Anyone considered bilateral orchiectomy: Why or why not?

@seeker001 Thank you for your reply.
Does not the same thing happen on ADT? Testosterone levels drop to castrate levels very quickly. I don't know what happens to estrogen, but I believe you can take estrogen without causing the cancer to grow? I am thinking once the cancer is controlled I could go on HRT just like I would stop ADT. I might still have to do the radiation treatment to control the cancer, my urologist is saying that is likely even with an orchiectomy. I am thankful for this site as I am getting many comments which I will take into account before I make the final decision.

@jeffmarc Thank you for your reply.
I am thinking that if the cancer gets under control and I could effectively stop ADT I could go on HRT to restore my testosterone levels to normal. It is just that I hear than many men have problems with the ADT similar to orchiectomy, but there can be more pain from the drugs, greater risk of diabetes, and cardiovascular risks. The other factor is that I live far out in the country where it would be difficult to make regular trip to the doctor for the injections and blood tests. I do thank you for your reply and I will take into consideration your reply.

@john1951
Not many doctors will let you go on hormone therapy after having prostate cancer. That can really aggravate the cancer and get it growing and spreading quickly.

They do Hormone therapy alternating High dose testosterone with ADT drugs In advanced cases where People become castrate resistant to the ARPI. I can really screw up the Cancer because he doesn’t know which way to go when it all of a sudden gets testosterone and then gets ADT. That’s A style of BAT.

They can also do BAT, if you become castrate resistant to ARPI drug. In that case, they just give you testosterone for a while, And some people then can have the ARPI drugs work for them again.

Just some alternate treatments, you may not have heard of.

@john1951
You can take estrogen while on ADT. It will reduce the hot flashes, Help with bone strengthening and Make sex interesting again.

At the ancan.org Weekly advanced prostate cancer meeting a few weeks ago. One guy was talking about how he was trying different estrogen strength patches to get the best results. You don’t put on multiple patches like you do with Estradiol replacement for ADT you only need a single one of a much lower strength. You can experiment around to see what gets the best results.

As long as you don’t have genetic issues that can work very well.

@jeffmarc Thanks for your two replies. Obviously I need to speak more with my urologist and possibly another too. Thank you again for your feedback. I have a lot to investigate before I go down any path now.

I opted for bilateral orchietomy as soon as I was told that I would need ADT for at least 3 years. When looking into it my decision was based on: 1 I did not want more kids, as at 53 I see having kids is irresponsible. 2. After a prostatectomy I am sterile anyway. 3. Even if I can come off ADT it can take months to years for testicular function to recover, if at all. 4. The ADT drugs increase the risk of diabetes and heart conditions beyond the effect of castration. It took some time to convince my surgeon to perform the operation but he said faced with such logic I was correct.

@john1951
If you use Orgovyx for ADT, your testosterone will come back much quicker when you stop.

There are other things that cutting out your testicles affects. Here is information from somebody that did it. He was not happy about the results.
https://connect.mayoclinic.org/comment/1526325/
Just some things to consider.

I’ve been on ADT for eight years and it’s not a big deal. I lead a normal life.

I haven't read this whole thread (& am not going to), so maybe someone else has said this:

1. Castration is permanent (obvious), & may require different medications. Substituting one set of medications for another doesn't sound like a great idea, unless there is real benefit.

2. We know that all prostate cells (cancer or not) require testosterone to reproduce, so that ADT & other drugs are used to stop the prostate cells from processing the testosterone. Now suppose (this is fiction) that medical science was able to create a substance that looked like testosterone & was absorbed by the cancer cells when they tried to divide, & instead killed them without affecting non-prostate cells? That would be the end of prostate cancer world-wide. I'm sure techniques like that are under investigation.

Now, that is medical science fiction, but my point is, who wants to make a choice that has unpleasant permanent consequences, when the consequences of current medications is not that bad, & there is hope for the future?

No one knows what the future holds.