Similarly at 65y, I had localized, 7(4+3), PSA of just 7.976. I had 28 sessions of proton radiation (during April-May 2021) + 6 months of ADT (Eligard).

Your Gleason 7(4+3) is considered intermediate-unfavorable; but your PSA of 59 might bump you up a level to high-risk (which might explain the 2 years of Lupron). You might ask your doctor if this was the reason for the 2 years of ADT. (If that was the reason, I would do the full term.)

Because of the metabolic side-effects of ADT, most of the side-effects of can be minimized/avoided with resistance-training exercises. There has been much reported on the physical benefits of exercise while on ADT. Here are just a few that I’ve bookmarked:

> Drs. Sholz and Moyad talking about exercise and hormone therapy: https://m.youtube.com/watch

> A paper on The Benefits of Exercise During Hormone Therapy: https://static1.squarespace.com/static/54c68ac6e4b06d2e36a4b8c9/t/55cb7275e4b0d97ae7ff60af/1439396469154/The+Benefits+of+Exercise+During+Hormone+Therapy_Insights+August+2015_PCRI.pdf

> A study about the benefits of exercise to counteract the adverse effects of ADT: (They describe a good resistance-training program): https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx

If you do what it takes to minimize the side-effects, you’ll do very well with the hormone therapy - it’ll just be an annoyance.