ADT response

On average how long do most men respond to ADT therapy?

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  • Blair77, I was talking to a prostate cancer survivor who was diagnosed when he was 71 and is 79 now. he said he had his prostate removed then it came back a couple of years later so he said he gets a hormone shot every 6 months and has been working for him since he had his cancer comeback over 5 yrs ago. I know they have more then one type of Hormone therapy so when a patience gets immune to it they have another to take its place and as time keeps moving forward so does the Htherapy protocols.

    God Bless

    Robert

  • Hi Blair77, I am 47 diagnosed this year and have been put on Zoladex and ZYtiga as first treatment. The question you asked is a difficult one as all men are different and the resistance time varies. I met a chap last week who has had aggressive prostate cancer Gleason 9 with lymph involvement and remained on hormone therapy intermittently for the last 16 years with hormone resistance starting this year so he's done amazingly. Stats online often give us an average but some men like the one above have amazing responses. My friend is a doctor and also echoed this to me saying he has many advanced patients who are over 10 years without resistance. I always prefer to look at the positive stories as it gives me hope and encouragement. There are many other treatments available when your original treatment fails to be as effective. I hope this helps 👍

  • Appolo123

    The story of the chap on IADT for 16 years is amazing. Can you tell us about the process he employed? eg what was psa when he stopped , when he restarted , what drugs did he use?

    How about the doctor you referred to ? Is he a urologist? What is his IADT process?

    Thanks

    Bob

  • Hi Bob he is the patron of a large prostate cancer charity in the uk, I am seeing him in the next few weeks so I will ask him for his full history. He told me he is a walking miracle, I do know they never removed his prostate and this year after 16 years on hes only now resistant and they have done radiotherapy on the rumour which has left him incontinent but he’s incredibly positive at all times! My wife just suggested that I show him this site and hopefully he may share his story. 👍

  • Pls do, he will be such an invaluable inspiration for us all 👍

  • Sorry with regards to the doctor he is a GP in a local surgery who has looked at patients registered in his practice who are still coming for the monthly hormone jabs and were initially diagnosed with metastic prostate cancer. He doesn’t treat it just administer the hormone therapy on behalf of the consultants in the hospitals. He is also surprised at the increase in patients with prostate cancer and how young some are now (4 40-50year olds been diagnosed this month in his practice).

  • Thanks. I guess awareness is improving!

  • I believe the average time for primary ADT before resistance is around 18 months. But there are very large deviations from that depending on a number of factors so it's difficult to predict an individual response. Typically those who have the longest response are those that have had successful initial treatment with either surgery or radiation and have recurrence after several years or longer. Those who have the shortest response are usually those with extensive metastases to organs and soft tissues or a poor initial response from ADT.

  • Well that sounds like my husband diagnosed with extensive mets 😞

  • Depending on how long he has been on therapy you may want to consider using mixtures of hormonal therapies. They had found, for example, longer time cancer free and longer lifetimes using a mixture of Lupron and Zytiga together rather than just starting on Lupron and only switching to Zytiga when Lupron fails. Some references are listed below.

    nejm.org/doi/full/10.1056/N...

    ascopost.com/News/55700

  • I have extensive mets as well. They haven't gone to any organs so I'm lucky that way, but my skeleton is full of them along with some lymph nodes.

  • Hi Gregg,

    I certainly didn't have as many mets, just three bony ones, but they are no longer recognized, compared to last years imaging. I can only say the Xgeva did it. It was the only change we made. I didn't even experience any pain when I did have them.

    Joe

  • What’s the plan at this point to combat it?

  • He just finished 6 cycles of upfront Docetaxel now we wait using Casodex & lupron

  • Support he will need ..Get through it and come out with good results .God bless!

  • Blair77, Remember one thing, your husband is a man not a statistic.

  • Amen!

  • Hey gregg77 that's interesting what you said about men with recurrence.

    Do you know of any studies on this?

  • I remember reading that somewhere, but can't find the source. I'll keep looking. I'm wondering if it was overall survival vs. location of mets.

  • It's a coin toss. Everyone is different. I started out with a psa at 850 and 3 mets. My nodes were a cancer factory working two 12 hour shifts. I did the chemo thing right of the bat. 3 years later ADT (Lupron) is still working for me, (psa is currently 0.09). You can Google all the stats you want, I did and never did find a stat with my name attached to it. It's a waiting game.

  • You have a great way of describing your prostate cancer journey, I read your posts to my wife as she loves your responses. You are inspirational and your humour has helped me laugh during some hard times👍

  • Apollo123 - I have been through far worse in my life than this pain in the ass stuff called cancer. I look at my life this way, I could have been on a 3rd grade field trip at a local zoo and had an elephant with a tick in it's ear trample me. Cheer up, when you see your grand kids come popping out you will know your life has come full circle. I make a point of reading at least one dirty joke everyday, lace up and get on with my life.

  • That's funny. Based on when some oncologists said I'd die, I would never have known my 2 younger grandsons, & would have seen little of the 2 older ones' lives. It has been an enormous pleasure & privilege to enjoy those boys, from birth to age 13 in the case of the oldest. Of course I've gotten to enjoy much more time with my 3 kids, too, who are parents of the boys. It's wonderful that we all live within 20 minutes drive.

