Hormone Therapy & Side Effects For High-Risk (Gleason 8)
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- čas přidán 29. 05. 2024
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0:30 Why is Gleason 8 cancer considered "high-risk?"
2:57 Do men with localized Gleason 8 prostate cancer need hormone treatment?
4:38 Does the volume or location of the disease affect the treatment plan?
6:38 Are PSMA scans, usually covered by insurance for high-risk patients?
7:19 What is the difference between first and second generation hormone therapy?
8:59 What side effects are associated with hormone therapy?
11:13 Can weight gain be associated with gynecomastia and breast enlargement?
11:50 What effect does hormone therapy usually have on PSA levels?
13:39 How long does it take the effects of hormone therapy to subside?
14:15 Can younger Gleason 8 patients attempt short course hormone therapy?
15:27 How universal are the side effects of hormone therapy?
16:34 Alex's conclusions
17:47 If you need more help
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PSA of 28, High Risk diagnosed early 2023. Thirteen months into ADT and it sucks. 12 months post radiation. I thought the hot flashes, extreme fatigue, diarrhea, chills were going to kill me. Then in Dec 2023 the radiation proctitis developed in my colon causing serious blood loss. I've had two flex sig procedures since then to burn/seal the blood vessels and ulcers but continue to bleed. Recent labs show I'm finally producing more blood than I'm losing but only by a little. Going to see a colorectal surgeon in a couple of weeks to see what they can do. Prior to treatment I was told about the possibility of side effects but they were downplayed by the doctors saying only a small percent of patients suffer from them and because of my relatively young age I would probably be fine. I'm posting this so everyone can know that the side effects can happen to anyone and do not let the doctor's downplay them. Ask questions and do your research. Good luck!
Thanks for speaking up.
I was coerced, deceived, intimidated and extorted into one Eligard shot that was supposed to be a six month shot. It still has my T level far below normal even after two years.
I was treated like a concentration camp inmate here at the CROSS CANCER INSTITUTE in Alberta.
We need to join our voices and demand FULL DISCLOSURE so we can give FREE AND FULLY INFORMED CONSENT.
@@robwells230 Aw man, this is depressing me :(
Did they inject the protective gel between your colon and prostate to protect your colon from the radiation treatment?
@@schmingusss I asked my Urologist about it and he said he didn't recommend it. I never asked the radiation doc about it. Maybe my Urologist was mad because I decided to do radiation instead of surgery.
Prostate cancer sucks no matter how it’s treated (unfortunately I know this personally)
I’m from Brazil. Age 61. Gleason 9. Surgery 3 weeks ago. Planning to Start radioterapy in 3 months + 3 years of hormone therapy. It will be a long battle !! I’m catholic with a huge faith in God !
Dr Schultz is just brilliant. I was suicidal when surgery was the only option presented to me but I realized that there was a chance to save my physical and sexual self by radiation when I started listening to him. (Grade 5 prostate cancer, Gleeson 9, age 66, PSMA scan shows no metastasis.) I was always fit and slim but my serious depression led to me losing 10kgs (22lbs) so I am now only 136lbs (and have been for the past 9 months) despite being 6 feet tall. But I added rigorous strength and resistance training to my usual cardio and upped the cardio by adding a force march component of between 15 and 30kms every day so that my bowel would be completely clear and flexible for the radiation (you also need your bladder full, to push the bowel out of the way). I also opted for many radiation sessions (39) with low fractionation so as to reduce radiation side effects, and installed the spacer gel to protect my rectum.
That was 8 weeks of radiation every day Monday to Friday, except for 4 in the first week. It was highly stressful but by the end of the 6th week I realized that the only effect of the radiation was 3 days of tiredness, diarrhea since the middle of the second week and some pain when urinating. The diarrhea went away completely 10 days after radiation and 2 weeks later, the only sign is that I have some slight pain when urinating. I am taking a muscle relaxant as well as a cranberry concoction that turns urine from acid to alcaline. The whole ordeal has been much, much less onerous than a bad cold. The most stressful part was the force marches (with diarrhea) and actual sessions - every week one of them was more complicated despite all my prep, because they have to align the daily CT scan with the planning CT scan to get today's remarkable accuracy and reduction in ancillary harm.
