Guest post: emotional impact of ADT

By Adrian

When my prostate cancer came back in 2020, I had salvage radiation for six weeks and now I am on ADT hormone suppression treatment for three years. It has changed me big time. And it has motivated me to write about the emotional impact of ADT for me and my relationship with my wife.

When I was first diagnosed with prostate cancer in 2018, it was a shock but not a surprise – my father died of prostate cancer in 1991. My wife and I cried in the car park after our consultation.

Initial treatment: robotic-assisted radical prostatectomy

By the time I was diagnosed, the cancer was just beginning to escape from the prostate gland. We had to pay privately for my robotic prostatectomy as the NHS was not going to respond quick enough. My surgeon removed 17 lymph nodes as well but on biopsy test found it had progressed to one lymph. I had partial nerve sparing surgery.

I am mildly incontinent – really not socially limiting. Just a drop or two sometimes leaks when I am lifting or coughing – not a serious problem. I just use pads for going out. The hardest thing back then, after my initial treatment was being unable to plan further than the next PSA test.

Relapse and further treatment: radiation and hormone suppression (ADT)

Initially I was cancer free and things were going well but had a biological relapse May 2020. I had a PETCT scan and it showed a recurrence in a lymph node. So I had salvage radiotherapy starting Feb 2021 for 6 weeks and I am on Hormone Therapy (ADT) for 3 years after starting October 2020.

Emotional impact of hormone suppression (ADT) treatment

The hormone therapy has changed me big time. The emotional impact is the hardest thing about my cancer journey. I was coping with the cancer OK until the hormone treatment. Very positive and faced it full on – I was trying to lead a normal life. I even had a good job as an engineer when I was diagnosed and was really enjoying life.

Now, although I am positive about the future, at the moment I cry a lot and I am easily upset by other people’s sorrow or tragedies. It is very tiring and hard to go on sometimes. My wife is very supportive but struggles sometimes with my moods and feelings due to the ADT. I am not the man she married but we are getting through this with our love for each other. Her support has been the most helpful thing for me adapting to the changes brought on by my cancer.

Physical and sexual impact of ADT

When I was put on ADT I initially worried about growing breasts and losing my ability to get a partial erection which was starting to get stronger and starting to appear in the mornings.

So I have experience of ED and its effect, trials and tribulations. I am on a journey with it. I’ve just started Viridal injections and getting a response but not good enough yet. Under my doctor’s advice, I will soon start to increase the dose gradually.

ADT changes the way you think and can make you tearful

Initially, I found I would be upset at certain situations on TV. So I used to turn the TV over if it got too strong for me. After about 6 months on ADT, my wife was commenting that I was getting to be Mr Angry and confrontational. A year on I found I was becoming more sensitive and would have a period of being “a hormonal sixteen year old girl” – my wife’s words not mine – when I was due another hormone therapy injection.

I would get really stressed and emotional over breaking a drinking glass or when something was not going to plan.

Now, after two years on ADT, I am only a year away from my last injection – unless I relapse again. I am still just as emotional but now get random thoughts and situations that occurred in my past that can take over my thinking. Usually I can take myself away from everyone to a quiet place and just have a cry and move on.

There is one exception to moving on. There was a life event that has stayed with me but remained buried although never forgotten. Over 40 years ago I met the woman of my dreams who had recently been divorced. I gently wooed her and we were together for about a year. I really thought she loved me but suddenly she decided we wanted different things in life and ditched me for someone else. To say she broke my heart is an under-statement. It took me a long time to recover. I thought I had grieved over this at the time but it has bubbled up in my mind again. Sometimes, if I let it dominate my thoughts, I struggle to cope with the emotional upset.

Developing coping strategies

I am slowly starting to get over it all. But I have been thrown completely off kilter by how strong the emotions can feel to me. I am developing strategies to distract my thoughts – provided I can remember what it was I was supposed to be doing (another hormone therapy gift).

I hope this helps someone else who is suffering this type of side effect and that they are not alone.
Perhaps I am alone with this? Unless I tell my tale I will never find out.

[Editor’s note: This post arises from my invitation to tell your story. And here’s more on this website about ADT and other hormone treatment]