For Newly Arrived Bros: A Day In The Life With ADT
Gentlemen, gather 'round. You’ve just joined the club. Not by choice, of course, nobody fills out a loyalty card for this one. No, you were drafted into the Great Prostate Parade, handed a pamphlet with clip-art prostates and words like “treatment plan,” “Gleason score,” and “androgen deprivation therapy,” and then politely pushed off a hormonal cliff. The pamphlet, if you remember it, featured two suspiciously cheerful mature adults riding a tandem bike through a tulip field in Ottawa—because nothing says “chemical castration” like a leisurely spring ride near the Parliament buildings. He’s wearing khakis. She’s wearing a pastel sweater. Neither of them is crying, sweating, or yelling at a toaster. Clearly, they’re actors. Or on drugs. Probably both.
Welcome to the next phase of your life: ADT. The doctors will call it “testosterone suppression.” The brochures will say it’s “generally well tolerated.” And your oncologist, with the calm detachment of someone who still has their own hormones, will inform you that it’s a necessary step. What no one tells you, at least not until it’s too late, is that you’re about to become a walking biology experiment with the emotional stability of a raccoon in a washing machine.
In this episode, I’ll walk you through what a typical day looks like once Firmagon (or Lupron, or any of its chemical cousins) has declared martial law on your endocrine system. Expect night sweats. Expect hot flashes. Expect to tear up at car commercials. And above all, expect to be told, repeatedly, that it’s “just temporary.”
That was the brochure version. Spoiler: it’s not temporary enough.
But don’t worry, brother. You’re not alone. You’ve entered the weird, wild, sweaty world of Firmagon Man—and this is your survival guide. There are superheroes, and then there’s Firmagon Man. Unlike your typical caped crusader who gets their powers from radioactive spiders or military-grade gamma rays, Firmagon Man gets his from a 4-inch needle jabbed into his belly fat by a smiling nurse named Janet, who cheerfully announces, “This might sting a bit,” right before plunging you into menopause. Yes, menopause. The one they never warned you about in Boy Scouts.
6:00 AM: The Awakening
I wake up in a lake. Not beside it. In it. My sheets are soaked. My pillow is a sponge. My pajamas cling to me like desperate polyester. A hot flash, they say. More like spontaneous human combustion. I strip down like a drunk wizard shedding dignity and whisper a quiet curse to the gods of endocrinology.
I stumble to the bathroom mirror to confirm that yes, I still resemble a damp, middle-aged raisin with slightly less testosterone than a vegan housecat. My testicles have gone on a sabbatical. My chest is developing the soft swell of early motherhood. I weep gently. Or I would, but I’m too dehydrated from last night’s sweat tsunami.
9:00 AM: The Coffee Incident
Caffeine is supposed to help you wake up. Unfortunately, in Firmagon Land, it’s the equivalent of lighting a match inside a furnace. One sip, and I’m sweating like I’m being grilled by Homeland Security about undeclared hormone levels.
My wife watches me with mild concern and slight revulsion. “You okay?” “I’m great,” I pant, fanning my armpits with a cereal box. “Just experiencing internal global warming.” She nods. She’s stopped asking questions. There are no answers. Only hormone suppression and the vague scent of burnt toast.
11:30 AM: The Mood Swing
Something small happens. A bird chirps wrong. Someone uses Comic Sans. I burst into tears. Not soft, movie-tears. No, I sob like I just watched a puppy get denied bail.
Then, moments later, I feel fine. Euphoric, even. I decide to reorganize the garage, write a memoir, and start a podcast about glandular injustice. By noon, I hate everyone again and abandon all plans, except for the one involving a nap and some light cursing.
2:00 PM: The Great Nap and Post-Nap Identity Crisis
I nap for exactly 14 minutes and wake up in 1963. Or at least that’s how it feels. I'm drenched again. My shirt could be wrung out into a mop bucket. My dreams were vivid, mainly involving ice baths and revenge.
I stumble to the fridge, open the door, and just stand there, basking in the cold, whispering, “Yes. This is the way.” I consider moving in. There’s ham in here. And peace.
5:30 PM: The Attempt at Exercise
In a burst of misguided optimism, I go for a walk. Three blocks in, I’m a human lava lamp. Everything hurts. My joints feel like they’ve been swapped for mismatched IKEA hinges. A small child jogs past me and says, “You okay, mister?”
“No,” I reply. “But thank you for asking. You give me hope. Sort of.” He offers me a juice box. I cry again. He runs away.
6:30 PM: Cooking with the Castrated Chef
Tonight’s menu: grilled salmon, steamed vegetables, and whatever residual dignity I can find in the pantry. I approach the stove like a man on a game show where the grand prize is another hot flash. The moment the burner ignites, so do I. I am suddenly basted in my own sweat, seasoning my food with droplets of hormonal despair. The salmon steams, I steam, the kitchen becomes a sauna with cutlery. I stir rice while muttering Gordon Ramsay insults at myself: “It’s raw, you soggy bollock!” My wife wanders in, sees me glistening like a ham in church, and backs out slowly. Dinner is eventually served, though I can’t taste anything through the haze of thermal misery and low testosterone. Bon appétit, from your Michelin-starred eunuch.
