PSA levels started to rise again but negative PSMA PET

about 4 years ago I had a prostatectomy, 6 months later, 37 radiation treatments. Now my psa's have steady increased from 0.02 to 0.5. my urologist wants me to take a drug that will stop cells from using testeron. the potential side effects could be rather nasty. I'd prefer surgical castration. I'm 75. is my thinking flawed? my urologist gave me a brush off

@sammiam
I’m 78 and on ADT for almost 8 years. That’s the drug that stops you from producing testosterone, Mine has been less than five for almost 9 years. It’s really not a problem for me, I don’t get fatigue from it. Yes, there are other side effects, I have to go to the gym three times a week to keep my muscles strong, I run on a track twice a day a mile to keep in good shape.

Hot flashes are probably one of the most annoying things you could find happening.

Surgical castration will give you ALL OF THOSE SYMPTOMS and you won’t have a way to reverse them.

You should tell your doctor you want to take Orgovyx, That is a pill form of the drug you’re talking about and your testosterone usually comes back much quicker when you stop taking it. It also has fewer side effects for most people.

There is one other solution that has very few side effects. If you really found ADT to be too big a problem you could start taking Nubeqa. It works without needing to reduce testosterone, I’ve been on it for over two years and it works great and has almost no side effects. I know a bunch of guys over at ancan.org Advance prostate cancer group that are using it alone and are quite happy with the results. Almost all of them when they’re in late 70s or 80s.

I had my prostatectomy almost 16 years ago I’ve had four reoccurrences. The drugs they have available now work quite well and keep you alive for a long time. They keep coming out with new ones so you may have a better solution in a few years. Better than removing your testicles.

Some things to consider.

thanks for your reply, and the information. I guess my biggest concern is the possible side effects such as fractures, cardio issues and liver damage, that are potential serious side affects. honestly, at my age, I'm not concerned about surgical castration not being reversible, at my age, it no longer matters.

@sammiam

I understand your point and if that procedure makes more sense for you, you should be your own advocate.

Find a doctor that will do that for you. I am sure that there are some that do perform that surgery.

Try doing research on this site by inserting "surgical castration" in a search field above all of the topics (left corner).

Jeff is correct in stating that you will have many of the same side effects as with using ADT. Medications are heavy on liver and kidneys but medical castration actually can cause more heart problems than ADT, according to some studies.

Try to read as much as you can about pros and cons of each method and than decide what is the better solution for you. You know "you" the best. ; )

Thank you ever so much, this whole experience has pretty much un-nerved me. Again thanks

@sammiam

All of these problems can occur from low testosterone. It doesn’t matter whether you have your testicles removed or go on ADT you can have the exact same problems.

At least if you are on ADT you can reverse the issues and switch to different treatments.

@jeffmarc

yes, but the liver damage if it happens is caused by drugs. I'm discussing this with my urologist.

@sammiam For most of us ADT, if that is what you are referring to, isn't so horrible. Combine it with radiation and it can really suck. But is temporary. Surgical castration is permanent. ADT isn't and you could be a candidate for intermittent ADT which gives you a break. I would suggest trying Orgovyx if you can. It starts to work quickly and lets go quicker than Lupron if you stop. There are other drugs on the menu too. I can understand your internal battle. I had the same one and decided on ADT.

@jeffmarc

Thank you Jeff . Very informative.