I am also on ADT, begnun 4 months before radiation. Again, the only noticeable thing was loss of libido although I was still able to fully get there - I just couldn't be bothered most of the time.
I am one of those men Dr Schultz talks about - I feel much better now than even before, because, for the first time in my life, my upper body is strong - really strong - and I have well-defined muscles. You see those scans of men who are on ADT and don't do what I have done - massive gain in visceral fat, muscle and bone loss in the 80% range or higher, that can never be recovered. You can avoid all that. Also, exercise naturally creates a positive disposition and I have been positive throughout except for my first 3 months of depression.
I did start with another advantage. There are 4 things that work to support prostate cancer - being overweight, being unfit, smoking and drinking alcohol. Throughout my life none of this applied. So I focused on the positive things. The instant I got my diagnosis I switched to strict vegan - this had a major positive impact for me in addition to the cancer benefits because I had never realized the extent to which milk was messing with my body - and no sugar or corn syrup (because it promotes inflammation) and taking tumeric with black pepper (to activate it) - tumeric is effective in reducing inflammation which both helps radiation and impedes cancer. I also had my gut bacteria checked and my immune system was luckily top notch.
Thank you for another great educational video
Your videos are factual and calming
…….. I had my prostate cancer return in 2022
………PSMA scan showed metastasis to
T10-L1-righ 2nd Rib -all small to moderate
I was restarted on Lupron and XTANDI
The side effects have reduced my QOL
………..FATIGUE, MUSCLE LOSS and DEPRESSION is SUBSTANTIAL
………… but at age 64 in 2024 - my PSA on
these for mentioned medications
PSA has been UNDETECTABLE
…..Exercise is the only thing that helps manage the depression and fatigue side effects
The sword cuts both ways
Cancer is under control
vs QOL side effects = I choose
Cancer control and manage the
Side effects
Thank you again for you videos
I’m 3 months into ADT, and have a small fan for hot flashes. They come and go, so I have to turn the fan back off too. I get chills after hot flashes. It’s the radiation side effects that are more unpleasant. Urination blockage, diarrhea, extreme fatigue, and nausea. I’m down to 7 days of radiation sessions, then on to rest and recovery after a 2-3 month peak. Yay!
Tighten your seat belt, the rough ride is just beginning. It takes a few months for the real horrific side effects of ADT to set in. Testosterone actually doubles for the first month so you can be fooled into thinking this isn't so bad. But after five or six months, the hammer drops. Look out for Severe mood swings, serious brain fog, dementia, depression, extreme fatigue and muscle loss, frailty, permanent penile atrophy and a long list of debilitating effects that may make life hardly worth living.
Do not believe the big pharma sales propaganda that these effects are temporarily as up to twenty percent of older men NEVER RECOVER ABOVE CASTRATE LEVEL.
Know all that you are getting into before you decide how long you will allow this cruel and barbaric treatment to continue.
I was gleason 8, 6 of 12 cores positive, grade group four. Prolaris test high/very high. My RO wanted me to do 24 months of ADT after 45 IMRT radiation treatments. After 12 months of Orgovyx I said enough. I was working out every morning and walking a few miles but continued to lose muscle mass. The joint pain was getting unbearable. I changed diet and actually lost weight while on ADT but didn't think I'd make 24 months. That is old school. Almost at two years since ending ADT and PSA has been .04. I will credit Orgovyx, my testosterone was over 200 after 90 days and over 400 in 180 days so their instant off and on claim was true for me.
As someone who has personally experienced the challenges of hormone therapy, I understand how difficult and overwhelming it can be. Despite the hardships, I remained hopeful and continued to fight my battle against prostate cancer, ultimately undergoing nine weeks of proton laser therapy. I'm thrilled to report that I'm now cancer-free.
To those currently facing the struggles of hormone therapy or any other aspect of prostate cancer treatment, know that you are not alone. Stay strong, stay hopeful, and don't be afraid to reach out for support. Remember that there is light at the end of the tunnel, and your journey towards recovery may have its ups and downs, but with perseverance and determination, you can overcome the challenges and look forward to a brighter future."
