My husband got diagnosed in February (2025 so this year) PSA was almost 300, CT scan showed outside prostate, biopsy Gleason were mostly 8 and 9s, PSMA scan showed it all over his body!!
They started him on Firmagon and was going to switch to Lupron but like you, my husband was not happy about the possible side effects of Lupron, so they agreed to wait until his was ready and he's been doing monthly Firmagon shots since then! Side effects are hot flashes and night sweats and being emotional like sad..... It's all sad and I said I'd cry with him and we can have hot flashes and night sweats together and cry over sappy movies!
Of course no sex life either! But I'd rather have a live husband and no sex life than a dead husband and still no sex life!
A few months later they started him on Zytiga and Prednisone ( he has technically wrecked his liver from taking lots of supplements and once he quit those the liver went back to normal)
Then over the summer he did 6 rounds of docetaxel chemo and did very well! Other than more tiredness- so daily naps on the couch while I rubbed his head..... and after round 2 the hair started falling out so he shaved it- we also got the chemo gloves and mittens from amazon and I think they worked a bit, he only got one numb toe for a few months after it all, but he's fine now.
after the chemo was done they did another PSMA scan and it was a HUGE improvement! only 2-3 small spots now! How long that will last, we don't know, we were happy but not jumping for joy! and the doctor just said it's good and keep doing the ADT drugs.
It's really hard for a guy to accept to be medically castrated! we had lots of arguments about it, that if I got breast cancer and had to have them removed, I'd do it or whatever surgery, maybe because as women we already know we'll go thru a change and not be able to have children after a certain age! But with men, it's the manhood! don't mess with the manhood! He'd rather die than lose THAT! He finally relented and knows he sacrificed his body for the family!
we did try some "happy" pills a few months ago and succeeded but he said it was mechanical and no emotion or drive behind it, so.....
his PSA is 0.35 now btw going back next week!