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ADT or Orchidectomy?

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User
Posted 11 Feb 2025 at 18:03

 I initiated this thread about possibly having an orchidectomy rather than hormone therapy for the rest of my life. My oncologist confirmed my metastatic disease and that, although my PSA has been undetectable for 7+ years I would need to continue with hormone therapy for life.  He was quite clear that intermittent HT was never going to be an option for me.  My oncologist said it was up to me (and my wife!) but he could see no downsides but recognised the upside that we did not have to tailor our travel arrangements around Decapeptyl injections.  I discussed it with the urologist who had carried out my radical prostatectomy and he agreed to do it as a day case - said it would be a 10 minute job!  I decided to go ahead and it was carried out in October 2024. I chose a full bilateral orchidectomy via the scrotum. A small amount of discomfort initially but I am delighted with the decision.  Frankly after a radical prostectectomy followed by 7 years of hormone therapy my penis and testicles had atrophied so not having any testicles at all is no big deal. And I do not need to have chemicals injected into me! I can even arrange travel without one eye on the calendar with injection days marked in red!!  I still have hot flushes but my symptoms are no worse than before. And I can still manage to get an amazing (but dry, obviously) orgasm sadly no erection but you can’t have everything!!

User
Posted 11 Feb 2025 at 23:25

Good to get an update from you Nevis and I’m glad it went well and you’re happy with your decision. If I were in the same position as you I would give it serious consideration as I am more and more of the view that it’s the Prostap that has caused the worst of my side effects, given that my side effects started to improve long before there was any sign of my testosterone returning.

good luck for the future,

Derek

User
Posted 11 Feb 2025 at 23:50
Very brave decision Nevis, talk about taking control of your treatment.

Keep going brother and enjoy your holidays HT free.

User
Posted 12 Feb 2025 at 20:33

Hi Nevis.

This was mooted by my consultant last year but in the end I am pretty sure he said I became Hormone naive and so having the Orchidectomy would have been pointless. 
That would be the only issue. That your cancer might later become testosterone independent. 


But I think I would have gone for it otherwise. 

Hope it works for you for a very long time .

 

Phil 

User
Posted 12 Feb 2025 at 21:30

Thanks Derek! So far so good.  Alan

User
Posted 12 Feb 2025 at 21:33

Hi Jasper. Didn’t feel very brave actually - unless you mean in the “Yes Minister” sense!!  But thanks! I do feel liberated and physically not really very different!!! Alan

User
Posted 12 Feb 2025 at 21:43

Well Phil I did think about that - in fact my wife got fed up with me talking about it!!  According to my oncologist, if/when my psa starts to go up (it has been undetectable now since October 2017) then he would probably add abliterone  in pill form. Or maybe another dose of chemo. Either way, it seems that I would need to continue to suppress my testosterone and castration achieves that for sure!!  I do not understand what  the expression ‘hormone naive’ means!! Thanks! Alan

 
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