His diagnosis (grade, stage, etc.) and other significant risk factors determine how long he’ll be on hormone therapy, as well as his response to his treatments. So much can happen between now and then that often precludes being on hormone therapy “for the rest of his life.”

Difficulty with erections can be from a number of reasons - the hormone therapy (due to low testosterone) or the radiation therapy (often radiation hitting the nerve bundles is unavoidable). They also should have avoided radiating his penile bulb.

For me, except for the hormone therapy causing me to have zero libido, everything still worked. From what I was told by my medical oncologist (MO), the key is to continue “doing it” throughout, despite the “want to” not being there (due to the zero libido). I was told that it’s a “use it or lose it” scenario. It was up to me to keep the blood flowing.

Though I have no empirical data to support this (only my MO’s advice that it would work - and it did), my experience not having ED while on ADT might be related to me ramping up my resistance-training and cardio programs to minimize the side-effects of hormone therapy; that might(?) also have the side-benefit of keeping the blood flowing “down there” as well; I don’t know - but, I never had any issues. Libido eventually returned to normal after stopping the Eligard when my testosterone levels returned to normal. Everything in that department is as it was before treatments started.

This 2023 presentation out of Stanford University describes how everything works down there, and might provide insight into solutions —> “Penile Rehab: Optimizing Recovery of Erectile Function after Prostate Cancer Treatment” —> https://youtu.be/aRp1NXjPGLE?si=VyF2ALSgU1J5r4OI

Good luck!