Dr Schultz, I completed my Radiation Therapy (42 treatments of 5 days/wk) approximately 3 mths ago. I first started on Relugolix in Sept ‘23 for 2 mths. Then switched to Eligard injections due to cost. My first blood test show “undetectable” PSA & testosterone after 4 mths. My initial PSA was 4.08 Gleason 8 and my PET/CAT Scan showed High Risk Cancer with NO METS! Yea!
I’m hoping that by Dec ‘24 my physician will stop the Hormonal Therapy.
I have no Sexual interest with my wife of 50 yrs and my stamina is profound! Actually my wife & I are” closer” since the hormone therapy was started!
But I’ve made up my mind to ignore the weakness and force myself and do my yard work & gym work outs!
I’m 70 and I work out at a gym 2-3 times a week. And ride an Electric Bike once a week.
My blood glucose has been elevated. And I’m a Type II Diabetic.
I have a similar diagnosis. At 80 and in good heath and on Lupron for six months at the recommendation of my urologist. . My urologist and Rt oncologist are at odds about the continuation of ADT for 24 months. I’m in agreement with Dr.Scholtz about over prescribing ADT in certain cases. 28 Hyprofraction RT’s and 6 months ADT will be evaluated to determine their effectiveness post treatment. Being armed with expert opinions and facts will help me determine the future course of treatment.
Please add keto, when you said you ignore the urge to keep sitting and do yard work, you're a fighter, I just got my bad cancer notice, I'm going to fast, stop my blood sugar supper low, I reversed my Type 2, now I plan to beat prostate cancer, keep exercising, keep walking , I'm also going to take Fenbenzadole
@@user-qj2wb7ne4e I'm going to skip the treatment
@@daleval2182
Thank You for the advice and information!
I'm 66 with G8, did 28 treatments of IMRT (last November) plus Lupron, 10 months in, my PSA two days ago was 0.01. Shooting for 18 months total, so far, so good. No spread, going to the gym 2-4 a week. I have gained weight, and that is my biggest concern right now. Love these videos!! Bless Dr. Scholz!
I'm just over a month shy of 58 and I've been on the first of two scheduled 3 month Lupron shots for 5 weeks and will be starting radiation soon for 5/12 positive 4+3 cores which is still localized in my prostate. So far, the hot flashes have not been bothersome at all as I'm usually hot all the time anyway. Really, the only way I can tell when I have them is because of the sensation of sweating from every pore of my body for about 5 minutes. As far as fatigue goes, I don't feel tired at all. Instead I feel sleepy all of the time but popping a 5 hour energy just after lunch at work on the days I work out seems to help a lot. My sex drive is lower but everything down there still works just fine. If my side effects do not get any worse than this, I will not try to get out of the 2nd 3 month shot coming up in August.
I agree ... these Dr's need to do a much more thorough job on disclosing these side effects vs long term efficacy ... mine pushed 18 mo's where I knew many at same grade who only did 6 mo's during radiation ... he was not happy when I skipped the 3rd shot .... then tried to guilt trip me and said I was risking having the cancer coming back .... I'd just read that new study that shows I'd get maybe and extra 2 months 15 years out, he dismissed that data ... my insurance covered it, but they'd get another 3 grand and I'd end up even more tired, more muscle loss, more helpless, etc... I'll note I drove to apt's/treatments in a 24 year old Jeep ... Dr drives a $125,000 dollar BMW ... so I'm glad for this channel and glad I dug deep into the latest data ... I opted for a better quality of life for what I have left (68 yrs old, robustly healthy before P-Cancer)
This is My Situation EXACTLY... except only a 3+3 Gleason 12 years ago... and decided on HDR treatment. Now... 12 years later my PSA is climbing (@5.28) and my doctors CANNOT find where the lesion is. PSMA indicated a single lymph node spread. After 2 BENIGN biopsies (1 lymph node and 1 prostate) a Fusion Guided Prostate Biopsy is scheduled for next week. The miserable process continues. PCRI.... THANK YOU!
