In Parts I and II, I have chronicled my 12-year journey with prostate cancer. I ended Part II with my beginning in March 2023 taking monthly Lupron shots.  I have been on monthly Lupron shots now for two years. How has my journey on Lupron shots been? 

Let me preface my answer by saying, “I am still alive and very blessed.” Life on Lupron is not a picnic by any means. It can at times be a living nightmare, but the trade-off is, that they are keeping the cancer dormant, and I am still alive. Regarding the side effects of Lupron shots, they are an unwelcome nuisance and do impact one’s life.

Lupron reduces the testosterone in the male, which prostate cancer cells feed upon. Testosterone is the “drive” which allows a man to be a man. At last check, my testosterone had been reduced to an alarmingly low level!! For a man my age (73), one’s testosterone level can range from 156 – 700 ng/dL, with normal being 300 – 350 ng/dL. I couldn’t see those numbers with binoculars!! Lupron eventually brings about chemical castration. The turtle for all practical purposes never goes outside the shell except to water the grass! And there is no longer any need to book the Honeymoon Suite unless it is for obtaining a good night’s sleep!  My favorite song has come to be the old gospel hymn, “Precious Memories!!!  Well, enough on that issue…you get the picture.  It is a God-send when one has a loving and understanding mate who loves you for who you are, and who takes seriously that “for better or worse” clause in the wedding vows. 

With low testosterone, your metabolism is shot to “you know what.” You start to gain weight. I was told by the doctor when I first started taking Lupron that I might gain five pounds.  That was either a gross understatement or outright falsehood. Well, I gained over twenty-five pounds. To help ward off weight gain, I diet, ride a stationary bike daily, or do an elliptical. I still occasionally run…maybe two to three times a week, but I can no longer run like I once did. With testosterone diminished, one finds the onset of growing fatigue takes hold as the day wears on, so I exercise in the morning, as my energy level is at its highest. I don’t depend on motivation to daily exercise, as sometimes I don’t feel like it, I embrace a mindset of commitment because I know I must.

One on Lupron finds the muscles begin to turn into mush. Because of loss of muscle mass from lack of testosterone, it is best to lift weights to help in slowing down that process. I lift weights about five times a week to try and maintain the muscle mass I do have.  This I know, lifting weights helps a bunch. One truth is for sure, I always feel better afterward. The best advice is to keep moving. Don’t become a couch potato.

In addition to the weight gain, one on Lupron becomes a victim of gynecomastia. That is a fancy name for “man boobs.”  When a teenage boy, such “sights” were appealing when on the opposite sex, but they are not too appealing when the mirror reveals they are on you!!! Yes, this is embarrassing and strikes at the core of one’s manhood.  I try to lift weights to tighten up my chest. While it helps some, but not as much as I would like.  When wearing a shirt, I wear an underneath t-shirt purposely made to help compress “them.”

Loss of bone density and joint pain is another problem for men on Lupron. If measures are not taken osteoporosis can occur. I take high-dose calcium tablets with vitamin D and Glucosamine to help slow the process and help with joint pain. One can take an infusion to ward off the onset of osteoporosis. I have not done that yet.

Then there are the hot flashes.  They come without warning and last anywhere from a few seconds to a minute.  Some are not too bad; others make you feel like you are on fire starting on the inside to progressing outwardly. Now I sympathize with women going through menopause.

Lupron can, as well, at times hold hostage Mr. Sand Man from visiting in the nighttime hour. Most nights I find it difficult to fall asleep and stay asleep. Also, urgency finds one having to take a couple of trips of necessity during the night. I treasure when sleep does overtake me, as it is no fun waking up more tired than when you went to bed!  An over-the-counter sleep aid is most helpful.  

One taking Lupron will find themselves experiencing at least once a month a volcanic emotional upheaval where you for no reason want to sit around and cry all day. The day arrives without warning. The day before the volcanic eruption and the day after you feel fine, it is just that one day you must deal with. On those days surround yourself with people who will make you laugh and light up your life, and listen to good upbeat songs.  

Not sure how common it is, but when the sun goes down, I from time to time feel chilled/cold for a bit and have to wrap up in a blanket. The length of time the coldness lasts is never the same, and then it will vanish as quickly as it came. And did I mention there are evenings I experience nausea for a brief time? The nausea can be curtailed by sipping on some Ginger Ale.

Like a five-gallon water bucket with a hole in it, by the end of most days, my energy level has seeped out. I just can’t seem to muster enough energy to make an appearance at a square dance!! I must admit there are times when I grow weary of feeling like I have been hit by a Mack truck.  But I remind myself I am still alive and very blessed.

While I have mentioned many physical side effects, there are also financial side effects. Suffice it to say insurance doesn’t always cover all the costs of the shots or the many doctor visits incurred. The total cost adds up quickly. I have learned what the Golden Years mean…the doctor gets all your gold!!!

Then there is the emotional toll of prostate cancer. It is always in the back of your mind if it has spread to other places, or what if the Lupron shots quit working, or how long will it be before it finally gets me?  Many can’t deal with the emotional toll. Current evidence indicates that the risk of suicide is increased among men diagnosed with prostate cancer, particularly those aged 75 years or older, twelve months after diagnosis, and treated with hormonal therapy (National Library of Medicine, August 2018). The suicide rate for men with prostate cancer, the rate is 274.7 per 100,000, which is about 3%. While that is not an extremely high number, any number is too high.

Despite all the effects of Lupron, I must say I am a very, very thankful man to still be hanging around. I am too blessed to be depressed. Those on this rocky road can’t give up, we must fight onward. While prostate cancer can take much from us it need not rob us of our ability to love those around us and enjoy their company as long as the Good Lord grants us life. Prostate cancer can touch our bodies, but we need not let it rob us of our inward emotions whereby we feel and love deeply. If anything, prostate cancer has enhanced my ability to feel deeply, be moved with compassion for others who are hurting, and appreciate the precious gift of everyday life.  I have grown to appreciate the true wealth of riches around me that transcend the material; such as the beautiful music of laughter, the gentle touch or embrace of a friend, the vitality of grandchildren, the kiss of a gentle breeze upon the cheek which signals you are alive, the amazing inward warmth when family expresses love to you, and the sight of another sunrise and sunset.

The journey with prostate cancer can be a long one and at times a rocky one. I have been on this journey for 12 years now…but I don’t plan on throwing in the towel or calling it quits.  Attitude is everything. A good attitude will find you soaring with eagles; a bad attitude will find you in the pits of despair. Whatever your journey, no matter how rocky the road is….press on, my friend. It is a great day to be alive.

Blessings,

Dr. Dan