Anyone considered bilateral orchiectomy: Why or why not?

@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.

@overage
Thankx for sharing.
In term of daily nutrition or diet , any recommendation ?
Understand we can insert spacer to avoid radiation hurt our other organ. Is thks effective ?

@kingsiang
I am 92 years old now and had IMRT radiation to my prostate a few months ago. During treatment and shortly afterwards I had more frequent urination and bowel movements. Some small incontinence when I go up at night to go to the bathroom. Wetted my pajamas on the way to the toilet. Now there are no side effects. I had been on ADT (Eligard and the Zoladex) for 20 months prior to the radiation and will continue for 2 to 3 years after because my Gleason score was 4+4 = 8, considered high risk. PSA prior to ADT was 14.1, immediately prior to the radiation it was 0.944. The PSA at 5 months after radiation is 0.037. All the literature I have read says that a PSA value like that means a low chance of recurrence in the near future. Basically the radiation of 28 sessions did not cause any fatigue, and I was able to continue life as normal including gym sessions right after radiation 3 days a week.

@kingsiang I’m surprised the oncologist wants surgery at your dads age and underlying medical problems. He must not be in that bad shape because if something goes wrong you can sue him. If it was me I’d go with surgery. I have too much going on hypertension, asthma and other things. Radiation after 8 treatments I developed bad diarrhea and couldn’t eat solid food for 2 weeks. Good luck making your decisions I wish you and your dad the best.

agreed, tummy is out

@duberdicus
I had Eligard and Lupron for six years. They always gave me the shot in the upper thigh. Barely even felt it, unless I pressed into the spot where they gave it.

I can’t see any reason why they would do it in the stomach, Just poor training.