  • You made me smile on such a rough day ! thank you :)

  • Another factor, for some reason, is how low your PSA goes. Lower than 4 is a nice reponse, and lower than .4 is a quite nice reponse. The lower the PSA falls, the longer till biological recurrence (ie, the appearance of ADT failure to control the cancer).

  • He's gone from 1044 in February 2017 to 4.1 as of October 2017

  • After failed radiation treatment in 2001, I’ve been on Lupron since late 2002 with a one year holiday in the mix. Hopefully it keeps working for me. The side effects aren’t that much fun, but better than the alternative. Best wishes for all my fellow travelers.

  • I am now an 12 year survivor -8 years Eligard -i year Anandron -2 years chemo and i year Xtandi -lowest PSA on monotherapy was 0.7 and after 1 year Xtandi the lowest ever at 0.010 so one can have a good response=original PSA 24 and Gleeson 4 +4 and I still have my prostate so metastatic from day 1-still receiving eligard injections-still active and just played 18 holes of golf this morning and off to pilates this afternoon

  • 6 years so far. Diagnosed PSA at dx <600, Gleason 7, 7major bone Mets. Current PSA is <0.1.

    I’ve been taking Zoladex and Abiraterone with Prednisone. No other treatment.

    I’m one of 1900 men in the UK on the Stampede trial arm G.

  • I start your protocol next week. Difference Lupron and 10 mg. of Prednisone. I hope to duplicate your success. I am blessed, I think I will make it. My goal is to die with the disease, not from the disease.

    Rich

  • 10 years on lupron and casodex--just added zitiga when PSA got to 12

  • Depends on what you mean by respond. Time to PSA rise? About 2 years for me. Time to first or increased metastasis? My PSA has gone from 5 to 80 in the last year yet my oncologist believes that I'm still "responding" to Zytiga because scans during that same period do not show new mets.

  • When I was catching up on old studies 13 years ago, there seemed to be a boilerplate intro. which claimed that ADT resistance invariably occurred within the 18-24 month timeframe. It was also common to say that resistance was inevitable.

    Anecdotal accounts from long-time ADT patients don't change that. The last analysis on ADT usage that I read, reported that some doctors were still over-prescribing ADT, even though Medicare had removed the profit motive a long while back.

    I now think that the failure statistic was probably for ADT as monotherapy.

    By the late 80's studies were comparing ADT + Flutamide versus ADT alone & reporting modest improvement in time to biochemical recurrence (not necessarily overall survival, though).

    & later, ADT + Casodex versus ADT + Flutamide.

    & today, we see a lot of activity looking at the sequencing & combination of newer drugs. Even Taxotere, which has long been considered a lackluster drug (4-6 months extra survival at the end), was stunningly successful when given at the start of ADT to men with high-volume disease (CHAARTED study): "time until clinical progression was seen (33 months vs 19.8 months)" [1]

    I don't think that the old 18-24 month statistic is useful anymore. But it is important to have a doctor who is keeping up with the clinical trials & treating patients accordingly. IMO

    & I don't think that treatment should occur prematurely, since we still lack a therapy that is long-term durable for the majority, & resistance to combined therapies may promote a type of cell that is difficult to manage.

    I continue to believe that any therapy that, in essence, targets the androgen receptor, should include Avodart & a statin, such as Simvastatin.

    & throw in Metformin too & plenty of polyphenols. &, etc, etc, ...

    -Patrick

    [1] ncbi.nlm.nih.gov/pmc/articl...

  • Leutinizing Implant, Casodex, and I second, Avodart, along with Proscar, I use Policosinol instead of Simi--Metformin, DIM, Natto, Serra, and Zyflamend, with a dozen other Polyphenols, and a half dozen anti-oxidants, Pectasol-C, and Gator Blood---anyone using Conjugated Linoleic Acid? I will write on this soon, unless Patrick, gets into PubMed.

    Nalakrats

  • Just when I thought we had arrived. Mrs. S

  • I am apprehensive about using Metformin, since I have kidney disease, stage 3.

    Rich

  • As everyone here has said each patient is different and will react differently to ADT drugs. There is a progression with each drug treatment. The first ADT drug may maintain potency for several years. The next may only provide a few year, and so on in a diminishing capacity.

    In my own experience Caxodex kept my PSA below 2.0 for five years. Then aboraterone proved effective for 3 and 1/2 years. Then comes xtandi. I am on a drug trial with xtandi and a mystery drug from Eli Lilly. I have been on the trial for 1 and 1/2 years and still gone strong. The Mystery drug is suppose extend the effectiveness of xtandi and so far it is working for me. If I can get 3 or more years out of this combination the Ely Lilly Company is on to something.

  • Hello, We are considering what I think is same trial for my husband. I am glad to hear you are having success. How are you doing with side effects?

  • The side effects are manageable. The main problem is gas and I mean really gassy. I have been taking Beano and charcoal pills. My iron level is low and I am taking an iron supplement. Those are the only symptoms I am experiencing.

    One caveat, I am not sure if my symptoms are from the Xtandi or the mystery drug I take with it. It may be the mystery drug because my urologist said another patient on the trial is experiencing gas also.

  • Thank you for sharing your experience. I can handle an even gassier hubby. Ha.

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