Side Affects

Since my last post, I have found that I am easily able to report (objectively) about my progress on Hormone Therapy etc - see 'My Journal'. But it has become increasingly difficult for me to share (subjectively) on this blog. Let me try to explain.

Firstly, I find report writing/research comes very easily. But (like most men) 'opening up' and 'sharing' my emotional (or worse: psychological) responses/reactions is quite a chore. But for the sake of completeness, perhaps some cathartic release and the hope that others may benefit; I will make an effort.

At this point (if you haven't already) it would be useful to review this post; to gain some understanding of the range and complexity of the side affects of Hormone Therapy. This will help you to understand the potential stressors that the body (and mind) need to endure. Particuarly given that unlike chemotherapy, once you begin Hormone Therapy there is no respite until the treatment is over i.e. the implant in your abdomen is constantly releasing the testosterone-blocking agent into your system, for up to 13 weeks.

Most patients continue Hormone Therapy for at least 6 months before any (short) respite. This is of course dependent upon individual circumstances. Sometimes this respite period is used to introduce a 'complementary treatment' (in my case an 8 week course of radiotherapy) before re-commencing the Hormone treatment.

Where to start? In my last post, I spoke about having the LHRH implant injected into my abdomen. Well since then, I have experienced quite a range of side affects; beginning about a month afterwards and varying in intensity, duration and frequency.

The most annoying, initially were the 'hot flushes'. These would often occur at night, and along with the frequent 'urination' would be responsible for me experiencing a lot of broken sleep.

The scene at night in our bedroom; at times (I'm sure) took on a rather comical note. Picture: my menopausal wife, suffering with hot flushes; alternatively 'throwing off' and then 'retrieving' the bed covers. While meantime I entered and left the bed at random intervals (for trips to the bathroom) and then returned to join in the 'chorus' of: 'off again' ... 'on again'! Sometimes in synch, but mostly at odds with my (long suffering) wife!

Needless to say neither of us have been able to achieve much in the way of (consistent) quality sleep!

I know what some of you are thinking: What about separate beds? Well we considered it; but after nearly 36 years of marriage and overcoming (together) so many of life's hurdles, we decided to tackle this one together as well - with the help of electric fans and staggered bed times and a range of other 'aids'.

PSA Test

Today I attended our local GP's surgery for another blood test. Specifically, this blood test was to:


• Determine whether my PSA reading [previously 84.8] had begun to drop. Thus showing that the hormonal therapy I have been undergoing for a little over 4 weeks now, has in fact had the desire affect; and

• Determine whether my cholesterol readings had improved as a result of my [now] 'extremely healthy' diet.


I am told that it is quite normal for the PSA to rise after a trans-rectal biopsy. I also have to bear in mind, that I only started hormone therapy 4 weeks ago. [Orally for the first two weeks, followed by an LHRH implant and continuing the oral regime until two weeks after the implant procedure].

Having said that; it sure would be a 'shot in the arm' [pardon the pun] to receive a lower PSA reading! I am due to receive the results in a few days.

LHRH Implant

I attended the Urologist's Surgery in St Leonards today, to receive an injection of a luteinising hormone-releasing hormone (LHRH)- specifically a 'Goserelin acetate implant' (the generic name) or Zoladex (the product name).

Now, all of that 'techno-babble' translates to: 'A whopping, great needle (the size your grandmother used to knit with) is thrust (I DO mean thrust) into a fold in the skin covering your stomach area! Don't beleive me? Watch the video and see for yourself!

Now what [precisely] does all this mean? Well ... I'm glad you asked.

Let me ask you ... Have you heard of 'castration' (ouch)?

Yes ... well this is the medical equivalent!

The good news, is that you don't undergo a surgical procedure to remove your testicles (ouch again). The bad news, you are injected with a small implant which (in my case) lasts for about 13 weeks. This has the effect of neutralising the production of testosterone, both in the testes and elsewhere.

I was told that: "most men who undergo 'medical castration' will experience a loss of sexual desire and impotence. In addition, hot flushes frequently occur. However, medical castration is 'potentially' reversible. If treatment is stopped, testosterone is produced once again".

