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.
@mrrizzo, you can try using the group search function. Here are a few related discussions I found:
- Stopping Eligard early https://connect.mayoclinic.org/discussion/stopping-eligard-early/
- Side effects after stopping Eligard https://connect.mayoclinic.org/discussion/side-effects-after-stopping-eligard/
See all https://connect.mayoclinic.org/group/prostate-cancer/?search=ELIGARD#discussion-listview
Are you now on Orgovyx and Nubeqa? I am on Orgovyx but did not do well with adding abiraterone and prednisone. Were the side effects any better after dropping abiraterone? I likely second another medication in addition to Orgovyx.
Thank you,
Phil
Sorry, meant: I likely need a second medication in addition to Orgovyx.
Thanks,
Phil
My PSA climbed steady for 2 years and I kept putting off the recommended Colonoscopy.
I was found with cancer of the Sigmoid Colon.
I was doing very well after a resection with the exception of diarrhea.
A lung nodule was suspected to be cancer, and turned out to be a metastasized cancer from the colon.
Two major surgeries over 7 weeks. The colon and diarrhea for a complete year was not pleasant.
But compared to the lung wedge resection, the colon was just the appetizer. The lung was 7 courses of pain, difficult mobility, and shortness of breath.
I agreed to a visit with a Urologist for a certain enlarged prostate; the usual weak stream and such. This guy had just met me, started telling me about prostate cancer and told me that he was 99% sure that I had it.
We did the digital exam, an MRI, a biopsy, PET Scan, Brachytherapy, blood tests, and 25 fractions (m-f / 5 weeks) of IMRT PROSTATE RADIATION.
The radiation was completed 5 months ago, and I have now been taking ORGOVYX for exactly 1 year.
Hot flashes are now infrequent as compared to those first months where it was every day, all day.
Joint pain in right hip, right leg, sometimes knee and sometimes ankle and foot.
A bit wobbly and a bit dizzy walking around the house.
The radiation has damaged my rectum, and my bowels have really taken a beating. First from colon resection and now from radiation. The prostate gland and the rectum are very close neighbors and they definitely shared the doses of radiation.
My radiation Oncologist does not deny this and still refuses to do radiation with a gel oar spacer.
I have no erection ever for a year. I never think of anything sexual and have zero interest in all the above.
My testicles have shrunk and I have half the penis as before even flaccid. I have no man boobs, thankfully.
Im 75. My diet is not the greatest. My exercise is what I get moving about the house, vacuuming, etc.
I do park far away from store entrances to get some walking distance. Of course, I'm not going to stores more than once a week.
I live alone. No one bothers me. I sit up most of the night reading, watching TV news, movies. I can nap at any time day or night. My favorite thing to do is sleep. Love it !
I dont feel bad per se, if I could walk a little better.
Thanks for reading!
My name is PAUL and my life sucks!
I don't really complain because I am aware that it could be sucking more!
Best to Everyone!
I have nothing to say Paul, sometimes silence is what one needs and can say more than words, but I am sending you BIG heart-felt hug and a bunch of healing vibes < 3. You are AMAZINGLY strong person but I am sure you do not need me to tell you that.
@surftohealth88
Thank you so much!
I am strong by nature.
I think it comes from not being afraid of anything and jumping in and taking charge.
I remember the first time that a doctor came in and said, "Paul, you have colon cancer".
I was not much bothered by it; not freaking out .... I answered, "Okay, what's next ?"
It wasn't long after that, I learned my colon cancer had metastasized to the very bottom of my right lung.
So cancer again. Im two for two.
Not very long again, and I became 3 for 3 with the prostate diagnosis.
I was also found to have Hyperthyroidism and Graves Disease.
I was without any medical history for 72 years and then it all went to hell !
I am surprised that I am cancer X3. I never expected that. Any one of the 3 would have been enough.
I am playing the hand I was dealt. I would not trade that hand with many others that I see because most others arrived at the cancer center many years prior to me.
Its life.
I feel that I am in the home stretch. I will do my best to the finish line!
Best wishes to you!
Paul
Paul, You’ve really had the crap beaten out of you - no other way to say it. All you’ve been through totally sucks and you’ve earned the right to say so!
Just do whatever brings you joy, peace or comfort because right now you must live the best life you can. All the cancers couldn’t beat you and now is the time for your victory dance.
Phil
Thank you, Phil !
We all do our best!
Paul