1. Will I still be able to function sexually?
3. Will I need to stay on ADT indefinitely?
4. When one ADT drug starts to fail, will I switch to another one?
2. How will I know if the ADT is working?
5. Will health insurance cover the cost?
FAQs About ADT
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You may notice a loss of sexual function once you start ADT, says Armstrong. “Hormonal therapy lowers testosterone, and testosterone regulates libido,” he says. If that’s the case, your doctor may be able to prescribe a performance-enhancing drug that can help you stay sexually active, he says.
Your doctor will monitor your levels of prostate-specific antigen (PSA), a protein that’s made by the prostate gland. (Men with prostate cancer tend to have higher PSA levels than men who don’t have prostate cancer.) If your PSA levels rise, that means the cancer is growing or becoming resistant to the hormone therapy. On the other hand, if your levels drop, the cancer may be receding.
Because testosterone fuels the growth of prostate cancer, you’ll likely need to take ADT for the rest of your life, says Siddiqui. That said, some people may be able to take breaks from the treatment, which is referred to as intermittent hormonal therapy. If your PSA levels drop to zero, you may be able to pause the therapy for a little while to allow side effects to subside, says Siddiqui. When PSA levels start to rise again, the hormone therapy may be restarted, he says.
Once the cancer becomes castration resistant — continues to grow even when testosterone levels are low — the chances of slowing down the tumor growth with another form of ADT are less than 10 percent. This is most likely because the current ADT meds all work in largely the same way, says Siddiqui. But you may be given other life-prolonging treatments. These include a radiopharmaceutical treatment, which gives off radiation to kill cancer cells, and an immunotherapy vaccine, which uses your immune cells to fight prostate cancer, he says.
Health insurance plans can vary, but according to some research, the average out-of-pocket cost of ADT for the first year of care is $165 for people with insurance. Talk to your doctor and insurance company about your options. If you need help covering the costs, there are financial aid resources that may be available to you.
