Ready to throw in the towel

Scott, you sound exactly like me when I first started Lupron. I am an Internist and understand these things a bit more than most.
Please ask your Oncologist to drastically decrease your dose of Lupron. Try the 3monthly dose which is less than half of what you seem to be getting now. Decreasing the dose helped me tremendously without affecting the efficacy of the drug. I remained hormone sensitive for about three years and was able to continue to work 12 hours a week to date doing consults in my practice.
By all means see the Psychiatrist and the mental health team for all else they bring to the table.
Stop the starvation diet and find a way to accept the fact that your sex life will most likely never be the same. The brain is your most important sex organ and the diagnosis and treatment of prostate cancer primarily robs you of libido. In my case, a naked woman or even erotica might as well be covered furniture.
I would quit the gym. Do as much walking as you can but don’t exhaust yourself.
Remember, we are very lucky to be living in this Universe at this time, the probability is in the trillions of trillions, so ride it out. You can still find some joy once your maintenance treatment is adjusted to manageable doses.

I’m sorry to hear you are going through this and here on the forum, but to that extent, you have found a strong support community, so that is a plus! There is tons of good input so far, so will try to share just new ideas

Meaning/Purpose – You are age 60 and claim to be “faking my way through work”. Congratulations, you are employed and have a job where your abilities allow you to be productive and add value. The issue here is that you are fully aware that your contribution has changed significantly, that is often hard to accept. My suggestion is to map out your retirement and come up with scenarios that allow for early retirement by reducing your annual expenses. Once you have a few scenarios mapped out, then take a step back, relax, and ask yourself about the meaning/purpose of your life. This is an extremely hard question sometimes (sometimes it is easy), but in general my suggestion is to get a piece of mind about the necessity of employment and in doing so to re-energize a new sense of meaning/purpose.

Perception by others – You are human, so it is perfectly fine to have raw emotions that result in worries and feeling down about how others perceive you as your body takes on radically different shape and ability, and your daily activities change. Just remember the physical side of our lives is just a tiny layer of physical material that is wrapped around who we are as a person. Your friends, family, sexual partners ultimately love you for who you are, not for the size of your muscles or the ability to maintain an erection. If folks truly don’t want you in their lives because of physical imperfections, let them go, gently.

Your feelings – How you feel is who you are, so embrace it (it is a gift of equal value to be happy or sad) and seek out a professional to talk to about how you feel. Dealing with cancer and the active grief that it brings may be the catalyst for bringing to the surface a multitude of pre-existing conditions not limited to trauma, loss of innocence, abandonment. This is heavy stuff, and you just need to talk with someone. You might need cognitive behavior therapy, who knows, but start talking with a professional and stick with it, they will help peel back this onion with you.

Three things – Refine quality of life by three things. 1, having a healthy bowel movement. 2, having a good night sleep. 3, being kind to people each day. A healthy bowel movement requires a good diet, increase your fiber, reduce ultra processed foods, but do what you enjoy and be mindful. You want a hot dog or ice cream, have it and enjoy it, just don’t do it frequently. A good night sleep might require taking long walks before going to bed, taking a shower before bed, stretching, drinking tea, etc. Find a way to infuse gratitude and calmness into your end of day activities and your brain should slow down and allow for sleep. Kindness - Being kind to people is key, sure you used to be very active and have f& buddies and do pre-cancer stuff, those are great memories and cherish them, but now try to be more Zen-like and express good wishes to people you see and think good thoughts.

Final thoughts – None of these steps are easy, life isn’t easy. Pace yourself. Your past is a treasure trove of memories and experiences, no one can take it away from you, share it widely and often as the opportunities present themselves. See this as an entrance into a new chapter of your life. Life is mysterious which means it is beautiful and terrifying at the same moment, we are lucky to have today.

It gets better, much better. I'm sitting here in my Lazy Boy feeling your pain. We've all walked the same prostate cancer path. Pain, depression, and fatigue are a part of fit. But, so is learning to live with cancer. Creating Quality of Life goals are mega important.

We live two lives. One, our life before our prostate cancer diagnosis and two our life after our prostate cancer diagnosis. For most of us on this board we've been disgnosed and our life is getter better.

Scott, you sound exactly like me when I first started Lupron. I am an Internist and understand these things a bit more than most.
Please ask your Oncologist to drastically decrease your dose of Lupron. Try the 3monthly dose which is less than half of what you seem to be getting now. Decreasing the dose helped me tremendously without affecting the efficacy of the drug. I remained hormone sensitive for about three years and was able to continue to work 12 hours a week to date doing consults in my practice.
By all means see the Psychiatrist and the mental health team for all else they bring to the table.
Stop the starvation diet and find a way to accept the fact that your sex life will most likely never be the same. The brain is your most important sex organ and the diagnosis and treatment of prostate cancer primarily robs you of libido. In my case, a naked woman or even erotica might as well be covered furniture.
I would quit the gym. Do as much walking as you can but don’t exhaust yourself.
Remember, we are very lucky to be living in this Universe at this time, the probability is in the trillions of trillions, so ride it out. You can still find some joy once your maintenance treatment is adjusted to manageable doses.

In addition to the links I provided above, here’s a paper about the benefits of exercise to counteract the adverse effects of ADT —> https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx

I don’t run as much as I used to, but I still use an elliptical machine at the local gym - anything to keep things moving. At one point I enrolled in a water exercise class at the local Y - that form of resistance training helped keep the pressure off of the knees. Again, anything to keep things moving. No excuses.

Being a gym rat, I managed my own weightlifting and cardio regimen without the need for a personal trainer. Based on my tracking, along with a noticeable loss of muscle mass, I experienced an approximate 30% loss of strength. But, it never prevented me from engaging in any vigorous activities. As my strength dropped (due to the loss of testosterone), I had to reduce the weights I was lifting so as not to injure myself (muscles and joints) during that time. (Always listen to your body.) Setting expectations as to what’s possible while on ADT is important.

Despite being on Eligard at 65y, I pushed myself and swam in U.S. Masters and Senior Olympics events in my state in 2021. I didn’t make any world records(!), but I was competitive in my age bracket. More importantly, it kept me active and in shape while on Eligard. Never give up.

Just as most cancer centers have trained counselors to help men and their families get through the mental health aspect of prostate cancer, many have fitness programs to help men get through the physical and dietary aspects of prostate cancer and hormone therapy. Consider contacting them.

Thanks. Do you ever reach a point where you can go an entire day without thinking about cancer?

I know in my head that you're right but don't feel that way in my heart yet, though I do know from life experience that eventually you can get used to just about anything so we'll see. Just out of curiosity, why can't you fly a small plane, even solo, if you have prostate cancer?