that real diagnosis and help started. He has been gradually improving and is stable now on the right medication. But fighting our sons illness and a broken mental health system takes a toll on your own health I believe. Otherwise he isn't overweight,  walks regularly, most days,  doesn't drink coffee, and we have an allotment and have a decent diet with organic produce.

Hopefully we will find a solution, as I hope you do too. He has started taking a beetroot supplement. Ironically we grow lots of beetroot ourselves and eat quite a lot, but not in the same concentration as supplements.  

User
Posted 07 Feb 2026 at 09:57

Hi Peter

I've had my phobia for 50 years. I cope by taking charge, but enough of me! 

Husband is exact opposite,  practical science based. Of course having a PC diagnosis is stressful and could easily put up your BP, also over last decade or so the bar has been lowered for a healthy BP which is why so many are on medication now 

 
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