Updated: 31 August 2022
I’d guess that most advanced prostate cancer patients want to avoid androgen deprivation therapy (ADT) for as long as possible. So did I.
However, when it came time to do salvage radiation therapy (SRT) for my recurrent cancer, my radiation oncologist (RO) had recommended concurrent ADT with the SRT. The ADT would be administered about six weeks before the start of SRT to give it time to weaken the cancer cells before they were attacked with the radiation. Additionally, he recommended a six-month dose to get me through the entire process.
It’s funny how your mind plays games with you because I got really emotionally worked up over getting the injection. Part of that was because I was a bit fearful of what an injection in my abdomen would feel like, but mostly it was because this was taking the first, irreversible next step in my treatment.
For years, I was content watching my PSA slowly increase. When it reached the point I needed to take action, I was committing to something that I knew could never be undone—the SRT—and that scared me.
I had never had an injection in my abdomen before, so I was uncertain how painful it would be. My mind had imagined one thing, but the reality was that it really wasn’t that much worse than getting my annual flu shot. Same pinch, different location.
For reference, I received a 45 mg injection of Eligard on 3 May 2022.
The Side Effects
The known and more common side effects of ADT are fatigue, hot flashes, muscle loss, mood swings, weight gain, and bone density loss. On the whole, I’ve been pretty lucky with the ADT side effects so far.
There was a bit of soreness at the injection site for the first 24 hours or so, but nothing intolerable.
A few weeks later, though, fatigue started to set in. It wasn’t debilitating, but you could definitely tell that you weren’t firing on all cylinders at all times. (It seemed to ebb and flow in intensity, too.) I was able to power through it most days without much of a problem. However, once the SRT started and brought its own fatigue to the game, things compounded quickly.
Luckily, I haven’t had any hot flashes at all through four months of ADT. I also have maintained my weight really without doing anything to control it—no additional exercise or change in diet. There were a few days where emotions got the better of me, but it was in relation to silly things. I’d hear a song and tears would well up in my eyes. No biggie.
I have had some musculoskeletal aches in the middle of my back. They first surfaced about a month after my injection and were minor and intermittent. I asked the urologist if she thought that they could be a side effect of the ADT. She didn’t seem to think so. But now at the end of my SRT—and after four months of being on ADT—those aches are more prominent and more frequent. It’s something I’ll ask about when I have my appointment in a few weeks.
Simply put at this point: I don’t know what effect the ADT has had on my PSA yet. I’ll go for a PSA test on or about 13 September, so we’ll get our first glimpse. Of course, because the ADT was administered concurrently with the SRT, it will be difficult to sort out which had the greatest impact on my PSA, if any.
This round of ADT was intended to be a one-time treatment to get me through the SRT, without a need to continue with additional doses for now. Save those for later down the road if they’re needed. Even though my side effects have been mild, I’m okay with not continuing the ADT for now.
I’m sure I’ll add more to this page if I can directly attribute something to the ADT going forward.