Anyone considered bilateral orchiectomy: Why or why not?

@john1951
ADT is not a lifetime sentence. When you stop it, your testosterone comes back. Have the surgery and that won’t ever happen.

The radiation treatments are really not that bad for salvage radiation. I had it many years ago and had no side effects at all. I can give you a significant number of years before you need to do anything. I am 78 and I’ve been on ADT for eight years because I have a genetic problem. While I got a lot of hot flashes in the beginning They’re no longer much of a problem. There are many side effects from ADT, which will be identical if you have the surgery.

I live a normal life besides the fact that I go to the gym three days a week because the loss of testosterone really does deteriorate your muscle muscles.

Hello, I had my prostate removed over 2 years ago and my PSA remained low for 6 months but since then it has been steadily increasing up to 0.1 as the latest figure. My urologist suggested ADT to keep it uncer control. I am now 75 and seriously considering it rather than go through radiation treatments. I no longer want to produce children! I am thinking of a bilateral orchiectomy for my ADT. I know it is permanent, but if things improve I will ask to go on HRT and possibly get implants at that time. I see this as a good solution as it will have none of the side effects of the ADT drugs and the necessessity to remain on them for the future. Does this sounc crazy to some?

@dale1618
Dale, it's been a few months since your post. I'm wondering what you decided to do, and hoping that you are doing well. I've had no regrets about choosing orchiectomy, as it has enabled the quality of life that I was hoping to continue, and I've still been fortunate that the SBRT and Pluvicto have kept the PC at bay for now. I had my fourth round of Pluvicto, which has brought my bone mets and PSA down to the point that we're banking the last two treatments until symptoms return or PSA starts to rise again. Keepinig my fingers crossed that you'll also have good results.

Try Orgovyx, studies have shown there is no large difference between surgical and medical castration except surgery had a few more deleterious side effects.

Try Orgovix it’s just a pill, no pain , little nausea and you can take it with you.

@shane18 I experienced anemia while taking Lupron. Might be something to watch for. After 3 months switched to Orgovyx and anemia corrected itself.

@dale1618 Dale, I had a bilateral orchiectomy four years ago. It was indeed a simple removal with an incision through the scrotum, and at the same time they did a TURP procedure, which completely cleared up the urinary urgency and leakage problems I had been having. The orchiectomy was almost immediately effective in dropping my PSA to undetectable, and I had some of the usual side effects of ADT, but my quality of life convinced me I had made the right choice. I'm 78 now, and after I became castrate-resistant last year, I had five SBRT targeted radiation sessions, and am now halfway through 6 rounds of Pluvicto, which is again dropping my PSA way back down. I'm one of the fortunate ones for whom the next treatment development seems to come along at just the right time.

@shane18
Estradiol works quite well, Just as effective as ADT With many fewer side effects.

There are videos over at ancan.org by Richard Wassersug Who is been using it for almost 10 years. He wrote a book on ADT. He uses the gel right now, instead of the patch.

If you look up the patch study, you will see that it discusses using estradiol.

Beware that estradiol can cause breast enlargement for about 50% of the people that use it. You can get radiation to the chest before you start it to prevent it from happening.

@duberdicus

It's more painful than a bee bite but now I switched over to Lupron depot but my new care team may do things differently. I'm really wanting to go with estradiol patched to replace the adt.

@kingsiang
I do not have any specific recommendations on diet as an aid in combating cancer. My diet was revised at the end of 2024 when after a year of ADT, my fasting glucose levels came in at 110 to 115, the pre-diabetic range. I tried a low-carbohydrate diet for about 2 months without success, and called the nutritionist back and had her revise the diet.

The revised diet further reduced the carbohydrates and consists of a lunch, the main meal of the day, of cooked vegetables, a protein source, meat, chicken, or fish and salad. Evening meal is a salad plus a protein source as in the lunch. Breakfast cooked oatmeal or low sugar granola, eggs a small piece of baguette, an empanada with chicken or beef, and possibly a tortilla and a dish of fresh fruit. I have milk at all meals.

The revised diet did not reduce the glucose enough so in August I asked my Oncologist to prescribe Metformin. He replied enthusiastically and brought up the report of the Stampede trial on his computer. This is the trial mentioned in the article you posted. I started on Metformin in mid-August. The only adverse effect was that on the second day, I had diarrhea. I cut the dose down to one-half tablet for 6 days and then moved to a whole tablet. When the first 30 tablets were exhausted I moved up to 1 and a half tablets for 6 days, and then the 2 tablets of 850 mg. The tablets are taken twice a day with a meal.

Results:
Fasting glucose 2 weeks ago 97. I am hoping for a further decrease on my next test at the end of this week which will include a A1C.
No adverse effect after the first diarrhea.

On your question on the spacer for the rectum, I asked about that with my Radiologist. He said that it was not available in Panama. If it were available, I would have asked for it.

If the spacer is available for you, I think it may be advisable to have it placed, if your doctors recommend it, to further reduce the risk of any side effects.

Radiation technology has improved in recent years, and comments you see on this website and other sites have to be evaluated based upon what type of radiation they received.