Get a psma pet scan and it will show you where the potential new tumor is located , that's what I did when my PSA started climbing again after I was in complete remisión. Now I ow I have a new tumor in the prostate and can treat it directly. Theranostics is brand new and check it out thats less side effects than anything else. Good luck.
Thank you folks!
I've suffered extreme tiredness and hot flushes ever since starting Hormone therapy 18 months ago. this has impacted greatly on my quality of life, sometimes I regretting ever agreeing to it. However my PSA level is now down to 0.04 and was looking forward to getting my life back, before suffering a Heart attack and undergoing Angioplasty. Oh well, onwards and upwards.
For the hot flashes, try Pristiq (venlafaxine). 50mg in the morning and 50mg in late afternoon.
Thank me later...
Congratulations..you deserve a medal for suffering through ADT that long. Best wishes
I had RT and got mild radiation proctitis 18 months later. Using Salofalk suppositories (Active Ingredient:
mesalazine) first every day, then moving to once a week, has been sufficient to keep it fully under control. I also had ADT for six months and had the usual side effects plus a painfully infected tendon below my knee and then a rash over my chest and arms. All disappeared after the ADT wore off.
Another excellent video. This is a very complex area where individual experiences vary considerably. Based on my own experience, one of the first steps that should be taken where a patient is categorised as “high risk” is to try to pinpoint the reason for their high Gleason score and any metastatic activity. That should involve genomic testing. In a significant number of cases, the root cause of a more aggressive cancer and an accompanying high or accelerating PSA is a gene mutation such as BRCA1 or 2 or ATM. The presence of such a mutation upends much of the logic of treating patients with the primary goal preserving their sex drive. A gene mutation generally is a reason for intensifying treatment and for closer and more regular monitoring. It also brings a different range of drugs into play. Also from personal experience, lifestyle changes - even modest ones - can make a huge difference in how well first and second generation drugs are tolerated.
As always very informative as well as empathetic, thank-you
About those side effects, mental and emotional issues should be included.
Having no libido is no fun, but many of us find ourselves on an emotional roller coaster. Without testosterone, most are less aggressive, but how one feels about one's masculinity can be a major issue. Some of us cry very easily.
While the above are testosterone related, I have noticed one fairly well known side effect; brain fog. I my case, I occasionally fail to put words in the proper order when speaking. Also, after being on it for 15 months, one effect I think is a direct effect of Abiraterone (Zytiga) is a loss of equilibrium. I'm not dizzy, I just can't balance without three points of contact. I'm now taking half the dose, and saw immediate improvement.
Finally, please don't dismiss hot flashes as minor until you have experienced dozens of them a day.
Thank you for all the videos.
Thank you for posting as I fall into specific scenario being discussed. I was a couple of weeks away from a radical prostatectomy as recommend by my urologist when I decided to consult a radiation oncologist for another opinion. He concurred on the recommendation of surgery, but advocated for six-months of ADT beforehand. The oncologist feels this will improve surgical margins and overall better long-term outcome.
What is your PSA and Gleason score? Did you have a PSMA-PET scan and MRI targeted biopsy before the decision for surgery was made?
@@monetizepresentknowledge5621 PSA was 18, 6 of 9 cores had cancer with the worst being a Gleason 4+4. Bone scan, Pelvic MRI, and PMSA PET Scan indicates no spread outside the prostate.
Fantastic thank you, Please @pcri can you please do a segment on decipher testing and how these genetic tests can help with deciding on future treatments? Thank you
Thanks for continuing to educate Prostate Cancer patients like me through your videos. These are most wonderful. Can you please do a video and talk about how long it takes for PSMA PET SUV max scores to come down in primary prostate cancer site and the metastatic sites after PSA has reduced below 0.1 following Lupron and Xtandi hormone treatment. Also can you help us understand how the SUV Max score in FDG PET scan can be very different from PSMA PET Scan. Thanks again for all you are doing at PCRI. Very Grateful.
So interesting to watch and to read of the different experiences with hormone therapy. Gleeson 8 PSA 22 T3aN1M1 December 2018. Now 74 yrs, retired from “active” service many yrs ago.
Have been on hormone therapy since beginning 2019 starting Qtly and last couple of yrs 6 mthly Injections. If the PSA is down I don’t have any Inj. until it rises above abt 2.
