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Why is the experience of negative SE’s of ADT so variable…or are they?
Those of us who remain “treatment neophytes” are all about risk-reward, with heavy emphasis on zero risk.
I’ve often wondered why some men seemingly breeze through ADT like it is/was a walk in the park and others indicate it’s like being continuously run over by a Mack truck minus the bruises, broken bones and internal hemorrhaging.
At first I thought it may have to do with one’s pre-ADT testosterone level and the magnitude and nearness to a perpendicular roller coaster drop to enter into the chemical castration abyss.
My research indicates that while pre-ADT testosterone levels, 700 ng/dL (my current level) vs. 350 ng/dL (for example) may subtly influence the initial intensity of side effects, it’s (apparently) not the primary driver.
While baseline testosterone level is certainly important, apparently one’s age, how long you’re on ADT, your health before starting chemical castration, diet and exercise choices during ADT, and how side effects are managed with the host of prescription drugs used to counter the slings and arrows of those inhabiting the abyss, that mainly determine how bad the side effects one will experience.
Any comments by those who climbed aboard the amusement park’s “Ride to the Abyss”?
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❝I have minimized my pain on occasion to give the impression I am a “tough guy”❞
For me, it wasn't that. I mean, I was paraplegic at the time and couldn't even sit up or clean my own behind, so it was hardly possible to act tough or cool around the nurses and PSWs. 🙂
I did experience extreme pain once (I'll call it a 7–8), when they intubated me trough the nose with a stomach suction tube. The first two times it went down my windpipe and hit my lungs. No tough guy there — I was begging them to stop and try again the next day, but they got it on the third try.
After that, I wasn't going to call soreness from recent spinal surgery and screws an "8," because I knew what an 8 actually felt like.
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2 ReactionsYes, that's a good point. The measurable side effects vary as much as the perception-based ones.
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1 ReactionThe side effects of ADT are well known by the medical community and patients. Just going to the manufacturer's website for the drug will provide that laundry list.
The question is, which ones and to what degree will each of experience and how will it impacts our lives.
The answer, it depends....
There are mitigating strategies:
Diet
Exercise
Managing stress.
Your medical team may be able to help with the side effects, drugs for hot flashes....
There are statistics - Bell Curve, averages, mean, mode, standard deviation....an example, I have read where statistically, 80% of men on ADT lose libido, ergo 20% don't. I am in the 20%, why, who knows though my sex drive has always been "strong." My wife simply rolls her eyes and shakes her head.
Not saying I'm a gym rat but last year my gym logged me as working out 270 days. Throw in days that I ride my bike, play pickleball hike in the mountains, ski...a typical gym workout for me is 45-60 minutes on an indoor bike, weights, swimming.
I think attitude may play a role. I've done the Garmin Unbound, a 50 mike gravel bike ride in the Flint Hills of KS and the Bataan Death March Memorial in White Sands NM gone skiing with friends in Colorado, did the Ring Road in Iceland with my wife while on ADT. Kind of like Nike's slogan, just do it.
There are health issues which may come into play - CV, kidney...
I'm high risk, GS8, GG4, rapid PSADT and PSAV, 18 months to BCR...yet, 11+ years after diagnosis, here I am. Three of those 11+ have been on treatment, the rest off.
To be honest, the difference in my life on versus off treatment is generally not what I do, it's how I feel doing it!
The hot flashes suck. Yes, I notice the fatigue, my genitalia shrink...
And yes, I take the damn nap when I feel like it!
Kevin
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