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Surgical Castration

ZetB1
Posts: 6
Joined: Dec 2016
I am on the road to surgical castration.  After surgery I will be given 50mg of Casodex to take daily.  The worst part is that I may have a tendency to gain weight (Lupron tends to cause people to gain weight too.)
 
If anyone has had surgical castration please write about you side effects.  I am scheduled for surgery in early 2017.
 
Thanks
 
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http://jamanetwork.com/journals/jamaoncology/article-abstract/2476248

check out the above abstract. It concludes thatt Gondotropin-releasing hormone agonist therapy is associated with higher risks of several clinically relevant adverse effects compared with orchiectomy. 

In the Discussion section of the full article is the following: "..Primarily, our findings indicate that GnRHa was associated with significantly higher risks of fractures, peripheral arterial disease, and cardiac complications compared with surgical castration>"

Your local library (interlibrary loan) may be able to order a copy of the above JAMA Oncol article titled, "Comparison of Gondotropin-Releasing Agonists and Orchiectomy Effects of Androgen-Deprivation Therapy."

 

 

VascodaGama's picture
VascodaGama
Posts: 2969
Joined: Nov 2010

ZetB1,

The best of orchiectomy (medical castration) is that it is a simple and cheap procedure. The worse is that it leads the patient to permanent symptoms of hypogonadism being fatigue very pronounced and constant. It also affects body systems dependent on testosterone in its function.
Chemical castration (Gonadotrophin-releasing hormone agonist) requires periodical administration of shots but once stopped the patients can recover to normal status and vitality. While on the effects of the drug, hypogonadism side effects are equally experienced in addition to the effects from pituitary's disturbances such as impaired recognition and bleared vision.

Both treatments are only palliative providing, to certain extent, control on the advancement of the cancer. Some types of PCa are not hormone dependent turning HT absolute. Some types can survive without testosterone living on androgens produced by itself.

Surely, all treatments for prostate cancer prejudice the quality of life of the patient. His age and the specifics of his life should be considered when deciding on an option.

I read your other post where you informed being diagnosed T4N0M0. Can you provide more details about you and your case. What is the Gleason score? Do you have symptoms? How old are you?

Best wishes,

VG

ZetB1
Posts: 6
Joined: Dec 2016

Thanks for your detailed response.  My Gleason 8 (4+4),  PSA 6.0, 67y.o., symptoms: fatigue, and using flomax.

So far I have received three Lupron shots and have another year or so of the shots. I have found Lupron gives me extremely dark thoughts. 

VascodaGama's picture
VascodaGama
Posts: 2969
Joined: Nov 2010

Thanks for sharing details. I think that your experience with Lupron (leuprolide acetate) is taking you to consider orchiectomy (surgical castration), the main theme of your thread. Surely you can cut off your balls however such doesn't assure you a relief of the symptoms. Hypogonadism causes mood changes and these can influence dark moments to the extremes of considering death. I believe that with Lupron you are better fit to counter the effects. It all depends if your status permits an intermittent administration of the drug.

We are both young with the same age and doing the same treatment of ADT (androgen deprivation therapy). I also experienced strange moments, probably not that dark, but I changed habits and managed to counter the effects. I found that the best way to deal with the symptoms is to know in advance what to expect and react mentally against it. I also change the time of dinner and changed diets, (lesser liquids intake before bed time) to counter wakeups for peeing at night. I managed to counter Fatigue with daily walks to exercise the muscles (stress vitamin manufacturing) and afternoon naps. I started newer hobbies to have my mind involved in matters of interest. In fact the symptoms were numerous but mild or unnoticed. I am now enjoying a vacation period free of leuprolide acetate (Eligard) back with normal levels of testosterone. 

Because of the particulars of my case, the treatment involves intermittent administration (on/off drug periods) allowing me to recuperate the normalcy status (out of hypogonadism). I wonder about your clinical stage (T4 N0M0). Have you done reliable image studies to classify T4? Can you provide some clues on the treatment protocol recommended by your doctor?

T4 stands for; The cancer has grown into tissues next to your prostate (other than the seminal vesicles), such as the urethral sphincter (a muscle that helps control urination), the rectum, the bladder, and/or the wall of the pelvis. N0 means; The cancer has not spread to any nearby lymph nodes.

The above status may be of a case that can be treated with intent of cure (radiation therapy or combination RT+HT/ADT) with success. I wonder if such option has been considered or suggested by your doctor. ADT can be a good starter to fight a Gleason 8 case (aggressive) but it is palliative and only provides control. The PSA of 6 is not that high for a 67 yo patient. Surely, some cancers produce lesser serum so that the value 6 could have an higher meaning. I realy wonder about your treatment choice.

Best,

VG

 

 

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