So been having this type of treatment for abt 5 years now. Nightly hot flushes sometimes 3-4 times per night. We won’t mention the nightly loo breaks please. Otherwise Im happy waking up each day and put up with the inconveniences brought on by the treatment.
For the hot flushes :50mg of Pristiq (venlafaxine) in the morning and another 50mg in late afternoon.
Thank me later...
That medication did nothing to reduce my hot flashes, but it certainly inhibited orgasms...one poison to try to mitigate the harm of another poison..
It never ends
I have been watching many of your videos and it helped me a lot. I have been on a long road after learning Gleason of 7 and 8 and PSA of 149 with BRCA 2. I got the PSMA scan within 3 months and started on ADT. The scan showed Prostrate and bone involvement. I did lupron and Zytiga for 2 years and stopped taking the drugs R/T the side effects. My PSA was 0.06 for a year. I had intense testicle pain, hypertension, migraine headache for 8 months and became very weepy possibly R/t the prednisone . I stopped in late Feb. and the side effects have stopped. I took the zytiga and prednisone every other day for the last week.. I searched and couldn't find any information on how to get off the meds properly.
I'm greatful to have found this info early ( 2023 ) in this adventure , when my Urologist did the cores (12 of 12) he put me on Eligard for 36 months so I ask him "what can I expect from this" , all I got was " you will lose some hair". Yes you got that right , now that I'm armed with so much good information from PCRI , I'm able to speak up and ask the important questions. After 12 months of ADT and radiation I feel like I.m playing on a level playing ground with my team. PSA check ( last was .02 ) and 3rd Eligard shot in July. Hopefully I'm still doing well and still in this thing. I want to thank DR. Scholz , Alex and PCRI for being there for me through all this.
I hope the Eligard doesn't give you the severe brain fog, depression and mood swings that it gave me.
It's time we demanded full disclosure about ALL the side effects of ADT, not just big pharma sales propaganda.
It's easier to ride out the side effects when we know what to expect before hand, and when the decision on ADT treatment has been made with our FREE AND FULLY INFORMED CONSENT.
Good luck on your journey. You are not alone.
@@robwells230 I have alot of those but I think it's mostly because I'm alone and left to dwelling on these things. for me. it's fatigue so far. ( it's ridiculous )
@@robwells230 I almost forgot about the brain fog and the mood swings. And speaking of mood swings they always seem to be from mad to sad and back. Never have swung to the happy side.
Can someone answer, how do patients already hypogonadal fit into this? Thanks
Navigating the daily challenges of hormone therapy can be incredibly difficult. It's a grueling process that can sap the energy and strength right out of you, making even the simplest tasks seem insurmountable. I understand how disheartening it can be when progress feels slow or non-existent, but it's essential to keep pushing forward.
Remember, you're not alone in this struggle. There are others who are going through the same journey, and we can lean on each other for support. Keep trying to stay active, even if it's just a short walk or gentle stretching. Every little bit helps, and it's important to celebrate even the smallest victories.
You are stronger than you think, and your resilience will carry you through this challenging time. Keep your eyes on the prize-a cancer-free future-and know that with perseverance, you can overcome this."
I opted for Brachy Therapy and IMRT with no ADT, my PSA was 5.8 now it's at 0.827. I did not want to face the side effects associated with ADT.
How old are you? I’d love to have a conversation with you. I’m black, 42, 8mm lesion, Prostatitis, PSA 17.
If you ever find it necessary to go on ADT, make sure you get full disclosure about ALL the horrific side effects including the unpredictable long recovery and risk of permanent CASTRATION.
Once you weigh all the factors, you can make YOUR decision, and it will be easier to ride out the effects.
Best wishes on avoiding ADT.
@@robwells230 I’m not going on ADT if diagnosed. It doesn’t make much a difference & if it did, I still wouldn’t.
@@JasonRoberts556 I'm thinking the same thing. I don't think I could handle all the side effects of ADT. This is so depressing. I took Propecia (Finasteride) for hair loss for ten years between the ages of 30 and 40. It gave me horrific panic attacks. I think this may have something to do with my high PSA score. What a dumb move that was.
