Intermittent Androgen Deprivation Therapy

[Gudgelm]

I know the studies favor continuous life long ADT for advanced disease. My oncologist favors intermittent ADT for some patients, particularly those with cardiovascular disease. I'd like to know who out there has tried IADT, how long they were off deprivation therapy and how they decided when to go back on. I'm particularly interested in my brothers who had RP and ADT. I was diagnosed two years ago. Had RP with lymph resection, chemo and ADT for two years. I just went off ADT about 5 months ago and I'm starting to produce testosterone. My PSA is rising and I'm trying to decide when to restart. (They are using the PSA spike to do an Auximen scan to locate any tumor tissue) Thanks to all.

[arete1105]

Dx in 2013, SBRT in 2016, highest PSA was 86, brought down to .2 in 10/18. Am currently on ADT Sabbatical. Will check in about a month for PSA.

[Gudgelm in reply to arete1105]

How long were you on ADT? How long is your sabbatical so far?

[arete1105 in reply to Gudgelm]

Started Lupron on 8/18

Labs on 10/18, Started Sabbatical on 11/20/18

[billyboy3]

Well, I am one of the rare and lucky guys who has been on AHT for many years. I go at it in combo, until my psa drops, usually 3 or 4 months, then stop until my psa goes to 3 to 4 max. Each case is different, and the side effects are mounting from each round, as one does not recover totally, but the fact is, I would not be alive if AHT did not work.

[Gudgelm in reply to billyboy3]

Did you have prostate surgery? Do you use Lupron or Firmagon when you are on hormone therapy. Thanks

[billyboy3 in reply to Gudgelm]

yes as to surgery, thought they got it all, psa 5.5 at surgery but year later back, but now 18 years later, still here, lupin and casadex, but also changed to flutimide pills, also added one more drug to the mix on alternative cycles. most of my on time were three to four months, then off until psa went back up to 3 or 4 max, then repeated on cycle. lots of side effects as time moved forward but what is the choice-there is no choice if you want to live longer, not as well, but still here. ok good luck !

[Gudgelm in reply to billyboy3]

Yes you have to keep a positive attitude other wise you'll circle the drain. Not much of a choice when you think about it! Good Luck.

[j-o-h-n in reply to Gudgelm]

"circle the drain".... putting that one in my back pocket for the future...

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 02/08/2019 9:43 PM EST

[smroush]

I was diagnosed in July 2012, a Gleason 9 PCa with mets to bladder and pelvic lymph nodes. I was on ADT (Lupron and Casodex) for 26 months, plus external beam radiation. The radiation therapy was in November and December of 2012. In February 2013 my PSA dropped to undetectable (< 0.1) and stayed there. I stopped the ADT meds in October 2014. After a year my PSA rose to 0.1 and a year later to 0.2. It has stayed at that level ever since so I have not yet gone back to ADT - 4 years and about 4 months of the “off” cycle and counting....

[Kevinski65 in reply to smroush]

I was diagnosed 2012. Gleason 9, PSA 31, stage M1, doubling time 5 months. Hit with lupron , casodex for flare, PSA dropped to .2 . Had bone spots on L3, sternum, c3. Switched to xtandi and lupron, stayed at .04 ever since. Bone mets u detectable. I'm 10 years out. Diagnosed late 59... I'm 70 now. No hormone vacations.

[Gudgelm]

Congratulations. My diagnosis and staging was close to yours. It gives me hope. I went off ADT four months ago but my PSA went from .08 to .29 in one month. If they find diseased lymph nodes or other targets I'll go in for radiation next month. It's good to know it worked for you. Four years is terrific.

[Hawk56]

After successful surgery in March 2014, T2CNoMx, ECE, margins and seminal vesicles negative, 10% prostate involvement and GS8, I had BCR 18 months later.

SRT failed and in Jan 17 after a C11 choline scan at Mayo showed four pelvic lymph nodes involved. I did six cycles of taxotere, 25 more radiation treatments and 18 months of Lupron.

PSA dropped from 4.8 to less than .1, T to less than three and stayed there.

My last Lupron 90 day shot was in May 18, T was 135 in October and 482 in February. Last PSA was .06.

Our plan is when the PSA returns to image at 1.0 using the aximun scan and then decide on treatment.

Given my clinical data showing aggressive disease, GS8, only 18 months to BCR and PSADT and PSAV less than three months we agreed to not let the PSA go above four before resuming treatment to minimize chance of bone or organ involvement.

I am enjoying the Lupron holiday.

Kevin