Sorry to see you here but welcome none the less. I am in the midst of radiation treatment augmented by hormones. Research has increasingly noted that hormone therapy in addition to either radiation or surgery gives better results. A typical course of the hormones is two or three years depending on your circumstance. In my case the cancer had a high potential and indications of spread (lymph nodes) so I went with the radiation and hormone. The following is my experience with the concerns you have.
Do hormones work: The hormones work by starving the cancer cells of a food source. (testosterone) In the case of micrometastasis the starvation may be enough to kill off the cells. I had a PSA test done eight weeks after my first Lupron shot and prior to the first radiation treatment. It had gone from 21.5 to .82 with just the hormones. Significance of this still eludes me other than it may be slowing the advance of the cancer.
Side effects: So far I have had very little in the way of side effects from the hormones. Yes, loss of libido (no 1 on everyone's list) and I get the hot flashes. The hot flashes are brief and infrequent during the day. Seem to come on mostly in the evening and early morning. I have put on some weight but I attribute that to having to back off on my excercise regimen due to radiation side effects. I have also noticed that my skin is not as oily and that the hair on my legs seems to be getting thinner although I have never had really hairy legs. Could be my imagination too. I read all of the websites and potential side effects (emphasis on potential) and, like you, imagined the worst. Experience has been considerably less dramatic.
Second opinion: I had a second opinion rendered at the Mayo Clinic and it was anticlimatic. Merely confirmed what I had already been told. Mayo said I had some gleason 5. So what, gleason 4 gleason 5 treatment is the same. Significance is overall survival odds and reocurrence. Highly individual responses to treatment involved here.
Surgery vs radiation: I urge you to do some research on this. My own said that there was no significant difference in overall survival for surgery vs. radiation. There was a slight advantage to the surgery in terms of reocurrence but not statistacly significant. Surgery will mean a recovery period. The laproscopic is probably the least invasive. I had this done for a hernia repair some time back and was back at work five days later. Admittedly I had a desk job that did not require a lot of physical exertion. Surgery also provides a fairly immediate assessment of whether or not you have gotten the cancer out. PSA should drop immediately.
The radiation treatment has been realtively benign. I have been given a combination "full pelvic" and prostate course. The last week of the "fp" I had diarrhea but found it easily contolled with imodium. I have had some fatigue but that seems to have subsided now that the "fp" is complete. I still have 15 to go but feel well enough to resume my workout program. I only missed a week of this during treatment. Measure of success for radiation is a little harder to capture. Takes longer to reach a low point PSA so you don't know if you are successful or not. Recent research indicates the longer it take to nadir (as much as 24 months) and the lower the nadir (below .5) the better the results.
I am getting long winded here so I will close. If you want to know more or have a question about the above I will be glad to answer any and all.
Keep your wits and good luck.
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.