I wasn't quite sure what to expect after this, but since several weeks have now passed, I can attest to the following:

The downside to this treatment is that while you still look like a male; [assuming you did in the first place] you begin to feel decidedly like a female (or, 'she-male').

Quite seriously, I have days when all I want to do is cry! Other days my moods swing violently from one extreme to another and back again. Most days, I'm plagued by 'hot flushes'; so much so, even my 'menopausal' wife is feeling sorry for me!

The GOOD news however is, my PSA level has dropped by a whopping ... 71%!

HE-male? She-male? Who cares! The treatment is working!

Well that's about it for now ... I've just gotta go and have myself measured for a 'training bra'! The things we men have to endure!

You found Blood ... Where?

Now this I wasn't expecting ... I was told, that after the Biopsy I could expect to find blood in the urine. I was also informed that I could discover blood in the semen.

However, what I wasn't told, was that my first semen sample (4 weeks after the biopsy) would be the colour and consistency of (black) tea.

Now that was a shock! I was ready for evidence of blood, albeit dark; (as bright blood would indicate present bleeding) but to all appearances, what I was observing was not semen at all!

Even now, I am surprised at the profound impact that this unexpected occurence had on me. I guess ... anything to do with the male reproductive system, is closely linked to a man's perception of his 'male-ness'. Therefore any sign that something may be amiss in that area, causes alarm responses to reverberate through to the very core of a man's self-identification.

At this point, I turned to my research and discovered that such an occurence was 'normal', and that the semen (I became assured that it was semen) should return to normal after a few more weeks and several ejaculations.

Well ... after all that research was I re-assured? No not really!

I then spoke to my daughter (yes ... my daughter) who is a doctor and specialises in sexual health. She also assured me that what I had witnessed was indeed semen and a return to a more 'normal' colour and consistency could be expected.

Re-assured? Not quite!

I then spoke to my sister (yes ... my sister) who is a registered nurse. She too assured me that all was (or would be) OK.

Re-assured? No not yet!

I then spoke to my Urologist who ... you guessed it ... assured me that all was well.

Re-assured? Hmmm ... I decided to wait and see!!

The result of all this watchful waiting ... you'll have to be patient for a few more weeks!

Bone Scan

Today I attended Dee Why Nuclear Medicine facilty for the injection of a small amount of a radioactive isotope (technetrium). This material is attracted to the bones where prostate cancer is present and thus aids in viewing any such cancer in a follow up bone scan - which in my case is scheduled for 1:15pm later today.

Well I'm back again, I wonder how this experience will compare with the 'big doughnut'? [aka CT Scan].

I didn't have long to wait before my question was answered. Soon I was ushered into another 'scanning room'.

In similar fashion I was asked to lie down, flat on my back, on the scanning bed. The 'Bone Scanning' device was decidedly dis-similar to the CT Scan. (See picture below)

After lying down as instructed, the 'operator' began to lower the upper scanner into position. As the scanner was getting 'uncomfortably close to my head'; I did what any 'red-blooded', macho, Aussie, male would do in my circumstances ... I closed my eyes!

When I opened my eyes briefly, there was precious little, if any, clearance (or so it seemed) between my head and the scanner! This was REALLY discomforting!

It was about this time, that I received a 'revelation'!

The 'operator', was not 'a patch' on the nurse who prepared me for the CT Scan - she was brilliant!

This guy by comparison ... was a loser! He had no personality, zero compassion and very little patience!

But ... I was at his mercy ... and so I decided that this was not a good time to tell him what I REALLY thought of him!

Fortunately for me, I had become very good over the years, at mastering a 'yoga breathing technique' and a companion 'relaxation therapy'! I was therefore able to 'evacuate' for the entire procedure. [Which to me seemed like just 5 minutes, but turned out to be more than 45 minutes!]

I was also more than a little 'put out', by the fact that the 'operator' (that's about as flattering a term as I'm prepared to use to describe him) disappeared after each subsequent re-positioning of the scanner.

Finally the ordeal was over, I abandoned my semi-naked state, for the more acceptable 'fully clothed state'; and made my way back to the real world.

At least there, I thought to myself: 'you KNOW that most people DON'T care about you; but at least they [mostly] don't try to pretend they do! Boy what a jerk!!