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Regarding minimizing ADT side-effects —> At 77y, are you able to engage in rigorous resistance-training exercise?
Here’s a PCRI video discussing this topic: https://m.youtube.com/watch?v=YE61HSAsFb0
Here’s a clinical trial paper with details about the benefits of resistance-training exercise as it relates to ADT side-effects: https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx
If you research the data, and can start exercises before starting ADT, as those experts point out, you’ll do well on ADT.
For me (with a localized Gleason 3+4=7; PSA of 7.976; at 65y), that level of resistance-training exercise led to minimal ADT side-effects: just zero libido (but, everything still worked), muscle atrophy, about 30% loss of strength, and very mild “warm” flashes. That was it. Quality of life was good. Yes, that extra 10% was worth it. (I had 28 sessions of proton radiation.)
Good luck!
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@brianjarvis Your experience (described in the last paragraph of your post, is similar to my experience. We differed in our treatments, I only had 5-fraction SBRT.
The 10% improvement in chance of remission @cobratk mentioned is new to me. I am 3 months in Orgovyx, my RO will advise if I can stop after 8 months or a year. Your comment that the extra 10% is well worth it -- it's encouraging. The only benefit my RO mentioned to me was that starving the cancer cells (they feed on testosterone or androgen) will help radiation kill the cancer cells. I wish I knew about the 10% from the beginning -- as it is, I spent the last months wondering if I still need it. I didn't question ADT the first two weeks pre-SBRT, during SBRT 1-1/2 weeks and the week after, but the next 2 months I was torn between stopping it sooner or waiting up to 8 months.
In my experience, this is proof positive that questions & answers among our support group members really. Helped me before, helped me today.