Anyone considered bilateral orchiectomy: Why or why not?

@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.

@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.

@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.

@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.

@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.

@john1951 I suggest you think very carefully about bilateral orchiectomy. I had my orchies removed 4 months ago, and it was the worst mistake I have ever made. Testosterone and estrogen levels in my blood both went to zero, which introduced a profound and continuous fatigue. For 2 months, I could do little more than lie in bed and stare at a wall. I now wear estrodiol patches which, over several weeks, restored some capability, but I am nowhere near as capable as I was before the surgery. I did research the procedure (on this forum and others) before proceeding, and ALL postings said no biggie, go right ahead. I was not so lucky.

@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.