PSA decreased from 1.4 to .355 in one month after going back on ADT after five month holiday . This time trelstar only; stopped casodex and dutasteride. Had sbrt to two bone nets.
So I’m still castrate sensitive (T = 9.0) after 4 1/2 years of IADT and SRT to mets discovered on each holiday in 2015, 2017 and 2018.
See profile for details. The one major positive seems to be that I have low volume mPCa ( oligomets).
So the question is “should I fix something that ain’t broken” or should I try to drive PSA down to zero? At this point I don’t think I’ll take any more ADT holidays but I can’t help but wonder if the holidays , albeit brief, have prolonged the efficiency of first line ADT?
Bob
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Great news Bob! When I visited Johns Hopkins last fall they talked about the importance of ADT holidays - to give you a break from the side effects and presumably to lengthen the time that the cancer is sensitive to HT. Glad to see the theory worked in practice in your case.
I've yet to start long term ADT but certainly plan to incorporate these holidays when I do. Just curious...during your holidays, how far does your T levels rebound? I was on ADT for 6 months a few years back in conjunction with adjuvant RT. My T levels rebounded slowly, getting back to "normal" in about 6 months after it ceased.
I agree it's not giving me a break but my unstated question is, given that I've remained castrate sensitive on ADT3 and now ADT(1) is there anything to gain by adding say, zytiga or xtandi , and (2) has IADT prolonged castrate sensitivity? My inclination is to not add anything unless PSA starts to rise aka "don't fix what ain't broke"
No it hasn’t failed. I was simply asking if adding second line before first line failure was advisable and I guess you’re saying it isn’t necessary nor would it be paid for by Medicare.
trust your instincts, brother. casodex and finasteride for me has kept my PSA indectable while keeping my T good and high - good because T is great stuff not just as male juice but for many various metabolic functions. T may be food for PCa, but if the PCa is blocked from using it, i want as much as possible in my manly blood. :o) -- RT, RP and surgical castration are last resorts - kind of barbaric compared to popping pills or getting injections, imho, but they are viable options when all else has failed.
no. lupron and its cousins stop the testes from producing Testosterone. casodex prevents the T-receptors of the cancer cells from using the stuff. so most drs want you on the lupron AND casodex- double whammy. reduce T and reduce cancer cells' ability to use T. for now, i'll just do the casodex. if PSA goes up, i'll add the lupron or have testes removed. got no more use for them other than play toys. lol
What is your casodex dosage? I was under the impression that 150 mg of casodex was an alternate type of ADT to an LHRH agonist and was used to reduce T as well. I’m shocked that you’re keeping Psa diwn without lowering T to castrate levels.
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