How has ADT affected your enthusiasm & motivation for life?

Posted by scary1 @scary1, 14 hours ago

My 61 year old husband (I'm 55) has been on ADT - Nubeqa and Orgovyx - for over three months and will likely take both for two years for high-risk prostate cancer (Gleason 9, cribriform, visibly contained within the prostate per scans), and I'm trying to better understand what other couples have experienced.
For those of you who have been on ADT, how has it affected your passion, enthusiasm, and motivation for life? My question isn’t about libido, but more about hobbies, excitement about future plans, ambition, or simply enjoying everyday conversations and activities.
Did you feel emotionally flat and less connected with loved ones and life? If so, did those feelings improve over time or after ADT ended?
My husband and I are a team for life; we still play (shorter) tennis sessions (we’ve played together for 30 years). We still laugh, but I sense an indifference and apathy that I’ve never experienced before. He's also less patient. Of course, this is to be expected, but I guess I’m asking: how did you feel differently toward your significant other? Clearly, testosterone is there for a reason, hence all the “low T” ads.
My husband says other than hot flashes and fatigue, he feels almost normal, but I see a difference. I don't want to make this about me, and I know this medical journey won't fracture us, but it’s also hard feeling our relationship off-kilter.
Thank you.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

zzotte | @zzotte | 1 hour ago

In reply to @brianjarvis "(I had two 3-month injections of Eligard; the Eligard stayed in my system a total of..." + (show)

@brianjarvis

(I had two 3-month injections of Eligard; the Eligard stayed in my system a total of 9 months.)

When I was initially diagnosed with prostate cancer in 2012, my wife was quite upset. She said she “couldn’t bear the thought of cancer being in me.” But, I’m the more pragmatic, logical (retired computer scientist) type, and was able to show her (based on the data), that there really wasn’t anything to worry about, many treatments were available, and that I would carefully evaluate and analyze all aspects of this situation and make a decision that was best for us.

In that process, much of my time has been spent maintaining normalcy for her and myself, and insulating her from the continuous grind - physical and mental - of test-after-test-after-test. (That effort exhibited itself a few weeks ago when I mentioned to my wife about it being the 5th anniversary since the end of my 28 proton radiation treatments. She replied “yeah” and went back to watching her TV show.(!) That was an appropriate response, given my purposeful efforts to maintain normalcy in our relationship during this time.)

During my hormone therapy, I asked my wife if she had noticed any emotional changes in me: moodiness, crankiness, aggressiveness, anger, etc. She said that she hadn’t noticed any. (But, she did joke that I started watching too much Hallmark Channel on TV!)

This diagnosis did not adversely affect my passion, enthusiasm, and motivation for life in any way. In fact, it motivated me to be more active, eat more healthily, stay occupied, and continue with all I had been doing. (When I was diagnosed with prostate cancer, I had recently been elected vice mayor of my city; later I would be elected mayor. Nothing around me changed with my diagnosis.)

The things you’re expressing that he’s going through are all due to low testosterone. Think about your own menopausal years. What it took you years to get to and through, he was put fully into in a few weeks. “Male menopause” is what it’s called. He’s feeling 15 years older practically overnight; yes, that might cause him to be emotionally flat, less connected, shorter tennis sessions, indifference, apathy, patience, hot flashes, fatigue, ….feelings in general. (Again, think menopause.)

His feelings aren’t likely to improve until the ADT is out of his system and his T levels return.

However, there is a solution….

We often hear about the physical benefits of exercise to minimize the physical side-effects of hormone therapy. But, there are also mental health benefits as well —> Exercise turns on many types of switches in the parts of the brain that puts us in a better mood. It reduces stress, anxiety, depression, catastrophizing, and more.

A short video with Drs. Sholz and Moyad talking about exercise and hormone therapy: https://m.youtube.com/watch

Incorporating a resistance-training exercise program is a necessary part of the routine to minimize the potential physical/mental side-effects of hormone therapy.

It will improve the situation for him (and you).
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@brianjarvis well said, thanks

guybe | @guybe | 1 hour ago

When you write that your question is "not about libido", I'm not so sure. I believe libido is strongly related to "excitement about future plans, ambition, or simply enjoying everyday conversations and activities..." Among men, I think testosterone is about excitement of all kinds, sexual and otherwise, so those things are hard to separate. But separate them we must, somehow, in order to lead happy lives. In my own experience (short so far, but I can feel things coming) I try to put more effort into exercise, activities with friends, reading novels and nonfiction that are positive in outlook, and never-ending home projects (admittedly harder to get excited about, but there's always satisfaction in "gettin 'er done").

That's kind of a "solo" answer, seemingly not directly related to your query about relationships. But it is tightly related in the sense that those are things I have to work on for myself in order to be tolerable (at least) to my loving and supportive wife of 45 years. She knows and supports this work I have to do, and I try to give back as much as I can. That's really the main project here.

It's always work; as you write, things are often "off-kilter". Maybe think of it more as "new kilter" and trying to find some reward from this journey. It sounds to me like you're lucky to have each other, and you're going to be okay.

71/502 | @brucerichardson | 1 hour ago

I think what you need to know is that you are the most important thing in your husband‘s life. The cancer has taken a toll on him that you won’t ever know about. Most importantly he has you and your support. You should know that means everything to him. Even if he doesn’t say it, it’s important, incredibly important to him. He’s also questioning how this cancer will impact his life in two years, five years, 10 years. you’re both still young. Prostate cancer will always be in the back of his head, even though he won’t discuss it with you. Oh, it’s there. it never goes away. My wife is my anchor, like he is yours. For me only, I never, in my wildest dreams, thought at 67 I would be saying goodbye to intimacy the rest of my life but here I am. We still have plenty of fun. I’m restoring two old cars for my two kids. Everything between us is wonderful, but no, I never forget and it’s always in the back of my mind like it will be in his. Just stay close, always be there for each other and you’ll knock this thing out of the park. Best of luck to the both of you.