6 months injection and getting ready for IMRT.

Hi quick update – After PSMA I’ve decided to go for ADT eligard 6 months injections. It took a lot of planning and thinking before making this decision as I am going through ‘Depression Period’ and HT might make this worse however based on my recent PSA .19 which shows increment of .9 as compared to PSA done 3 months ago, I’ve decided to go for ADT.
Now my RO & MO wants to initiate IMRT to pelvic area as per PSMA scan in 2 months time.

Jack1954,

I am also a Jack. I did three+ years on ADT. Thankfully it did not cause me to be depressed. Actually, it had some very enlightening aspects as it was somewhat calmative at times and some of the side effects helped me understand what my wife has gone through with similar cancer treatments and menopause.

However, my brother's brother-in-law has been on ADT twice in the last 10 years and each time has suffered from depression to the point that medical assistance was indicated.

I also suggest that you do have this discussion with your doctors and consider contacting a therapist for their assessment. Do take the possibility of treatment depression seriously, but please guard against being talked into it by others or even yourself. It is natural to be down when treating disease, but that may not be the same as clinical depression.

In the meantime, get plenty of sunshine and exercise. When you are feeling a bit blue or lost just go outside for a walk. Observe other people and nature. Go to a little kids baseball or soccer game. Purposely and physically get out of your disease for awhile. It will do you good.

ADT... down the rabbit hole!

Do you expect to remain on ADT, or is this only to go along with the radiation treatment? How long on ADT? Do they expect the local therapy to be "curative"?

The six month shots were easy for me (Lupron). Very minor bruised sensation at the injection site for a day or so, and then nothing further. Really easy. Living with ADT however was more challenging.

After 6 months, my mental state was in trouble. I lost my mom (heart issues) in the fall of 2013, and then in short order lost two of my friends to cancer. One was my pastor, and that was particularly hard, as we had been at the same cancer center and shared a lot. Those losses, plus my own situation, exacerbated by 6 months by then of ADT, just started to be too much to handle.

Around that time, I talked to my GP about it and we agreed to try Prozac. That turned out to be too strong (zombified me), so we switched to Lexapro, which worked great (it however caused "anorgasmia", which is weird. Google that if you're interested. Though after 6 months on ADT that wasn't much of a concern any more anyway). I got off of Lexapro after about a year and a half of using it.

The goal is just to help you be yourself. Lexapro is really hard to get off of, taking months of careful "weaning" to avoid some unpleasant side effects. There are others with similar function that may be easier.

Anyway, the point is not to be too afraid of anti-depressants. Kind of like "glasses for your brain", they can help get you through a time you may not be able to handle unassisted. No shame in admitting that.

Hot flashes are tiresome, but manageable. The relentless fatigue was problematic, costing me my favorite pastime of motorcycle touring. Partly a depression symptom, but also from no T, I found myself uninterested in anything. I literally did not "want" to do anything; just sitting and staring at the wall could be enough. That was completely unlike me, as I've always liked to be busy, and always have had some sort of hobby or pursuit. Not on ADT. Nope. Just keeping a chair warm was fine. Combine that with no sex at all, and the marriage relationship starts experiencing stress. Gotta watch that.

All the best, Jack. It's not a path any of us would choose, but it sounds like you're doing good research on your options.