I was diagnosed last March Gleason 3+4, but right margin threatened (Ie close to edge and danger of breakout) so urologist said early treatment advised and he wanted me to have HT as a COVID stopgap measure.
GP prescribed short burst of Bicalutimide then Zoladex. I thought side effects sounded dreadful and deliberately delayed start until I knew what was likely.
I wanted Brachytherapy, and was lucky to get fast phone consultation with consultant. As soon as I mentioned Zoladex, she virtually erupted “no, no, not Zoladex, not Zoladex ” explaining that as a short term measure it was likely to have “undesirable permanent consequences”.
Her letter to GP said treatment should be Bicalutimide + Tamoxifen + Sildenafil, but she didn’t say I HAD to have HT, inferred the delay till treatment due to Covid might be short.
I was lucky. Brach appointment offered very quickly and treatment done only a few weeks later (I suspect I got a slot due to a cancellation but my refusal of HT may have helped).
I was told that if my prostate had been enlarged they might need to use HT to shrink it (if enlarged, bones can get in way of procedure.) But as my prostate wasn’t enlarged, I didn’t need HT.
Do you know WHY you need HT? I would have accepted the Bicalutimide cocktail for shrinking reason.