anticipating HT

My uro doc believes with my PSA rising at this rate(2.7 in Feb) we'll proably begin HT late this summer.  We haven't talked specifics yet but  I believe it is the intermittant approach and is injected once every other six months.  I've read much on here about differing experiences with side effects.  My question to those who have been there, or who are there now is will I be able to continue to work. I only work PT these days but enjoy it very much, It does not require any manual labor  but it is a commitment. Can side effects be so debilitating that they can keep you from being able to work or maintain a relatively normal lifestyle. I'm not running any marathons but would like to get a sense of what I might expect lifstyle-change wise. I'm now 63 and in otherwise good health.

Thoughts and advice here have been a blessing over this adventure of the past few years.

Hi Englishteacher, There has been some excellent discussions here at HW about HT, although sometimes the search function can be difficult.   I’ve not been on HT, but last year one member started a thread with the comment that he was concerned that HT would turn him into a “insensitive, uncaring emotional monster.”   He received many replies from others who had been on HT; here’s a summary: dkob131 said:  "...the side effects have been minimal for me" IdahoSurvivor tolded about a friend's experience:  "I don't know if this helps you, but I talked to a friend on Sunday that has been on HT for quite awhile and he is tolerating it well. " pa69 talked about his brother's experience:  "He holds a full time job as an excavation contractor and has suffered essentially no side effects from the RT or the HT. " Geebra said:  "I am enjoying life and small unpleasant side effects are nothing compared to being together with my wife, seeing my grandson turn one, sailing with friends or even putting in an honest day of work." sancarlos put it this way:  "It is certainly no bed of roses to be on HT...However, with the exception of sexual functions, which I hope are temporary and will go away when I go off HT, most of the side effects are "manageable"." kak (wife) added this perspective:  "The only things I have noticed and he talks about is, hot flashes, which he handles very well. He is more emotional, but I am not sure if it is from the diagnosis or from the HRT. He has a little bit of nipple swelling, but that has disappeared...but in our case I just want him around and it's crazy, but in a way we are closer than we were before." And F8 pointed out:  "...if it really gets to you you can stop treatment"   Nobody replied that they turned into a monster.   Hopefully this helps get the ball rolling for you with some additional responses…  

Hello Englishteacher,
You should be able to continue working while on HT if you institute some of the remedies to ameliorate the potential side effects of treatment. See:
tinyurl.com/7j4l7rl
For side effects and remedies

Your PSA is doubling approximately every 5 months. That is indicative of an aggressive cancer common for a GS8 at diagnosis and primary treatment and salvage treatment failure. Consider starting HT sooner than “late summer” although it is a patient’s preference when to start therapy. I am biased for early therapy and more so in aggressive cancers.

Preferably start therapy with a 28-day depot of a LHRH agonist to ascertain the degree of side effects and after two or three months if SEs are managed switch to a 3-month depot of the same medication. Ask for an oral antiandrogen for at least a month of the start of the LHRH injection. Preferably continue on the antiandrogen until stopping therapy and going intermittent. Wish you the very best outcome!

RalphV

Well - I started today. So far so good (12 hours worth) LOL. 

Hello,

In your post, your mentioned your uro is suggesting that HT may be your next treatment. Noticed, like me, you have both failed surgery and failed radiaton. At this point, it would make sense to me, that you should be seeing a good oncologist. Nothing against your uro, I love mine too.

There are oncologists that strongly believe that in your situation, you should be on HT now. And there are oncologists that feel equally strong about delaying HT for now, despite your rising numbers. Both present good arguments, and there are pro's and con's about both views.

I too had a quickly failed surgery, and quickly failed SRT, but my oncologist is of the school of delaying HT. He watches over me closely. My PSA in December of last year was up to 14.0. He does not feel there is a specific PSA number to draw the line in the sand to start treatment. I have no evidence of mets at this point. For me (and I am not a worrier by nature) am comfortable with my situation. My doctor, who only deals with advanced prostate and advanced breast cancer, said he has had patients, with PSA's of 100, after failed treatments, with no evidence of mets.

Not trying to talk you out of it, its between you and your doctor(s). If you don't have a dedicated onclogist, it might be worth the investment in time to do so.

My doctor feels that once you start HT, whether now or later, the meter is running, and it's "x" amount of time until a person becomes refactory to its effects. If my situation turns to the worse, or if there is ever any evidence of early mets, we are both prepared to go forward with additional treatment, either in the form of HT or Chemo.

Whatever you do, we are here for you.

David in SC

Post Edited (Purgatory) : 3/22/2012 8:39:00 PM (GMT-6)

Englishteacher,

Here is a link to a good overview of HT.  The article covers the pros and cons of early vs. late, intermittent vs. continous, and complete blockade vs. monotherapy.  Not a lot of info on side effects.  From the AUA: http://www.urologyhealth.org/urology/index.cfm?article=124.

Carlos