Questions about ADT for 6 months, during/after affects

You are 56 with a G7 and a tumor confined to he prostate. Surgery is the answer in my opinion. UNLESS you have reasons you can't have surgery OR you have other medical issues going on.

I am 50 when the biopsy showed a G9 also confined to the prostate.

I was offered all the options (on the assumption that the biopsy was correct and that it was confined to the prostate. The biopsy is not 100% accurate).

I read about hormone therapy where the testosterone in the testes and adrenal glands is stopped. This is politely sold as "ADT". If I was 80 I would go for it. At 50 there was no way I would.

The side effects of ADT are bad and they do not stop once you stop the treatment in 6 months. They include, weight gain, sexual dysfunction, cognitive dysfunction, hot flashes, depression, mood swings etc.

Also if you take ADT do not be surprised if your urologist extends the period you're on it in case the cancer does not respond accordingly. He doesn't swear on the Bible when he says "6 months".

As for Brachy, note there are a few types: Low dose; high dose and high dose & Radiation.

Sorry to hear of your diagnosis. The good news is that you have options. At 56, you want to get this thing treated and over with. And your age is an advantage.  I had prostatitis  too, so I understand that unpleasant experience. I had the biopsy done, which is also not fun. My PSA was at 5.2, with 2 core samples out of 12 positive for non agressive prostate cancer. Fortunately, the 2 samples were low at 2% in one and 10% in the other. Gleason score of 3 + 3 = 6. I researched my treatment options at that point. I didn't feel comfortable with the active survailance which was also an option for me - just knowing that  there was cancer and it could grow and develope into something more than 2 cores. After lengthy discussions with my urologist, and the oncologist I decided on the low dose radiation Brachytherapy. It is a one time out patient treatment done under anesthesia. It takes about 30 to 45 minutes. The low dose radiation helps in keeping the treatment where it needs to be - within your prostate. There is a much less chance of the radiation causing damage to surrounding tissues like your bladder or colon. It has been 7 months since I had the treatment and I am doing very well. For the first few months, there is some inflammation to the prostate and the urethra, but ibuprofen helps with that. Also, my urologist put me on Tamsulosin (generic Flomax), prior to the procedure as a precaustion,. I was not having any urinary issues, but since the radiation would most likely cause some inflammation, he put me on it. I think that was a good call. After the procedure,  I was taking 2 capsules daily for a short time, now I am taking one and will probably go off of it entirely in a few more months. Check out all of your treatment options. Brachy is a good choice if it is offered to you. The high dose Brachy is administered in 2 sessions I believe. They leave the needles in the prostate for a set time (I think an hour or so), then they are removed. The procedure is repeated about 2 weeks later. The benefit of the low dose, is that it is one time and you're done. The seed implants stay in. The radiation is totally gone after about 8 months. I have suffered few side effects. There is some urgency and frequency for urination in the beginning, but that gets better with time. No incontenence. As far as sexual side effects - not much interest in sex for a couple of weeks wihich is understandable. But soon, the interest is back. The main difference in sexual activity that I experienced is a big reduction in the volume of your ejaculation. At least it is for me. I don't know if that will change over time. But at least the pleasure and feelings are still there. And that is a good thing. Better to be cancer free. At my 6 month follow up, my PSA is now at 0.15.

Do some research - what ever treatment you choose, make sure your doctor has performed that procedure many times successfully.  Good Luck to you.... Charles

Hello. Maybe it's different in the uk. My other half had brachytherapy nearly 2 years ago. No hormones were needed. He was 57. We were told he didn't need hormones as prostate was normal size. But we know quite a few people that have had brachytherapy and none had hormones. His PSA is now 0.4 and hoping it will stay that way. Good luck.

A good place to start getting accurate information is from a PCa support group and your Urologist. Harvard Medical School has an online wealth of information related to ADT. Usually a short course of 6 months has few long lasting side effects. My husband had the 6 months, had no side effects. He did have lowered energy but nothing much else. I have Intermediate risk PCa and will get the same treatment as yours. Ive found the cancer center I am going to an excellent source of info. I live in NW Massachusetts.

My radiologist looked at my pelvic structure , the shape of my prostate and location... I am not a candidate for Brachytherapy. They would not be able to put the seeds in about 1/4 of my cancerous area without a really wickedly curved set of needles. That also takes out surgery as the RAS would not be able to take it out completely and spare the nerves.

I go into the urologist in two weeks to get my gold markers inserted for beam radiation.