ADT Side Effects

JerryB · Regular Joined: 13 Jul 2009 Posts: 43 Location: UK

I have been told that the side-effects of ADT are essentially the result of reduction in testosterone, rather than anything directly relating to the drug itself.

However, others have suggested that the type of drug taken may influence the extent of side-effects. If I recall correctly someone at this forum said that the side-effects from Casodex and Proscar are about 20% of Lupron.

Can anyone comment on whether the reduction in testosterone or the direct effects from the drug are the major influence with regard to side-effects? Or, to put it another way, would having an orchidectomy produce similar side effects to ADT?

Jeremy
_________________
Age - 67
PSA – 7.8 ug/L. in February 2009.
Gleason – 7 (4+3). T stage – 2b. Prostate size - 52 cc
July 2009 - ADT for 3 months to shrink prostate.
September 2009 - decided on HIFU. Scheduled for 30th October 2009.

Putt · Regular Joined: 04 Aug 2009 Posts: 27 Location: Kansas

You are basically correct that ADT side-effects are caused by reducing the level of testosterone to a very low level. Treatment by ADT is not meant to be forever. A few months after the influence of the ADT expires at the end of the treatment, the body (testicles) start producing testosterone again. Guess what when you have an orchidectomy???? We are talking forever here. As young as you are, I think I would say "Leave the family jewels alone."
_________________
PSA at Dx 105 at age 68, 4/04. ADT, RRP, 5/04. Gleason 4+5=9, Staged pT3c N0 MX, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09. Will start ADT3 after PSA reaches 1.2.

JerryB · Regular Joined: 13 Jul 2009 Posts: 43 Location: UK

Thank you Putt

Fortunately, I'm not considering having an orchidectomy myself. My question arose partly out of general curiosity, partly relating to my own short-term (three months) period on ADT, and partly acknowledging the possibility - remote, I hope - that one of these days I might have to go on ADT if primary treatment should fail to restrict the spread of cancer. The mention of orchidectomy was merely to highlight the point about whether loss of testosterone is the major factor in side-effects.

During my time on ADT I have experienced a number of side-effects; some mild, some rather disruptive and unpleasant. I am now at the end of the three-month period, but obviously I'm interested to know how long these side effects may or may not continue. Assuming they are related to the return of normal levels of testosterone in my body, this may take some time.

Like you, I'm inclined to think that the primary influence producing side-effects is the reduction in testosterone, but it is the fact that there is apparently opinion among some people that the type of drug can influence the degree of side-effects, which is of interest to me.

Thank you. Jeremy
_________________
Age - 67
PSA – 7.8 ug/L. in February 2009.
Gleason – 7 (4+3). T stage – 2b. Prostate size - 52 cc
July 2009 - ADT for 3 months to shrink prostate.
September 2009 - decided on HIFU. Scheduled for 30th October 2009.

Putt · Regular Joined: 04 Aug 2009 Posts: 27 Location: Kansas

Jeremy
My experience has been with Lupron only. As far as side-effects, I should be the "poster boy" for it. I was lucky (?) enough to be able to experience every possible effect known to be caused by Lupron. The degree of intensity of each effect varies with the individual and for some reason, I qualified for the max of all. I received dozens of suggestions to try to receive some relief but nothing worked so I had to learn to grin and bear it.

When the time frame of my last injection ( 3 months) expired, it took about another 3 months before my testosterone started to rise, the hot flashes stopped and my energy level improved. The time it takes to get back to being close to normal is basically age related. The younger the better.

One more thing to be aware of while on ADT. This theapy will cause bone loss. There is a simple urine test that will determine if you are losing bone, and it is called Pyrilinks-D. With your short term of ADT treatment, it should not be a problem, however it is something to keep in mind for later if required. I wasn't aware of this possibility for quite a while and when I finally found there could be a problem, to keep a long story short, I am now taking Fosamax for osteoporosis. Were having fun now.....

Good luck with your treatment. We each have a story to tell which hopefully will help others in some small way. Come back and let us know how you are getting along.

Gary
_________________
PSA at Dx 105 at age 68, 4/04. ADT, RRP, 5/04. Gleason 4+5=9, Staged pT3c N0 MX, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09. Will start ADT3 after PSA reaches 1.2.

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