@gkgdawg
To prevent atrophy, you want to get a penis pump. The pump will get you erected to a certain point, but probably not stiff enough for Intercourse. Many people are getting Cialis to use daily to keep the blood flow working properly.

There are a number discussions in this form about using Trimix and Bimix Injections to get good stiff erections. You should go to the top of the forum and do a search for it and you’ll be able to read a lot of People’s opinions and personal experience.

Here’s some info from the experience of one person in this group
https://connect.mayoclinic.org/discussion/my-trimix-experience/
If you have a visible metastasis, they should be treated as soon as possible. At least that is the opinion of doctors like Doctor Scholz Who does the PCRI conferences?

They can use SBRT radiation on all of those metastasis to get rid of them. Normally, if you have over five, they want to use chemo or Pluvicto, But I know people who’ve had as many as 15 mets Zapped with SBRT in multiple sessions.

I think it might make sense to go to a center of excellence and get a second opinion on treating these mets.

I’ve been on ADT for eight years. I don’t get the fatigue, but I run a mile twice a day and go to the gym three days a week to do weight training. Those help keep my muscles up and help prevent the fatigue that people get. You can be really tired and then go walk or run or do exercises and find that the fatigue becomes much less. You may get hot flashes, I had really bad hot flashes for the first year, but my doctor recommended a depo-provera Shot and it really worked. I got them quarterly for about four years. There are other issues that come up if you have problems, you can post about them here and people will give you Their experiences and how they resolved them.