Headed for HT : | - What should I Expect?

Just finishing two years of ADT and I have to admit it bothered me. But the knowledge that it was only temporary has helped me and your situation will be a little different, but not that much. More and more men are doing intermittent ADT (IADT) and most comparisons with continuous ADT have found it similar in terms of the various sorts of survival endpoints they look at. For relatively young men whose testosterone recovers faster than their PSA rises they can often spend a fair portion of their time with reasonably normal hormone levels.

I have also talked to my oncologist about bipolar ADT -- where instead of giving a man an occasional "vacation" during which he is allowed to recover his T naturally, they immediately slam him with high levels of T once the ADT seems to be getting into diminishing returns. Some (small) studies have shown that in some men the cancer cells that have grown more and more sensitive to testosterone (grew more receptors) will actually die when subjected to high levels. It's a crazy idea but one that actually shows some promise. My oncologist says he doesn't usually do that but he agreed that if I recur we would seriously look into a small n=1 study where I am the only participant.

Lately he has also been excited about the possibility of going after targeted lymph metastases with surgery after a C11-cholate (or similar) scan has found them. He's had a number of young patients go that route and is frustrated that the nearest place to get the C11 scans is Arizona (as I recall). Thats another thing to talk to your oncologist about. It may not apply but it doesn't hurt to ask.

If you are like me you will do fine on the trail hiking while on ADT. The two big challenges are staying fit and not getting depressed. Hiking will help with both of those. Mowing the grass will be harder.

I didn't have any hot flashes for at least 45 days after my first injection and, if I did, they were so mild that I did not notice them. What came later and has continued has been severe. I can be fine one moment and then like a flash, I break out into a full on sweat. Additional side effects are: bone pain, fatigue, and insomnia. Strength has diminished as testosterone levels drop to almost zero.


DX 10/04/2013 PSA 187.5
07/11/2013 psa 3.31
3/10/2010 psa 1.87
1/24/2006 psa .87
Biopsy 10/28/2013 4 cores positive gs 9 (4+5)
Bone Scan 12/09/2013 2 hot spots in spine
Hormone Therapy started 12/17/2013 22mg lupron, 50 mg Casodex
Bone biopsy 01/09/2013 negative
RALP 2/19/2014 Non Nerve sparing, Lymphovascular invasion
Pathology T3B NX, MX, prostate size 4.2 X 4 X 3 cm, 31 grams
Bilateral cancer found involving 6% of prostate
03/07/2013 PSA .6
05/29/2014 psa <.01

It's better than dieing but that's the only good thing you can say about it..The effects become more profound as time goes on..None of the side-effects are anything to look forward to..Depending on your wife's sexual appetite, it can have a devastating effect on a marriage..