It is my understanding that almost 90% of men who start hormone therapy initially respond to the drugs with their PSA falling significantly. However, there are many costs associated with ADT, many of which I have already discussed in this blog.

The hot flashes, bone loss, weight gain, decreased libido and erectile dysfunction are often discussed in other people’s blogs, my blog, our support groups and in the literature. However, rarely have I seen a discussion about frailty. Men dealing with advanced prostate cancer already are older men and we have already lost some of our youthful strength to our age. Some of us are also suffering from some of the common ailments associated with older age, Alzheimer’s or Parkinson’s disease. But ADT seems to also increase, or accelerate our frality.

A recent study emphasizes that hormone therapy further increases the standardized measures of frailty, “unintentional (lean) weight loss >/=10 pounds in the past year, weakness (measured by grip strength), slow walking speed, self-reported exhaustion, and low physical activity.”

Depending upon your current physical condition and your disease situation, the cost of hormone therapy might actually be higher then the benefit you might gain. Don’t look just at your PSA and allow it to drive your decisions, look to your complete self as you evaluate all your options in consultation with your doctors.

Joel T Nowak MA, MSW