Hormone Therapy (ADT)

To Peter2016:

I've thought about what you said. I believe the doctor was telling me (but I will meet him again) that by having the HT first, it will lower the PSA and reduce the presence of cancer, which I presume (I should not, which is why I'm meeting with him again) will make it easier when receiving the MR-LINAC treatment. 

The last thing I want is a reoccurrence. IF having the HT will prevent that (is anything preventable, I do not know), then HT it will be. 

I feel quite naïve in that I honestly thought I was going to go in, schedule 5 sessions of MR-LINAC and be done with it. But it's seeming that that will not be the case. 

Thank you for your comment; I appreciate it. 

I was going to start a new thread, but perhaps it is best to keep it here. I don't really know how this site works. I'm really grateful for all of your responses. They have greatly benefitted me. 

In brief, I met with a radiology oncologist two days ago, as had been planned. I really thought that I was going to set up an appointment for my 5-time MR-LINAC treatment. Instead, the doctor said I should start with 6 months of HT, using Bicalutamide and Leuplin (Lupron). 

I was honestly taken aback and ended up stuttering through the rest of my session because HT was the last thing on my mind, and all my research indicated that the side effects were unpleasant (that's being kind) and long-lasting. 

I said couldn't we move past the HT and start with the MR-LINAC radiation treatments. He said it was possible, but I would first have to have a (rectal) spacer inserted. This was also news to me and threw me off again. 

The doctor, I will say, was quite fantastic, and spent nearly two hours with me (and my partner) explaining everything about the HT, the spacer, and the MR-LINAC treatment. 

He said, if I understood him correctly (remember, I was basically in shock) that the chance of reoccurrence without doing the HT first was higher. 

Obviously, I do not want any chance of any reoccurrence. 

I'm saying all this to let you know that the drugs mentioned were Bicalutamide (daily) and Leuplin (Lupron) (injectable, 1x every 3 months). 

He said 80-90% of the patients he treated agreed to it. 

I am wondering if any of you gentleman had this combination of drugs for HT? Also, did you need to do HT for six months prior to receiving EBR (which is essentially what the MR-LINAC machine offers, if I understand correctly)?

I have been extremely fortunate for 72 years. I do have high blood pressure, for which I've been taking medication for at least 10 years. So, the idea of these two drugs with multiple-side effects has been causing me untold anxiety (although I've been keeping it to myself, hence turning to this community). 

Some of you have been very kind to respond to my posts. As I have not actually received treatment yet, I cannot offer words of wisdom to anyone, but I promise that, assuming I get through this in one piece, I will share my experiences in the hope they may benefit someone. 

In the meanwhile, I want to know specifically how long your HT was for, which drugs you were told to take, and what kind of an effect they had (or have had) on your life. 

Thank you in advance. 

(NOTE: As I finished writing this, I see a message from CeePee which brilliantly sums up what I may need to know. Nonetheless, all responses are welcome!)

DaveMn:
Thank you for your response. I greatly appreciate it. 

So, you only had to take a month's worth of Bicalutamide? But then the downside (?) was the six Prostap injections? In my case, I was told it would be Lupron. I have to research it all. 

When you say "a few side effects" -- can you let me know what they were? I'm deeply concerned about them. As for "a little weight gain" -- you mean 1-2kg? Did you maintain it by doing extra exercise? 

May I ask how long ago you were on that HT? Did the effects linger for long after you finished it? 

Again, thank you. This is incredibly helpful. 

DaveMn: Again, deep thanks. This is such a huge mental adjustment that it's taken me about two months to wake up to what's really going on. 

Your letter is informative and helpful and encouraging, especially knowing that you are well on the other side of it. May I ask how often you had to have your PSA checked? I imagine it was checked during the HT period, and then... 3 months after the last MR-LINAC treatment? May I ask what the high point was and what it finally dropped to? Was your cancer contained in the prostate or had it "broken out"? 

Well, I know I can go on a bit. 

Again, thank you for a very helpful letter. 

Thank you again for the information. 

I was informed that it was contained, but "might" be at the outer edges. The doctor simply couldn't tell. My highest PSA was 5.62 in May of 2022. Last reading (September 2026) was 4.15, after the 2nd biopsy. 

I am inspired by your exercise regime. I want to follow it as closely as I can. 

So, while you were doing your walks, you weren't hit by the need to suddenly urinate? Did the hot flushes hit during the walks? 

I ensure I use the restroom before I embark on any walks, but I sense this treatment will create additional stresses.