Morning.
My husband is due to have his next HT jab in October, which will take him through to January, thereby completing a year of injections plus the 20 sessions of radiotherapy earlier this year. When we had our follow-up appointment with his oncologist a couple of moths or so ago, the oncologist said he would be open to my husband just doing one year of the injections rather than the two originally prescribed and see how it goes re PSA levels. My husband is really hoping that he can just have the October injection and then stop. He is really struggling with the side-effects. The brain fog is very pronounced as is his anxiety, which often prevents him from sleeping. The fatigue is hard for him to deal with as he has always been fit and active, doing work in the garden and going walking. He has never looked his age. The hot flushes have increased in frequency although they don't last long. He has lost strength and muscle. He lost weight before his diagnosis and now it is stable BUT he has a roll of fat around his midriff and thinks this is the reason for his breathlessness: it is pressing on his lungs and diaphragm and restricting his breathing. He is currently working out an exercise plan to try to combat this. (There are no PureGyms near us and I don't know if they still offer free sessions for cancer patients).
The breathlessness really worries him (thereby increasing anxiety levels), the back pain is hard to tolerate. He has had scans/MRi etc. and nothing untoward was found. Just age-related 'wear and tear'. He also has Dupuytrens, though has been told he has to wait till his fingers are at a 45° angle before any treatment will be offered. The restricted 'efficiency ' of his fingers and hands is very tedious and frustrating for him. With all this going on, he is at quite a low point generally. To be honest, the cancer nurse we were allocated originally was not always very helpful as she had her own health issues. Her stand-ins were responsive though. When we saw the oncologist, he said a cancer nurse would contact my husband to do a telephone review, which I think may be next month but we don't know whether we currently have access to a cancer nurse. I have suggested contacting the cancer unit at the hospital to find out.
Apologies for the long post but my husband IS struggling somewhat at present and I wondered if anyone else has had similar issues, with the breathlessness in particular.
Hi, sorry to hear about your husband's experience.
I've been taking Prostap for about 2.5 years now and will hopefully be on it for some years to come. I would definitely speak to your GP or oncologist about the side effects, particularly the breathlessness.
It wasn't the best when I started Prostap. You do kind of get used to some of the side effects, but they are still there. Personally, I found that weight or resistance training helped with muscle loss and also benefited my mental health. Walking and similar exercise is really good for the heart, but if you can, I'd recommend supplementing it with some weight training.
I also found diet to be important. Try to cut back on anything that triggers hot flushes, such as coffee, spicy foods, etc.
Do you have access to Maggie's? They can offer advice and support with the day-to-day challenges that can become more difficult.
I'll call a spade a spade and say that it is tough, but hopefully you can find help and support here, as well as through organisations like Maggie's. Don't try to deal with this alone.
I seem to have been more fortunate than some others.
Just a potted history regarding my diagnosis in 2023 aged 75.PSA of 57 after visiting doctor re urination issues.Biopsy followed but I was never offered or requested the fine details that many can quote.
Prescribed Prostap and the Oncologist offered either Chemo or a choice of a couple of Hormone Tablets a day.Initially I thought chemo but then went for Erleada(Apalutamide) which was almost a toss of the coin as far as I was concerned.
This remains my only treatment so far although my PSA has remained stubbornly around the 9 to 11 mark when I have my 3 monthly bloods and conversation with the oncology team.
Physically I feel well although a permanent feature is loss of muscle tone and the hot sweats have always been manageable.
Mentally I have had my moments but sought help when needed from wherever I could get it.The Oncology team ,my GP and of course family have been great all the way.
Confronting your own mortality came out of the blue and as my GP says everything is alright …..until it isn’t.
I have felt ashamed at times when I feel a bit down and then coming across people of all ages who live with various issues and disabilities.
I can write this because the sun is shining,my family are well and I am off bowling shortly.
I don’t really know why I felt like writing this bur I hope that there are some positives that others can latch on to.
Best wishes to all.
Thank you very much for your reply to my post. I shall relay your recommendations to him. He has swapped his beloved coffee for decaffeinated.
I don't know if we have access to Maggie's. Is that a local MacMillan centre?
Hi.
I’ve been on Prostap just over a year now and had 37 sessions of radiotherapy February this year. Same side effects as your husband and I get breathless particularly when exerting myself like going upstairs. My GP did a blood test and the blood count was down, both red and white blood cells were lower than should be. GP consulted the hospital and they said this is common when you’ve had radiotherapy around the pelvic area and was to be expected and nothing to worry about.
Hope this help and best wishes on your journey
Following a Locally Advanced PC diagnosis in early 2024, PSA 24, Gleason 4+5, I finished two years of Prostap, Abiraterone and Prednisolone in February of this year. This followed HDR Brachytherapy and 23 fractions of External Beam Radiotherapy in 2024. Initially I accepted the treatment plan without question, heeding medical advice to be very careful what I read online. It’s only since February that I have gone into things in more detail, leading to the realisation that the biggest issue with hormone therapy is how it leaves you afterwards, not necessarily side effects during the treatment. On that score, I didn’t suffer too badly with hot flushes, but lost muscle mass and put on weight. ‘So what?’, I thought, I’ll tough it out and accept that it’s part of the curative process and I’ll get back to normal afterwards….
Testosterone depletion is obviously a deliberate part of the treatment, but is behind many of the issues you mention. I’ve since learned that it can take as long for testosterone production to recover after ceasing HT as you were on treatment for, and recovery may only be partial or not at all. My testosterone is gradually recovering but the weight gain is stubbornly remaining, even with careful eating and regular resistance training.
As I understand it, the two or three year HT period was often a blanket approach because any micro metastases which could later cause a recurrence could not be detected by MRI scans, for example. This situation is now changing with the availability of PSMA PET scans, enabling a reduction in the HT duration to be considered alongside careful monitoring for PSA rise and metastases appearing, which is fantastic news.
In summary I’m really saying that minimising ongoing effects after treatment ends is probably a better reason to consider pausing/stopping HT than stopping any current side effects.
Finally, I’d add that more recent HT medications than were available to me in 2024 can be better in terms of both side effects and ongoing testosterone recovery, so changing medication may also be an option to discuss with your oncologist.
Good luck with everything!
Thank you so much for your reply.
Good luck to you too!
Thank you very much for replying. That is useful to know and somewhat reassuring!
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