Can we talk about boobs please? Man Boobs. ADT induced gynecomastia.

I want to thank everyone that commented on my original post. Sorry for the long post here.
After reading everything here I contacted my Medical Oncologist and Radiation Oncologist to see what thought. Both of them are maybe in their early 30s. My Medical Oncologist said that the newer drugs has less of a chance of those side effects than older drugs. I said that the new drugs I was on Erleada and Orgovyx were what caused my gynecomastia. He replied that it wouldn't do any harm to talk to the Radiation Oncologist. The R.O. said the same thing as my M.O. , I said that it already happened and that I would be going back on ADT in the future. He agreed that treatment for it would be appropriate but that he did not do that procedure himself. But he was able to refer me to a Radiation Oncologist closer to home ( I live 2 1/2 hours away from my P.C. medical team).
The new R.O. was a man in his early seventies. At our first meeting I knew that he had read my whole Prostate cancer chart. He said "You have been through a lot in the past three years". He could name every one of the Doctors that had treated me and what treatments they did. Before he even examined me I also knew that he had actually looked a my most recent scans. He said that my left breast was larger than my right. And said it was likely because I already had radiation the the right breast area when I had the radiation treatments for a tumor in my right Hiluim (a lymph node attached to my right lung).
He told me about what the treatment entailed. It was just three short sessions of radiation to my breasts. He told me about some minor side effects. Asked if it was something I wanted to proceed with. I said yes but that my M.O. and other R.O. were less than enthusiastic about it though. He replied that was because they were young. He explained that back in the day when actual physical castration was standard treatment for advanced Prostate cancer this would have also been standard treatment. He said my others Oncologists are too young to have practiced when those treatments were standard.
I finished my last of the three radiation treatments Friday. Only side effect was a little redness.
I think that I will be back on some sort of ADT by the end of the month. I will have lab work done and see my Medical Oncologist Monday.

@aldenrobert
Having had this embarrassing thing is something that has bothered me for decades. I tend to have fat accululate in the breast area and very embarrasing. I know weight loss would help but went through proton radiation treatment in 2023 and gain a lot of weight because had reverted to eating a lot of comfort food.

I then was having some issues with my heart failure and my HFD put me on a drug that made my breast swell, hurt especially my nipples. I read up about it and sure enough the side affects of this drug causes them. Just what I needed more, bigger breast. He changed my medication that has a lot less side affects.

I just don't want anymore radiation and the heart medications I am on is important. I read your post and you have an outstanding doctor, ton of experience and a caring one. That is hard to find this days.

Last Sept or thereabouts I received some radiotherapy to halt any further breast enlargement. It seems to have worked so far. Very easy to tolerate, there were only 3 sessions not counting the simulation they used to develop a fixture. This was using electron beam, so not the usual photon beams. Because of that the depth of penetration was very shallow so no worries about secondary SEs.

What I had was very mild enlargement, just noticeable enough for my MO to agree that there was some gynocomastia. He explained the two main options, one taking a hormone pill, the other radiation.

I figure if when I get off the ADT in about a year if the tissue that had developed there bothers me I can always get surgery. That would be out of my own pocket though. I'm guessing less than $5k since only local anethesia is used.

This thread is just one of the MANY reasons i chose an orchiectomy with reconstruction (implants).
We have enough to deal with without adding to it.

My heart goes out to you guys.

PS: Just so you now, you can always switch from the chemical approach to the surgical solution.

Best Regards

There are treatments that can help with gynecomastia. One option is a couple of shots of radiation to the breasts (see a radiation oncologist). The other is a drug called tamoxifen. These options cannot reverse breast growth but they can arrest it.

Gynecomastia is common for both chemical castration (lupron et al) AND orchiectomy. It is caused be the lack of testosterone which both approaches cause.