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Help finding a study re treatment: EBRT plus ADT vs ADT alone
Prostate Cancer | Last Active: Jul 16 10:13am | Replies (15)Comment receiving replies
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!
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Dear Brian: Thank you SO MUCH for your reply to my queries and uncertainty. I really found the youtube video from Stanford University to be insightful. I encouraged my husband to watch it, as well. He had his original biopsy in late SEptember and was rated Gleason 4-3. A urologist, who had been assigned to us, called and said that the cancer had been caught early. This urologist only does surgery so as we discussed the options, and the fact that he didn't seem that concerned of the urgency, my husband thought he would go with the radiation seeds. We go away in the winter for 3.5 months but I made it clear to the doctor that we did not have to go away. My husband's health was our first and only priority. The urologist said he would refer us to a radiation oncologist and said that we would not get in to see him until after that time, anyway. So, we went away. As soon as we returned, my husband had an MRI and it looked a bit concerning. When we left his PSA had been 8 . When he got his blood test mid April, it had gone to about 15 . We paid for a PSMA on April 29 and it showed that the cancer had gone into two lymph nodes above the prostate. So, our options for radiation seeds , or anything else, really, were gone. On May 15 my husband had his hormone therapy shot, two weeks later he started on abiraterone and prednisone and on July 4 he began his 25 days of radiation. He has a medical oncologist and a radiation oncologist. Both have indicted that he will be on the hormone therapy for the rest of his life. I have watched you tube videos from PCRI. org and read some other information and so often they mention, when you discontinue the hormone therapy then your libido will come back and you must maintain your muscle mass, etc. for that event. I am not sure why these doctors feel that my husband will be on the hormone therapy forever. I really appreciate your personal information, saying that you maintained your physical strength training. My husband had always been in favour of that but, for some reason, right now, it is a difficulty for him to feel like doing it. I feel as though the side effects which have been outlined by the doctors have made him feel that it is inevitable and that he can't affect those inevitabilities. Your response gave me hope and I am going to encourage and support him to the best of my ability, so that he can see that he CAN impact these results.
Warm regards,
Glenda