Neither my urologist nor my external beam radiation oncologist fully explained the effects of ADT. Borderline malpractice if you ask me. I came VERY close but fortunately I educated myself before getting the shot. I now have an appointment with a doc who does HDR Brachytherapy. I'll do everything I can to avoid ADT.
Was administered a six month shot of Eligard. Am now at 7 month after shot. Eligard manufacture has informed me that they do not know when the 6 month shot stops administering medicine. They claim they have no data for patients after the 6 month period advertised. Still having significant side effects at 7 months.
Doctors and drug manufacturers deliberately withhold the critical information from patients and never inform them that 20% of older men on ADT will never recover their TESTOSTERONE level above castrate level and they will suffer the rest of their miserable lives existing as just another ZOMBIE EUNUCH created by the NARCO MEDICO CARTEL. Without free and informed consent, the administration of these toxins is criminal assault causing greivois bodily harm.
While on ADT at age 74 I had an erection every day (to make up for lack of nocturnal erections and avoid atrophy) and four or more orgasms per week. My wife helped, but at least 80% of time was through masturbation. I suspect that Dr. Mulhall's low numbers are from men not having libido while on ADT and "forgetting" to remain sexually active.
@@scottwillis5434 This whole thing is interesting as one point in time Dr. Mulhall totally discounted the idea of being able to reach orgasm without testosterone. Actually, the ability to have orgasm appears to be the last thing lost no matter the treatment. I'll have to ask some men who have been on years of ADT for confirmation. I do know that without testosterone keeping our attention on sex, it can take a long time to reach orgasm. One gent mentions taking 45 minutes. Without testosterone, sex is driven by the mind and it is easy to get distracted. I had to learn new ways to masturbate when my wife could not participate as the traditional full fist move caused a series of what looked like blood blisters behind the corona with the long time to orgasm. I am fully on board with Dr. Mulhall that men are not well informed about ADT side effects. Men on ADT go into instant menopause. Not quite andropause as I understand andropause often does not reach the intensity of menopause. ADT is the real thing and men don't handle it well. However, we can justify using ADT given the man is fully informed as it is one way to extend length of life while battling cancer. I will look into how much loss of testosterone with continuing sexual activity affects smooth muscle health. This was one question and worry I never had answered. I think this study is sloppy in that it is just a measurement of what happens when treatment is not done correctly. One problem is that the subjects had sex only once a month. What would more frequent sex have had on ED and recovery? Doctors are also guilty of not encouraging men to have daily sex while on ADT. I also question whether total testosterone is the correct target. There is a complex interplay in the feedback that controls the amount of testosterone. There is bio available testosterone (which I suspect should be the real target), free testosterone, total testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and sex hormone binding globulin (SHBG) just for starters. My TT went to 483 in less than 2 years, but my bio available testosterone is lower than normal. I am still experiencing fatigue and emotions I felt under ADT and suspect the low bio available testosterone is the reason. Soooo, with TT at 483 ng/dl why is my bio available low? Testosterone cannot mix into blood serum for delivery so SHBG binds with the testosterone (and estrogen) to transport it. That bound testosterone is not bio available. SHBG is sometimes a bit stingy about giving up the bound testosterone and bio available testosterone remains low. In my case, I have more than normal SHBG. When my TT went up 30%, the SHBG went up 25% and way over norm. I believe SHBG is produced by the liver (?) so there could be liver (?) problems involved. Dr. Mulhall has given no consideration to any of this, just a study of what happened with the treatment in place. I think that he may also need to put more thought on how surgery affected recovery vs no surgery given about half the subjects had surgery. I also agree that doctors should be doing baseline measurements. I very much regret not having the insight to request this from my urologist. My medical providers really didn't seem concerned about my sexual function and seemed embarrassed to discuss it.
Demand testosterone replacement therapy if Big Pharma successfully leaves you castrated for life, as happens in up to twenty percent of older men. Ask the doctor why it's ok for the lucky guys to regain normal testosterone levels, but if you are unlucky enough to end up below castrate level, you have to suffer the rest of your life existing as just another ZOMBIE EUNUCH CREATED BY THE NARCO MEDICO CARTEL???
