What they don't tell you about Androgen Deprivation Therapy (ADT, hormone therapy) 

Totally agree with the cognitive effects and short term memory impairment I’m on ABI + Pred

Good discussion. I started this journey stage 4, psa of 1230. First oncologist explained nothing. Had no idea what to expect. Second was useless too. Third is great. Malecare's APC page is where I learned the most. Eligard and Abiraterone expected for life but 5-1/2 years later I'm still going. Some days are hard but hey, I'm still here.

I am coming up 7 years since diagnosed with numerous bone nets, lymph nodes and psa 9000. Response to Zoladex and Casodex was immediate after 4 months psa

The biggest problem I've encountered in the decision whether to agree to ADT is that there is little to no QUANTIFICATION of the benefit of ADT. Doctors are chomping at the bit to tell you there IS a benefit, just not how much. To the best of my ability to research the issue I conclude that the benefit is pretty marginal and at great cost, both financial and physical. Ask your doctor how much longer you're going to live by adding ADT, and you're likely to get a lot of hemming and hawing.

Do a cardiac and benchmark bone density check before starting. Use Relugolix instead of Lupron to lower cardiac risk...lift weights and do cardio...we need to exercise anyway to stave off sarcopenia...

Dr. Walker's point at minute 13 is spot-on. It was tough for me hearing that I had choices and that I had to decide. I would rather have been a passive patient and been told "This is your plan" but am now glad I wasn't. I'm making better choices because my radiation oncologist really made sure I understood the choices and that he wasn't making them for me. I chose 1 year ADT (lupron & zytiga) along with 28 doses of radiation to my prostate and 5 to my L1 vertebrae. Stage 4b with met to spine. Diagnosed in June at age of 52. Gleason 7 (4+3).

Thank you for the wealth of knowledge. I want to exclaim that thinking about your body and self is not an asocial activity; our minds, our inward being is full of others. I do not believe that music affects our thinking negatively but helps us to move in a rhythmical manner. The obstacle to exercise is social: there are the “get out of here” boys at the fitness center which prompts the necessity for earbuds.

Been dealing with prostate cancer for 3 years now. The only thing I can say with certainty is this: Base your decision on what type of cancer you have. How aggressive is it, how soft is it, how is it likely to behave, how deformed is it etc,,,. Now there are numerous ways to find out these questions, you may need to force certain kinds of test from your doctors. Of course the insurance you have/don't have will play a large part in treatment. 😢

This information is so spot on in my experience. My husband age 64 diagnosis stage 4 prostate to bone psa level 2100. In hospital began radiation Kyphoplasty surgery chemo and lupron injection. Psa no in 4 range. Newly diagnosed hbp hot flashes no libido ed ( button as described below in comments), now mci and alzheimers dementia 😢

Very interesting video. I'm going through all of this. Was diagnosed with metastatic prostate cancer in March. I'm 61. PSA was 525. Went on Orgivyx and Nubeqa plus Lutetium trial. Two more Lutetium infusions left. Now PSA is 2.3 and still dropping. I exercise a lot every day (walking, weights, intermittent sprinting, climbing). I've had no libido loss at all. Still achieving erection, although takes a little longer. Still very sexually active. Younger partner. Total vegetable-based diet plus nuts, green tea, white tea, black tea, some beans, limited fruit, AMLA powder, tumeric, white button mushroom powder, vinegars, flax seed, milk thistle. No direct carbs like rice or pasta or flour-based foods. No simple sugars. Have lost weight (now at 169 lbs down from 194) due to not eating anything that will add weight. Am maintaining quite a bit of muscle and have built new stomach muscle, although it takes a lot to get results since T is 2. Most prominent side effects are fatigue, amplified emotional reactions, some depression, and sporadic feelings of hopelessness. Try to push past. Exercise always helps overcome any fatigue or cognitive negativity. I experience almost immediate turn-around of emotions once I'm exercising. Fantasy/goal is to eventually go off ADT's and "manage" with diet or less invasive alternate therapies/drugs. I can dream, right? I appreciate the discussion very much . Great advice to talk to yourself during walking.

I found the exercise discussion to resonate with my experience. My background is diagnosed with leukemia in 2006 and oligometastatic PC (Gleason 4x4) Jan 2018 - on Lupron only since Feb. 2018. I am now 80 and am very active. I walk daily for about 1 hour and cut firewood for our heat that involves weight lifting of heavier sections in moving, stacking and feeding the fire all winter. I am bothered by increasing hot-flashes and short term memory loss but in general life is good .