@@schmingusss I honestly think this is about business. This is about pushing fear into men when most would live for a long time if nothing was done
For the hot flashes, I have been taking 50mg of Pristiq (venlafaxine) in the morning and another 50mg in late afternoon.
That reduced the hot flashes by about 75%.
I am sleeping much better also!
Gleason 8, PSA 5.5, PSMA pet scan shows a very small lesion on a pelvic lymph node. Tri-modal therapy with brachytherapy and IMRT, plus ADT. Would Dr. Scholz agree that 12 months of ADT is sufficient even with the lymph node involvement?
My PSA drop 0.12 my prostate spread to my left about 9 matastes in 1 area I'm am harmone therapy abreteron and prestone why can I have reduction my doctor said no because of multiple mataste
I did six months of Orgovyx for Gleason 4+3 along with radiation. I was suicidal while on it and despite discontinuing it 18 months ago I am still suffering from psychological issues. My testicles have never recovered to their normal size and now I need testosterone therapy. I would never do ADT again even if it worsens my prognosis.
I’d rather die before continuing hormone treatment . I got one shot that was enough. It was hell.
Thankfully, my situation is no longer serious but here's something to consider about hormone deprivation therapy. I had no idea the therapy would cause gynecomastia, aka man boobs. Had I been told earlier I would've had my ripples radiated. Now I'm going to need plastic surgery to remove excess tissue.
Exactly..I requested a low dose aromataze inhibitor like letrozole, but no doctor would prescribe it. Now I've got bitch tits on top of all the other horrific quality of life destroying side effects of this cruel and barbaric ADT CASTRATION.
And the get pissed off when I complain that I've been treated like a concentration camp inmate after being Coerced, deceived, extorted and intimidated into a 45mg shot of Eligard that was supposed to be a six month shot. Yet, 18 months after that shit was supposed to expire, my testosterone remains barely above castrate level with all the association side effects that make my life not worth living.
Here in Canada, it is easy to get a MAID (MEDICAL ASSISTANCE IN DYING) injection than to get a prescription for testosterone shots that would give me some semblance of a quality of life.
I just had the robotic prostatectomy .After six weeks my PSA is 1.0 Am I have to follow with hormone therapy?.What will the side effects caused ?
I am not a doctor but this is much higher than it should be and suggests metastasis. My advice is to let the experts guide your next round of treatments. If you haven't had a PSMA PET scan I think you should get this done. Experts may say that the PSMA scan should not happen immediately because it can't pick up lesions less than approx 2mm in width, so you may have to wait a little bit.
I think your PSA is too low for PSMA scanner currently but ask anyway - do 3 monthly PSA tests. My husband showing PSA post op then doubled and doubled again indicating was on going. Did radiation PSA now >0.008 last three tests (undetectable).
I am aged 66 . My PSA is 4.1 The MRI prostate w wo contrast RAD showed 4 and the biopsy report from 12 samples showed one RA , biopsy 3+3 and one RMPZ biopsy 4+3 . The bone scan showed no spread . Am i considered as Intermediate Risk Prostate Cancer ? Should i do Radiation therapy with or without hormone therapy ?
It is entirely YOUR DECISION, but beware that your doctor will obfuscate and minimize the horrific quality of life destroying and life shortening side effects of ADT CASTRATION and exaggerate the small, hoped for cure benefit.
Ask your doctor if he has personally been on ADT CASTRATION for two years.. If he hasn't, then he only spews big pharma sales propaganda with all the integrity of a sleazy used car salesman.
Get full disclosure so you can give FREE AND FULLY INFORMED CONSENT to any treatment.
Best wishes for a complete cure
Hormone treatment was hell. Hot and cold flashes was severe. I’d rather die. After one shot for three months that was enough . I told the doctor no more.
I was Coerced, deceived, extorted and intimidated into getting one six month shot of Eligard that my dictator doctor said was a six month shot. She demanded that I be on her ADT CASTRATION protocol for two years.
The side effects were so INSUFFERABLE that I gave her the old 4 Q and I refuse to ever see her again at the notorious CROSS CANCER INSTITUTE.
