"Hormone Therapy" sounds.....nice. Hormones are good. Therapy is good. So far it sounds great.

What Is Hormone Therapy?
In the prostate cancer world Hormone Therapy means using medications to stop the production of testosterone.  One way to make the term more descriptive would be to call it Hormone Suppression Therapy. (In contrast to Hormone Replacement Therapy which is used to treat other medical conditions.)

Another term for Hormone Therapy is Androgen Deprivation Therapy (ADT), which is a more medically accurate description. Then, of course, there's the non-euphemistic, blunt way to describe Hormone Therapy:  temporary chemical castration.

When Is It Used?
Hormone Therapy is used when there is evidence that prostate cancer has spread outside of the prostate. Prostate cancer feeds primarily on testosterone. By suppressing testosterone production, prostate cancer cells, wherever they might be, are starved and, consequently, weakened.

What Medications Are Used?
There are numerous medications that can be used to stop testosterone production. I'm on Lupron (stops testosterone in the testicles) and Abiraterone (stops testosterone in the adrenal glands). This combination of medications is very commonly used. Other medications that stop testosterone product are Orgovyx, Firmagon, Xtandi and Nubequa, among others.

How Effective Is Hormone Therapy?
Hormone Therapy is typically extremely effective. It works so well in fact that, prior to the availability of high end prostate cancer PET scans, doctors thought patients were being cured.  It is a great treatment when cancer spread has occurred or is suspected.

While the treatment is effective, it is not "nice". Suppressing testosterone in a man brings on a whole host of side effects - which will be covered in another post.

My radiation treatment plan calls for nine weeks of radiation to my prostate and some surrounding areas. Two of these weeks also include radiation to (3) spots on my ribs which likely indicate metastases. More specifically, I am in the midst of receiving 45 weekday radiation treatments over nine weeks. Yesterday I completed treatment #18.

I’m 64 years old, my diagnosis was confirmed in October 2024 (when I was 63), I started hormone therapy in November 2024, and radiation therapy started on April 24, 2025.

Some people told me radiation would be easy, some reported challenges, doctors warned about side effects, and now that I’ve just passed the one third point of my own experience, I feel qualified to start sharing a few of my own observations.

Thirty five of the 45 treatments are focused exclusively on my pelvis area. These treatments last about 15 minutes.

Ten of the 45 treatments include my pelvis area and some ribs. Radiating the ribs adds 15-30 minutes depending on the number of ribs treated each day. So these treatments, which I’m in the midst of right now, last 30-45 minutes. It’s also worth mentioning that the radiation administered to the ribs is nearly four times as intense as the radiation administered to my pelvis each day. I was told that this increased intensity might increase the side effects, but so far I can't say that I’ve noticed a change, with the exception of some increased stress just because the appointments last longer and involve more time waiting on the table, which always feels a little surreal.  Each rib treatment requires a doctor’s approval to be sure the machine's aim is exact. Doctors are busy, and even a short wait can feel like a long one when you’re staring at a ceiling, so I always feel relieved when the techs push the "Give it to him!" button and the machine starts doing its thing.

I'm a rule follower. A diligent rule follower. So when I was advised to be sure to “rest” while undergoing radiation treatment, I took the advice to heart – and, in hindsight, maybe to an extreme. I hadn't planned to blog about my cancer, but in an attempt to help others, and maybe even myself, I’m responding to some nudging by my doctors and my wife to try to think about more than just my diagnosis. Sharing some of my stories with others is a small step, but one that I hope will enable me to do more than just sit around waiting for side effects to show up.

So far, the experience has been different than I expected. I’m experiencing some, but not all of the side effects I was warned about. The mental drain of managing daily appointments has been harder than I anticipated. Fatigue, which I was told is common, has been, so far, not significant. I haven't experienced any skin irritation which apparently is fairly common.
 
Eighteen (treatments) down, 27 more to go. If you’ve gone through a similar situation, or are going through one now, I’d love to hear how you’re coping.