“Is there a proven benefit to continuing ADT if you have high risk PCa even if your PSA is undetectable after RP and RT?”
I was diagnosed in November 2017 at age 68 after my PSA was found to be 45.5. Biopsy found Gleason 4+5=9, later confirmed by prostate pathology. Bone scan negative. CT scan showed one likely pelvic lymph node. Two Axumin scans (one just before surgery) also showed just the one lymph node.
Had RP in February 2018. Margins negative but PCa was extracapsular with seminal vesicle invasion. Of 69 lymph nodes dissected only the one was positive.
In June I started 30-days of bicalutamide followed by a 6-month shot of ADT (Trelstar). I underwent 37 sessions of IMRT beginning in July.
My post-RP PSA was .01. My post-IMRT PSA is undetectable as of two months ago—I’m scheduled for another test in January.
All this seems like very good news, but I don’t want to let down my guard. My question is should I continue ADT anyway? For me the side effects have been relatively tolerable, mainly hot flashes largely controlled by Estradiol patches Of course, the ED and lack of libido is depressing, but I have many other joys in my life and am in otherwise excellent health, very fit and active
Based on what I’ve read, I believe that continuing ADT now will not improve my survival odds. I’m hoping that one of the smart folks on this forum can confirm that belief with clinical evidence.
Thank you, and Merry Christmas!