Now, even 18 months after that shit was supposed to expire, I remain partially castrated with extremely low T with little hope of ever recovering any quality of life.
My Hot Flashes are awful
50mg of Pristiq (venlafaxine) in the morning and another 50mg in late afternoon.
Thank me later...
Physical side effects are always mentioned. What needs to be discussed more are the cognitive & emotional side effects of hormone (and steroid ) therapy!!!!!!!
Yes, indeed. The drug makes and sellers like to obfuscate or minimize these horrific side effects. I found the brain fog and mood swings so severe that I refused ADT after the first six month shot expired.
Agree. For me the brain fog was and remains a considerable issue. I stopped driving completely because I once tuned out on the road and got a speeding ticket - never happened before! I have lost my wallet 3 times on the train (never before) and lost my phone twice (never before). I am always forgetting why I am doing the thing I just started doing... I have got to the point where this is manageable although frustrating.
You speak my mind - fro me the side effects are horrendous but for others they are horrendous. But I am learning from women that ifs like that for women at the menopause - for some it is horrendous and others it presents few serious side effects . But we all laugh as they say, “now you know what is like to be a woman!”. I was Gleason 9 with a PSA of 832 and metastasised when is was first diagnosed and there is little alternative
Sorry second “horrendous” should be “little problem” - you can put that down to the meds!
I find the comments about testosterone recovery after completing ADT to be very misleading.
Testosterone may recover a very small amount in 6 months, but most men will remain hypogonadal for much longer, perhaps years, or forever.
It would be helpful to learn how much benifit is gained by adding 6 months of ADT to radiation,
How much more benefit is gained by adding another six months? And how much by adding another year??
It would also be helpful to explore alternative therapy such as adding Bicaludamide to initial Lupron type ADT, and to limiting Lupron to 6 months and replacing it with just Bicaludamide thereafter for another six months or year???
Many of us find the side effects of Lupron horrific and insufferable. We need alternatives to regain some semblance of quality of life.
Give is real options.
Our bodies, our choice.
Hope to see more of these questions answered in up coming videos
Thanks
I have seen studies from 2-3 years ago and heard experts say that if you have 6 months of ADT, you are likely to recover fully, whereas if you have had 18 months of ADT, you are unlikely ever to recover fully. I don't believe there have been valid studies for different intervals. One of the big news items of last year re prostate cancer is that intermittent ADT (6 months on, 6 months off) seems just as effective as continuous ADT in terms of overall mortality, but with the chance of full testosterone recovery.
It is very obvious that the good doctor has not personally experienced the horrific quality of life destroying and life shortening side effects of ADT CASTRATION.
.....There is a huge difference between the rosy picture he paints about ADT, and the actual reality of this cruel and barbaric treatment. Testosterone recovery takes years and is often permanent. After 18 your more of ADT, 75 PERCENT of all men will NOT RECOVER their testosterone levels even after a median time of FIVE YEARS. The brain fog, dementia, depression etc are deadly..
You are correct in stating the importance of men knowing before hand about ALL the side effects of ADT CASTRATION, yet the doctor continues to obfuscate and minimize these deadly side effects. Therefore, men do not get full disclosure and do not give their FREE AND FULLY INFORMED CONSENT and end up with treatment regret and outrage. Many of us, having been coerced, deceived, extorted and intimidated into this chemical castration would sooner be dead than continue to suffer barely existing as ZOMBIE EUNUCHS.
Give us the truth , the whole truth beforehand so we can make our own informed decisions, rather than being duped like concentration camp inmates
Why is it that ADT affects ECG readings if it doesn't directly affect the heart???????
Why do you continue to obfuscate or minimize the severe brain fog that results from ADT????
Why don't you warn men that after ADT, their testosterone levels will remain below castrate level for many months or years and could be permanent, and that after 18 months or more of ADT, 75 percent of all men WILL NOT RECOVER THEIR TESTOSTERONE LEVELS EVEN AFTER A MEDIAN TIME OF FIVE YEARS?????
These are critical factors that men must know and weigh carefully before they can give FREE AND FULLY INFORMED CONSENT, and considering the small benefit, if any, to cure rates.
You owe full disclosure to your patients and viewers.
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