Anyone considered bilateral orchiectomy: Why or why not?

@ronim2
Eligard will keep your PSA down, but it will not eliminate the cancer in any way. It will reduce the cancer so that it’s smaller but when you stop the drugs, it can come back.

I’m 78 and I have to be on ADT because of a genetic problem. I would be on just Nubeqa Alone if I Didn’t have that genetic problem. Nubeqa Has almost no side effects for most people. It doesn’t pass the blood brain barrier so it doesn’t cause brain fog. It also keeps your PSA down quite well, even if you have testosterone. After 16 years of prostate cancer and four reoccurrences, Nubeqa has kept me undetectable for the last 24 months.

I know a number of people in there 70s and 80s that are using it alone. You could check out an Advanced prostate cancer meeting at ancan.org And ask about it. They can also give you recommendations on what you can do with your current cancer case. The next meeting is next Tuesday at 3 PM Pacific time. They have been helping people for 15 years with Recommend recommendations for prostate cancer treatment. There’s at least three doctors in the meetings and frequently more.

Ask your doctor about this. Being on ADT is normally detrimental to somebody in their late 70s. I’ve been on it for eight years and have to do many things to get around the side effects.

Out of curiosity I asked my RO about orchiectomy. One thing he said was the testicles are responsible for things other than testosterone.

I chose not to. Glad I did because the cancer migrated to my spine and other places so the treatment would be the same.

Eligard is like a bee bite and is bothersome for a couple weeks. Have you tried getting the injection in the back instead of the tummy. I find it less of an annoyance.

@duberdicus
I had Eligard and Lupron for six years. They always gave me the shot in the upper thigh. Barely even felt it, unless I pressed into the spot where they gave it.

I can’t see any reason why they would do it in the stomach, Just poor training.

agreed, tummy is out

@kingsiang I’m surprised the oncologist wants surgery at your dads age and underlying medical problems. He must not be in that bad shape because if something goes wrong you can sue him. If it was me I’d go with surgery. I have too much going on hypertension, asthma and other things. Radiation after 8 treatments I developed bad diarrhea and couldn’t eat solid food for 2 weeks. Good luck making your decisions I wish you and your dad the best.

@kingsiang
I am 92 years old now and had IMRT radiation to my prostate a few months ago. During treatment and shortly afterwards I had more frequent urination and bowel movements. Some small incontinence when I go up at night to go to the bathroom. Wetted my pajamas on the way to the toilet. Now there are no side effects. I had been on ADT (Eligard and the Zoladex) for 20 months prior to the radiation and will continue for 2 to 3 years after because my Gleason score was 4+4 = 8, considered high risk. PSA prior to ADT was 14.1, immediately prior to the radiation it was 0.944. The PSA at 5 months after radiation is 0.037. All the literature I have read says that a PSA value like that means a low chance of recurrence in the near future. Basically the radiation of 28 sessions did not cause any fatigue, and I was able to continue life as normal including gym sessions right after radiation 3 days a week.

@overage
Thankx for sharing.
In term of daily nutrition or diet , any recommendation ?
Understand we can insert spacer to avoid radiation hurt our other organ. Is thks effective ?

@kingsiang
I do not have any specific recommendations on diet as an aid in combating cancer. My diet was revised at the end of 2024 when after a year of ADT, my fasting glucose levels came in at 110 to 115, the pre-diabetic range. I tried a low-carbohydrate diet for about 2 months without success, and called the nutritionist back and had her revise the diet.

The revised diet further reduced the carbohydrates and consists of a lunch, the main meal of the day, of cooked vegetables, a protein source, meat, chicken, or fish and salad. Evening meal is a salad plus a protein source as in the lunch. Breakfast cooked oatmeal or low sugar granola, eggs a small piece of baguette, an empanada with chicken or beef, and possibly a tortilla and a dish of fresh fruit. I have milk at all meals.

The revised diet did not reduce the glucose enough so in August I asked my Oncologist to prescribe Metformin. He replied enthusiastically and brought up the report of the Stampede trial on his computer. This is the trial mentioned in the article you posted. I started on Metformin in mid-August. The only adverse effect was that on the second day, I had diarrhea. I cut the dose down to one-half tablet for 6 days and then moved to a whole tablet. When the first 30 tablets were exhausted I moved up to 1 and a half tablets for 6 days, and then the 2 tablets of 850 mg. The tablets are taken twice a day with a meal.

Results:
Fasting glucose 2 weeks ago 97. I am hoping for a further decrease on my next test at the end of this week which will include a A1C.
No adverse effect after the first diarrhea.

On your question on the spacer for the rectum, I asked about that with my Radiologist. He said that it was not available in Panama. If it were available, I would have asked for it.

If the spacer is available for you, I think it may be advisable to have it placed, if your doctors recommend it, to further reduce the risk of any side effects.

Radiation technology has improved in recent years, and comments you see on this website and other sites have to be evaluated based upon what type of radiation they received.