Hormones & Radiation post prostatectomy - How to avoid/minimize side effects

Quick Background: Prostatectomy on Apr '20; PSA undetectable until Sep '21 (1.5 yrs); 0.21 PSA on Mar '22.
Recent Tests after PSA 0.21: EKG; PET Scan, CT Scan, Bone Density & Prostate MRI.......all looked good with the exception of the prostate bed near the bladder
Current Plan: Started Hormones in May, which will continue for 2yrs. I begin radiation on June 20th for 40 sessions (M-F for 8 weeks)

Here's my question to the forum: I'm 54 yrs old. For those of you similar in age when you went through this, how did you avoid/minimize the side effects? The thought of no intercourse with my wife due to low libido or ED coupled with the loss of muscle, weight gain and fatigue has my head spinning.

Are pills, devices and injections more likely than not what's needed for intimacy? I've read that exercise, workout with weights should help with weight gain and muscle loss. Do people who've actually gone through it agree with that. What else worked? Any other suggestions?

The weird thing is that the cancer because you can't feel or see it, seems to be less on my mind. The side effects which you can see and feel everyday seem to be on my mind far more often.

Any and all input is appreciated...the good and the bad.

Thanks
Dave

It was not as they wanted to see the 1st PSA test at 6 weeks post surgery. When that came back as undetectable, they said they wouldn't proceed with hormones and radiation until it became detectable. They tested me every 3 months.

My husband is 58--so a little older than you are.

He's been taking a low dose of Cialis (sp?) every day since his prostatectomy in 2014, and he takes Viagra to help things. We are no longer spontaneous but it's been fine.

With regard to the hormones, he's been on Lupron since late-January. When he was having radiation (late January to late March), he had intense burning when he climaxed--so much so that he didn't want to try it again during radiation. When we finally tried again, he was successful, with the help of Viagra. We felt pretty good about that. Then I got COVID and I've been isolating so can't report on anything.

My husband recently had a discussion with the Men's Health department. He has asked them about a pump because we have heard that it's better to have regular erections, even if produced by a pump. They quickly agreed that a pump was a good idea. (My friend's husband was told about the pump after his surgery. I'm not sure why no one had ever mentioned this to us.) So depending on how active you are sexually, you might want to ask about a pump if you don't have one already.

Regarding weight gain and muscle loss, my husband has been exercising regularly even during radiation. He runs about 30+ miles a week and lifts weights twice a week. He eats a pretty healthy diet. He's been tracking his weight and body fat and has noticed some patterns for him: he gains a few pounds right after his Lupron shot and then loses those few pounds in the next week or two. So far no weight gain and no appreciable body fat increase.

I know that others on this board have mentioned keeping up a regular exercise routine. It will keep depression at bay which means you're less likely to have a bad spiral. I think exercise is important but, whatever you do, be kind to yourself. Good luck with everything!

Dave - can’t help much with the ADT part although my Dad said no big deal in his 80’s. The stories are all over the place so hard to know how any one person will be affected but staying active is important.

ART/SRT was not a real big deal, just a long haul with a daily ritual to maintain, full bladder/empty colon. I mainly had minor side effects (seemed more important at the time) with significant fatigue being a problem near the end and for a month after. There were some increased urgency issues at times but nothing I could not accommodate (mental map of all bathrooms in all stores and stopping at rest stops on road trips).

Hope you do well with your program.

Rick - very helpful. Thanks. I'm very active and continue to lift weights. My diet could definitely be better.....;lots of meat and carbs. That's something that will need to change. The alcohol could be difficult. I enjoy watching games and hanging out with friends and beer and alcohol are definitely a good part of that. It's always good to hear from folks who are or have already gone through a similar situation. Thanks again

Dave