8:00 PM: Intimacy, The Concept
My wife puts on that silk nightgown. The one that used to mean something. I feel... absolutely nothing. Not indifference. Not affection. Nothing. My libido was taken out back and euthanized during my last injection.
We cuddle anyway. And by cuddle, I mean she lies near me while I radiate heat like a malfunctioning nuclear reactor. She says, “You’re very warm.” “I’m basically a fever with legs,” I reply. “A sexy, barren heatwave of doom.”
10:00 PM: Nightfall and The Return of The Boil
As I lie in bed, awaiting the inevitable midnight flash flood, I reflect on my day. Cancer treatment, they said. ADT. Just a “little chemical castration” to keep those PSA levels down. No biggie.
Except now I’m a sweaty, moody, neutered vigilante in loose sweatpants, fighting the slow hormonal apocalypse with sarcasm, Gatorade, and seven strategically placed fans. Some men get bat signals. I get hot flashes. And I handle them like a man. A very damp, mostly hairless, emotionally unstable man.
Firmagon Man. Saving the world, one hormonal collapse at a time.
Interested in more discussions like this? Go to the Prostate Cancer Support Group.
Understood, and thanks for the idea. Buddha and ADT coming up soon (no pun intended)
I am looking for an article written by former ELIGARD/CASODEX users that discontinued use. I am interested in their progress. I was Diagnosed Prostate Cancer 3+ years ago, Began CASODEX, Radiation 3 years ago, CASODEX for a year. Side effects of CASODEX and lifestyle not compatible, Issues with Joints, fatigue, etc., Switched to Elegard for 12 months, Discontinued Elegard for 6 months and believe I improved. Although I felt find, After 6 months PSA numbers increased < 0.1, 0.4, 4.0, 6.0, 18.0. Family convinced me to try Eligard again in January 2025. I am looking to cease ELIGARD again. The medical profession does not promote discontinuing ELIGARD, as it goes against the “Hippocratic Oath”, therefore there is limited cooperative spirit. I GOT IT!
I am an outdoors person. Work and Hobbies take me into the woods with the ticks and snakes. During the past 70+ years I have been very active. Cut and split lots of wood, did a significant amount of walking in the woods, Cut lots of Grass, Raised sheep, remodeled houses, etc. In the last 12 months there has been a significant change. Had issues with Cancer in one testicle and Kidney Stones both required surgery after 8 months (relocation of the urethra).
I have scanned the internet, evidently I am not utilizing the best search words. Can any of you assist in locating the article.
Don’t know of it…but have you considered Orgovyx? I only took it for 6 months but the SE’s - although there- were very tolerable.
Phil
Funny how life works. For more than half a century I was a big fan of boobs. But now that I'm growing my own, they don't seem so interesting.
Very well written!
68 years old
I’ve been on Orgovyx and ARSI(abiraterone/prednisone for one month, then new doctor change me to Nubequa) since mid January.
PSA was 168, and it’s down to .1 as of three weeks ago. Testosterone has been less than 10 for a month and a half or so.
I generally get a couple mild hot flashes during the day and a couple more once in bed.
My energy level isn’t what it used to be and my muscle mass is down. I do have a belly fat that I’ve never had before.
So far, no brain fog to speak of, and my emotions seem pretty stable.
Generally, how many months before folks start to experience these extreme reactions to chemical castration?
Hi Hans_Casteels,
Thank You so much for this article, I know for me and my wife it put smiles on our faces as we read through the daily journey ADT. (We also appreciated the Ottawa reference 😁)
I have Salvage radiation and ADT coming up so really enjoyed your lighthearted but real explanation of what’s to come.
Wishing You and all of on here the best of care health and happiness as we go through his journey together.
Be Well.
Good luck. The issue with the radiation thing is coordinating bowel and pp timing...
I have neither tried nor researched ORGOVYX to review side effects. Oncologist has not discussed the medication or suggested Orgovyx.
Based on the 10 side effects of Casodex and Eligard, I am hitting on 6 out of 10. Felt best when I stopped taking ADT and performed physical work. After 6 months of NO CASODEX or ELIGARD, PSA numbers increased rapidly. Returned to CASODEX then ELIGARD. Side effects most noticeable, joints painful, Lethargic, issues with sleeping. Don’t sleep well at night which could be caused by Kidney stone/Bladder issues which are a separate medical issue. I now only get up twice each night. There is long history of a sciatica issue. Since the operation to relocate the urethra there have been issues with sleep. Generally speaking after eating some moderate amount, I would become fatigued, sit down and fall asleep. If I sat down for 5 minutes or less I would fall asleep. Leg cramps have been an issue. Have issues with an ankle I broke about 30 years ago. Have received injections for that but have some neuropathy. Podiatrist indicates neuropathy may be generated by ELIGARD. So far I have not been able to distinguish which medical issue is the culprit or the combination of the two.
Have been advised I should contact MAYO CLINIC. Seems like there is to much stuff going on since the prostate cancer diagnosis.
Tomorrow will be another day in Paradise!
Orgovyx has all the same side effects as other ADT meds. However, many on the forum have reported a decrease in severity of SE’s after switching to Orgovyx. User experience may vary!
Your literary description fleshes/flashes out so much better than Wikipedia….
“Insufficient levels of testosterone in men may lead to abnormalities including frailty, accumulation of adipose fat tissue within the body, anxiety and depression, sexual performance issues, and bone loss.”