ALL THE TALK AND I AM 75 SO TO ME I HAVE DAY LONG SWEATS THAT PREVENT ME FROM DOING MUCH DURING THE DAY. NOBODY TALKS ABOUT HOW BAD THIS CAN BE AND DRUGS THAT DO NOT HELP TO REDUCE SWEATS. THIS GUY MUST BE ON HORMONE THERAPY CASUE YOU CAN SEE HIS NIPPLES. ANOTHER PROBLEM IF YOU NEED A BRA!
I'm curious as to why sex Is so important while going thru the cancer journey. Why do men worry so much about having sex. My husband is in yr 2 of stage 4. [Diagnosed in 2018 with PC... Had prostatectomy in 2019, with no other treatment.] In 2021 was in stage 4 and last week had his 1st, 3 month Lupron injection hoping to shrink a 2 inch tumor on his bladder in order to allow him to pee. He is retaining urine. Unable to have sex. But is not an issue. I'm truly curious why so much concern about having sex. Thank you!
Having sex, or more clearly, getting erections to ensure that oxygenated blood gets into the penis prevents Penile atrophy and shrinkage. It may not be important to some men with terminal cancer with short life expectancy, but for many men, it is hugely important. In the same way that women with breast cancer feel devastated by mastectomies and try to preserve their breasts. Chemical castration is cruel and barbaric treatment
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Well this was an eye opener. Thanks for the realistic look at ADT and testosterone recovery.
Thank you. This is an important topic too often overlooked.
DO NOT immediately accept ADT (ie: chemical castration). Look into Brachytherapy.
I took the option. I inherited the disease and saw what will happen if I do nothing.
Excellent discussion of the myriad of T issues that face ADT patients. All of which should be discussed/disclosed to patients before ADT therapy.
My doctor did none of that.
Neither my urologist nor my external beam radiation oncologist fully explained the effects of ADT. Borderline malpractice if you ask me. I came VERY close but fortunately I educated myself before getting the shot. I now have an appointment with a doc who does HDR Brachytherapy. I'll do everything I can to avoid ADT.
Was administered a six month shot of Eligard. Am now at 7 month after shot. Eligard manufacture has informed me that they do not know when the 6 month shot stops administering medicine. They claim they have no data for patients after the 6 month period advertised. Still having significant side effects at 7 months.
What kind of side effects still persists?
@@phenababitol Probably all the usual menopausal side effects we get while on ADT. I'm still dealing with some of it after 2 years off Eligard/Lupron.
Doctors and drug manufacturers deliberately withhold the critical information from patients and never inform them that 20% of older men on ADT will never recover their TESTOSTERONE level above castrate level and they will suffer the rest of their miserable lives existing as just another ZOMBIE EUNUCH created by the NARCO MEDICO CARTEL.
Without free and informed consent, the administration of these toxins is criminal assault causing greivois bodily harm.
While on ADT at age 74 I had an erection every day (to make up for lack of nocturnal erections and avoid atrophy) and four or more orgasms per week. My wife helped, but at least 80% of time was through masturbation. I suspect that Dr. Mulhall's low numbers are from men not having libido while on ADT and "forgetting" to remain sexually active.
Or, you were in the small percentage who do not lose the ability to orgasm mentioned around 7:00. One data point.
@@scottwillis5434 This whole thing is interesting as one point in time Dr. Mulhall totally discounted the idea of being able to reach orgasm without testosterone.
Actually, the ability to have orgasm appears to be the last thing lost no matter the treatment. I'll have to ask some men who have been on years of ADT for confirmation.
I do know that without testosterone keeping our attention on sex, it can take a long time to reach orgasm. One gent mentions taking 45 minutes. Without testosterone, sex is driven by the mind and it is easy to get distracted. I had to learn new ways to masturbate when my wife could not participate as the traditional full fist move caused a series of what looked like blood blisters behind the corona with the long time to orgasm.
I am fully on board with Dr. Mulhall that men are not well informed about ADT side effects. Men on ADT go into instant menopause. Not quite andropause as I understand andropause often does not reach the intensity of menopause. ADT is the real thing and men don't handle it well. However, we can justify using ADT given the man is fully informed as it is one way to extend length of life while battling cancer.
I will look into how much loss of testosterone with continuing sexual activity affects smooth muscle health. This was one question and worry I never had answered.
