Dave, I am starting both an HT vacation and a regular vacation, a week on the Maine coast. Mount Desert Island is fabulous. Great hiking, biking, wonderful seafood, and views. I am also easing into retirement, going to a 2 day work week after I return from vacation. I am very excited to have more free time this summer.
I had one year of ADT3 and the normal side effects; hot flashes, weight gain, loss of libido. My most significant side effect was loss of muscle mass in my legs. I also had some very minor breast tenderness and swelling. A good medical oncologist can significantly reduce SE's. I had breast radiation in advance of HT, a drug is also available. I used a estrogen patch for bone loss and hot flashes. Took vit D also for bone health. Diet and excercise for cardo risk and diabetes. And weight training to maintain muscle mass. Needless to say I let my weight training go.
I think that the most important thing that you can do is having a positive attitude going into HT. I think that this is easier to do if you know the term will be shorter. It would be tough if you knew you were going in for 3 years of the remainder of your life (as would be the case if you waited until you had mets to bone).
The analysis you seem to be doing here is QOL with and without HT, which of course is important. But you must also add into the the equation how long you will be able to maintain that QOL verses the risk of earlier onset of bone mets and a potentially shorter life span.
I have not the significant treatment issues that you have had to deal with. No one should have to through what you did. I am however very much at high risk like you. I failed RP within 12 months. PSA went from .07 to .5 in less than six months. I found that the early agressive use of HTwith SRT was found to be most effective with high risk men. That's why I jumped into it.
I hope this information helps you with your decision process. BB
Dx Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4)
Robotic RP March 2009
Path Report: T2c, G8, organ confined, neg margins, lymph nodes - tumor vol 9%
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT/SRT .01, < .01
End ADT3 5/11 PSA < .01