Anyone have a hard time getting back to normal after ADT?

@lacraig1 Except for the research on fewer months of ADT being almost as effect as longer terms I am skeptical. So, I would shorten what was 12 months to 6 and what was 24 months to 12. The other item is that if you have run the course of your treatment and seem cured you can add testosterone (TRT) if it does not come back naturally a year or so after the ADT has ended. It can always be stopped if the cancer returns and at that point a person may be able to have effective ADT without any drugs due to the inability of producing testosterone.

@corin
Abiraterone It’s very hard on the heart. It gave me high blood pressure, Five afib Events and many hot flashes.

It is not appropriate at all for somebody with heart issues. I had not had an afib event for 15 years before starting Abbie. I’m getting an echocardiogram tomorrow and I know the reason I have to do it is because I was on that drug for 2 1/2 years.

Nubeqa Works really well all by itself most people. I know a lot of guys in their late 70s and 80s that are on Nubeqa Alone and they are doing quite well. It’s suppresses testosterone’s ability to work with the prostate cancer.

@lacraig1

Lupron does not cause the side effects directly but because it causes chemical castration of the tentacles, testosterone drops typically to single digit. Low testosterone actually causes the side effects. If you are older like me, 84, you may never recover from Lupron caused low testosterone (mine was 111 at 15-months after my last Lupron shot (4 months total). My urologist put me on TRT to raise my testosterone six weeks ago. Most of my side effects vanished within a week of Testosterone Replacement Treatment. In 6 more weeks, my blood will be tested for PSA and testosterone levels. My TRT will then be adjusted to get me to a normal testosterone level.

Numerous studies have shown that TRT is OK after radiation and ADT treatment because testosterone does not cause or feed cancer as once believed. I have not had a chance to discuss this with my doctor, but it now makes me wonder why ADTs are prescribed, now that we know that normal levels of testosterone do not increase the risks of cancer.

@lacraig1
It definitely can affect your heart. I personally am getting a lot of Skipped beats. Low testosterone is not good for your heart.

Most prostate cancer patient don’t die of prostate cancer they die of heart disease.

Having very low or no testosterone is linked to a higher risk of heart disease, weight gain, and type 2 diabetes. While low testosterone does not directly damage heart tissue on its own, it is tied to poor blood vessel health, higher body fat, and increased inflammation.

@jeffmarc I was in Orgovyx for 6 months (late March to late Sept 2025). My T is still within castrate level, PSA 0.16 as of this month. My annual check ups indicated my cholesterol was under control, but on July 2, 2026 my angiogram showed four of my arteries were badly blocked. I had a quadruple cardiovascular artery bypass graft on July 8. I believe I have mentioned to my cardio care team that I had prostate cancer treatment last year, but they didn't look at T level or indicate that low T led to my blocked arteries. I wonder. They said my heart was very good; the arteries were the problem.f

@jeffmarc I was in Orgovyx for 6 months (late March to late Sept 2025). My T is still within castrate level, PSA 0.16 as of this month. My annual check ups indicated my cholesterol was under control, but on July 2, 2026 my angiogram showed four of my arteries were badly blocked. I had a quadruple cardiovascular artery bypass graft on July 8. I believe I have mentioned to my cardio care team that I had prostate cancer treatment last year, but they didn't look at T level or indicate that low T led to my blocked arteries. I wonder. They said my heart was very good; the arteries were the problem.f

@lacraig1

Unfortunately, you didn’t clearly say that your testosterone was still near zero but it appears that that’s what you meant. You also don’t mention your age with she’s a major factor and testosterone coming back.

After being on it for six months, it took my brother over a year before his hot flashes completely stopped and his testosterone came close to 200..

Here is some information from PCa Commentary about testosterone returning

Examples of the relationship of the duration of ADT exposure to subsequent recovery to their
original T levels after stopping ADT are as follows:
- After 3 - 9 months of ADT nearly all men fully recover by about 10 months;
- After 18 - 24 months of ADT only 60% fully recover by about 3 years; and
- After 36 months of ADT exposure only 50% fully recover by ~ 5 years.
It is clear that after receiving ADT for longer than 6-9 months many men never fully return to their
T baseline. This raises the very important question of whether it is safe to offer replacement
testosterone in symptomatic men who have been rendered persistently hypogonadal (<230
ng/dL).

If your testosterone is not returning after a year, you could get testosterone replacement therapy through injections. It has been shown in recent trials that it does not cause the PSA to rise. That can get you back to feeling normal again. Something to discuss with your doctor.