orchiectomy - suggessions

I am very sorry your Dad has been diagnosed with prostate cancer. I quite understand the feelings of panic on finding your Dad in this disease. I had a very strong emotional period on first being confronted by my own PCa.

I understand from your text that testosterone deprivation therapy is the only medical intervention for your Dad's disease so far. This seems unusual since your Dad is only 70 and is in good health apart from the PCa. PCa with a Geason score of 3+3=6 is not usually considered to pose an immediate threat of spreading.  You also state that you are concerned about recurrance of PCa. Testosterone deprivation therapy whether by orchiectomy or injection does not usually yield a cure but is frequently used in conjunction with surgery, implanted radioactive seeds or external beam radiation therapy. Perhaps you could comment on this point. 

Sorry that your dad is going through all this.  There is a lot of guesswork as to what to do when prostate cancer appears.  People get scared and just "want it out or want it dead."  The collateral damage is sometimes devastating.

Orchiectomy or removal of the testicles is, of course irreversible.  The goal (sometimes misguided) is to stop the production of testosterone, an androgen because prostate cancer feeds off of androgen.  Your dad's adrenals also produce some androgens. 

Stephen Strum is the expert on a thing called intermittent androgen deprivation.  Your father is on continuous deprivation.  Because cancer wants to live as much as your father does, it doesn't like it when you take away its food supply and in response it mutates into androgen independent prostate cancer.  My reading tells me that androgen independent prostate cancer is more virile and aggessive.  For this reason Strum thought it would work better to push the cancer back with deprivation and then allow it to feed, push it back and then allow it to feed, etc. 

Personally, I find this to be conceptually flawed.  First, the people least plagued by prostate cancer are young, generally high testostertone males.  Second, it is aging males entering andropause (a time in a man's life when his testosterone levels are decreasing) that  a man is more likely to be diagnosed with prostate cancer. 

The bulk of the material I have read on treatment via androgen deprivation, intermittent or consistant, suggests that the results are equivocal at best.  

Your father could have the results of orchiectomy reversed by taking testosterone supplementation.  I think that would be a tough call, however, and I suspect it would be difficult to find a physician who would support him.

Complex situation.  More than anything I would hope that we could all learn that prostate cancer is something that almost always gives you time to read and attempt to understand what is going on conceptually.  If the promoted strategy doesn't conceptually make sense it could be because it should be avoided.

My Best To You and to Your Father.