I think this study is sloppy in that it is just a measurement of what happens when treatment is not done correctly. One problem is that the subjects had sex only once a month. What would more frequent sex have had on ED and recovery? Doctors are also guilty of not encouraging men to have daily sex while on ADT.
I also question whether total testosterone is the correct target. There is a complex interplay in the feedback that controls the amount of testosterone. There is bio available testosterone (which I suspect should be the real target), free testosterone, total testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and sex hormone binding globulin (SHBG) just for starters. My TT went to 483 in less than 2 years, but my bio available testosterone is lower than normal. I am still experiencing fatigue and emotions I felt under ADT and suspect the low bio available testosterone is the reason.
Soooo, with TT at 483 ng/dl why is my bio available low? Testosterone cannot mix into blood serum for delivery so SHBG binds with the testosterone (and estrogen) to transport it. That bound testosterone is not bio available. SHBG is sometimes a bit stingy about giving up the bound testosterone and bio available testosterone remains low. In my case, I have more than normal SHBG. When my TT went up 30%, the SHBG went up 25% and way over norm. I believe SHBG is produced by the liver (?) so there could be liver (?) problems involved.
Dr. Mulhall has given no consideration to any of this, just a study of what happened with the treatment in place. I think that he may also need to put more thought on how surgery affected recovery vs no surgery given about half the subjects had surgery.
I also agree that doctors should be doing baseline measurements. I very much regret not having the insight to request this from my urologist. My medical providers really didn't seem concerned about my sexual function and seemed embarrassed to discuss it.
Where can I get a copy of his presentation?
I want one of those shirts.
Death, where is thy sting? I will avoid ADT at all cost.
My urologist and Radiation oncologist NEVER told me about the libido and ED issues long term. Everything will eventually "come back". Bullsh-t
Can't they give us x-tra testosterone after ADT, like a patch or jell?
Demand testosterone replacement therapy if Big Pharma successfully leaves you castrated for life, as happens in up to twenty percent of older men.
Ask the doctor why it's ok for the lucky guys to regain normal testosterone levels, but if you are unlucky enough to end up below castrate level, you have to suffer the rest of your life existing as just another ZOMBIE EUNUCH CREATED BY THE NARCO MEDICO CARTEL???
Man, I bet this guy is the life of the party. 😮
His arrogance makes listening difficult.
@@Wheels44735 Indeed. I don’t want him caring for me, for sure
Me either. Optimism leads to hope. This guy instills neither.
@@SinnerSince1962 I dunno. Not jumping off a bridge or anything, but man, I need hope.I'm on ADT.
@@EdWeibe it’s hard, Ed. I know.
ALL THE TALK AND I AM 75 SO TO ME I HAVE DAY LONG SWEATS THAT PREVENT ME FROM DOING MUCH DURING THE DAY. NOBODY TALKS ABOUT HOW BAD THIS CAN BE AND DRUGS THAT DO NOT HELP TO REDUCE SWEATS. THIS GUY MUST BE ON HORMONE THERAPY CASUE YOU CAN SEE HIS NIPPLES. ANOTHER PROBLEM IF YOU NEED A BRA!
I'm curious as to why sex Is so important while going thru the cancer journey. Why do men worry so much about having sex. My husband is in yr 2 of stage 4. [Diagnosed in 2018 with PC... Had prostatectomy in 2019, with no other treatment.] In 2021 was in stage 4 and last week had his 1st, 3 month Lupron injection hoping to shrink a 2 inch tumor on his bladder in order to allow him to pee. He is retaining urine. Unable to have sex. But is not an issue. I'm truly curious why so much concern about having sex. Thank you!
Its not just having sex, its all the other side effects that having no testosterone cause...its aweful
Having sex, or more clearly, getting erections to ensure that oxygenated blood gets into the penis prevents
Penile atrophy and shrinkage.
It may not be important to some men with terminal cancer with short life expectancy, but for many men, it is hugely important.
In the same way that women with breast cancer feel devastated by mastectomies and try to preserve their breasts.
Chemical castration is cruel and barbaric treatment
I.need anti endrogen medicine. . like to.injaction ..... Medicine time duration miniman 2 3 year