When i met with my RO 2 1/2 years ago to plan my SBRT treatment part of his recommendation was that we start with a 3 month course of ADT. i was 81 at the time and especially since i have heart disease and Type 2 Diabetes I declined the ADT. He readily agreed and put no pressure on me to change my decision. Since then...July 2021, my post treatment PSA has decreased from 19.3 before treatment to 5.1 and gradually now to .87. I am scheduled for my next PSA test in December, but I noticed that when i had my last PSA test in July, they included a Testosterone test which had never happened before. The test result was 300. I dont really know what that means since it was my first Testosterone but im wondering what my RO will say in January when we meet. Maybe he isnt happy with my PSA still being as high as it it after 2 plus years? Just wondering if he might now raise the issue of ADT again. I dont have any symptoms other than ED but at my age i dont worry about that very much. I doubt i would agree to ADT now but not sure how i should be thinking about it . .

No Doc ever mentioned dick-shrink or memory problems at the beginning of Lupron. I could not consider other treatments at the time as I was actively declining into an organ failure event in March of 2019 in which I spent 29 days in a cancer hospital from heart & kidney failure not expected to walk out after needing to be put on dialysis which lasted 7 months. Heart failure and kidney failure did stabilize but dialysis left me with weak leg bones. Diet, fasting and exercise have left my leukemia and prostate oncologists not to leave out my nephrologist scratching their heads that I am still alive let alone thriving. PSA rising slowly now @ .28 and PSMA from Feb. 2023 showing NO bone mets that were bright as tactical flashlights at diagnosis in 2018. Don't give up as you might well beat the odds.

Great discussion ... lot's of decisions to make ... ADT's therapeutic value vs lifestyle and long term side affects ... including insulin resistance , bone density, muscle loss, cardio vascular, etc ...

And doctors get about $4,000 per month profit from androgen deprivation injections (ADT) with lupron or eligard and they profit $4,000 per month if its 1 or 3 or 4 or 6 month injection ). So if its a 6 month injection doctors have a nurse give the injection and the doctor gets about 6 times $4k equals $24,000 profit.

Destroying my mind, thank you now i can be a single idiot

Pickleball is the answer. Works for me

No one ever said anything about penis shrinkage…with urination being difficult finding the button I am left with after 2 years on Lupron. It is a cruel drug.

I have watched many professional presentations like this and they all talk pretty much completely in generalities. Some may, sometimes, a few, occasionally, once in a while. Very, very frustrating. I get the impression that to these professionals the side effects are just an after thought and they'd rather not talk about them at all, especially the sexual side effects.

I could write a book next years 20 years of having prostate cancer removed in 2006 37 Radiation treatments few years later Clinical trial, after been on intermittent hormone therapy ever since finally found out at by having PET CT SCAN Dec 2023 will a second one next month when Psa gets high get shot Eliguard sucks it down then ok for a while

Amazing Richard & Lauren. Thankyou

My balls shrank and after almost 2 years being off ADT they still have not come back very scary and depressing

Its a mistake to think breathing longer is living longer. I am in year 26 starting with prostate cancer 12/98. I've been through everything including radical prostatectomy (biggest mistake of my life) except said NO to chemotherapy (because immediate dysfunction). Tried many alternative treatments. If I had the last 26 years to do over I would not have had surgery or follow MDs/urologists nor oncologists. I would use a herbologist and been better off even if I lived only a few years. Lupron causes major cognitive impairment.

What about Gynocomastia and what can you do before-hand to prevent?

My hot flashes disappears after some years. You can have sex or live longer with ADT. It's up to the patient. I was stage 4 but now is undetectable. It's been 12 years since my cancer was detected. I chose to live longer so I took ADT for 10 years. 🙂

my doctor has discussed all these issues with me at length.

If you have male pattern baldness and become an adult, it will not matter whether or not you take ADT or surgically remove the testicles because you will continue to lose hair. The removal of testosterone would have had to be before you ever gained puberty.

How is the man able to grow the beard?

Diagnosed w/ prostate cancer in April hormone therapy removes testosterone and you have ED as a result my is can I take penile injections while on treatment? Does someone know?

Just had a friend die from p cancer .. thants not a good way to go … either..

ADT based on what I'm hearing here is a real trick bag of side effects. There has to be a better way , I think there just might be, based on testimonies of others . The first rule of medicine should be do no harm. Ironic how when side effects from conventional therapy arise the solution is a more natural modality as a counter action. Spock were are you, lol

I'm on ADT and had very minimal side effects not everyone has a problem so don't put it down

sounds like taking ADT is NOT worth living longer but in such a miserable existence. Quality over quantity of life.

The liberation from libido is the positive. All else is noise